The Affordable Care Act was signed into law more than two years ago, and since then the crusade to dismantle it has steadily gathered momentum. Now, its fate rests with nine United States Supreme Court justices who are expected to announce their ruling by month's end. If they strike down the landmark law, it could adversely affect millions of small business owners and other Americans who are already benefiting from reform.
Since the National Federation of Independent Business and state attorneys general filed the lawsuit, there's been a constant stream of negative rhetoric surrounding the law, with opponents claiming it crushes small businesses. But we asked actual small business owners what they thought about it, and their answers might surprise you.
Half of entrepreneurs want the legislation to remain intact, either as is or with only minor changes, while just a third want to see it overturned, according to opinion polling Small Business Majority released last week. The poll, conducted in eight states (Florida, Illinois, Louisiana, Michigan, Missouri, New York, Texas and Virginia) also found that after small business owners hear more about the law, their support for keeping it fully intact or just making minor changes rises to a 56 percent majority, while opposition falls to half that number.
Respondents also support a smorgasbord of the law's components designed to make coverage more affordable. The health insurance exchanges -- online marketplaces where small employers will be able to band together to negotiate better rates -- are widely popular with entrepreneurs: 66 percent say they'd use their state exchange or consider using it; only 8 percent would not consider using it when providing employees with benefits.
Larry and Maria Emerson, who own Results Video, Inc. in El Paso, Texas, are two entrepreneurs who look forward to an exchange. With the coverage market as temperamental as it's been, they've burned through nearly every major insurer since 1995. Premium rates for their four insured employees continue to rise, while benefits are whittled away.
Larry and Maria's plan even left one employee, who already pays 25 percent of his own premium and the full premium for his spouse, facing a $3,000 deductible for routine childbirth. Since they're young and healthy, the couple chose to avoid the financial blow they'd incur with that steep deductible by opting to have a home birth. Thankfully, it went smoothly. But what if it hadn't?
"It's disappointing when you're an employer and want to offer good insurance but it's not even affordable enough for an employee to have a baby," Larry said. "We're always thinking about what we can do differently to take care of our valuable staff. That's why we're looking forward to an exchange. It will make it easier for us to shop for coverage because it offers more plans, plus it'll allow us to join forces with other companies to drive down costs. We haven't seen affordability in years. Overturning the law would rob us of it."
Most entrepreneurs surveyed find potential features of the exchange very appealing. These marketplaces are attractive because they'll help expand coverage, which is important to small business owners: 55 percent say the reason they want the law upheld is because we need to make sure everyone has insurance. Another third believe it'll make it easier to purchase insurance -- one of the features Larry and Maria find appealing.
There's no shortage of enthusiasm for most other provisions of the law, either. Nearly 8 in 10 owners support the ban on preexisting condition exclusions, 72 percent support requiring insurers to spend at least 80 cents of every premium dollar on patient care and 65 percent support allowing states to review and potentially reject excessive premium increases.
Having faced such high rate hikes for decades, small business owners' support for the Affordable Care Act really shouldn't be surprising. Something is finally being done to repair the faulty mechanisms in the coverage market that make insurance so expensive. Small business owners understand that, and it's why more of them want the law upheld than overturned. If Supreme Court justices are going to do what's best for small firms and the economy, they'll listen to what real entrepreneurs have to say -- not to a select few who are speaking for them.