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What Small Business Thinks About Health Reform

Add one more splash of bad news to the cascade that has spilled out since the Patient Protection and Affordable Care Act (PPACA) became law in 2010. The NFIB Research Foundation’s just-released study shows that small business is deeply pessimistic about the changing face of American healthcare as the new law sinks in. In the survey, business owners note some troubling trends in the health-insurance market and don’t expect things to improve with time.

Three broad conclusions emerge from the survey: (1) For small business, the health insurance market deteriorated somewhat during the law’s first year; (2) Business owners do not expect the healthcare environment to improve with time; and (3) Small businesses are seeking safer harbors, including defined contribution plans and abandonment of employer-sponsored insurance altogether.  We can add a smaller fourth conclusion: (4) The small business tax credit doesn’t appear to have much impact on the number of businesses offering coverage.

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The Incredible Shrinking Small Business Health Insurance Tax Credit

Last month was tax time, and some small businesses filed at last for the health insurance tax credit included in the health reform law. Most will be disappointed. Since the Patient Protection and Affordable Care Act (PPACA) passed a year ago, its supporters have touted its benefits. Yet, it’s important to remember why the credit does not deserve any lavish praise.

Relatively few will qualify for the credit: To qualify for the credit, a business has to jump through a series of hoops. Very likely, no more than 1 to 2 million out of the country’s 6 million small businesses would qualify for any credit at all. Self-employed individuals (another 21 million or so) do not qualify at all.

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Time and Money in Canada

A Canadian woman with ovarian cancer faced treatment delays in Canada.  So she crossed the border and had life-saving surgery in Michigan, just in the nick of time.  On return, she faced a six-week wait for chemotherapy.  So she went back to the U.S. for chemo as well.  The Canadian government won’t pay the bills.  The reason:  the woman didn’t fill out the right forms in a timely manner.