The piecemeal way that the Affordable Care Act is being implemented is posing some serious challenges for small businesses.
In terms of the Affordable Care Act, a small business is any company with fewer than 50 employees. According to the government’s published numbers at healthcare.gov, this encompasses 96% of all businesses in the United States and 5.8 out of every 6 million workers.
The Robert Wood Johnson Foundation reports that, as of 2011, an estimated 38% of those businesses offered employer-sponsored coverage, a number that was down from 47% in 2000. Blame that decline on whatever you want, but as a business owner I can tell you exactly why such a large number of employers dropped coverage: money.
Premiums for health coverage have spiraled upward as we were hit with an economic downturn, and so employers have been struggling to survive and cutting costs wherever possible to remain in business.
Like any entrepreneur, I went into business to create profits for myself and my business partners—not to create jobs and offer insurance. As my business and my employees create more profits, I can create more jobs and offer better benefits to attract top-notch talent. Each new hire comes at a huge price as every employee must learn company processes, software, customer service standards—and with every day of service, each team member becomes more valuable to Axiom and to me in my quest to generate profit.
With that said, Axiom offers employees a rich benefits program for a company our size, because talent attraction and retention are key. I would love to tell you that Axiom pays 100% of employees’ health, dental, and vision plans and that we have elected to match very richly on our 401(k) because I am a nice person and that I care about others, but that would be a lie. The owners at Axiom do genuinely care about our clients and our employees; however, we offer what we do because we cannot afford not to do so, and it makes financial sense when you consider the return on investment through the elimination of turnover, lower training costs, increased efficiency in client service, and so on.
My concern is that the intricacies of the Affordable Care Act and the changes it necessitates for how insurance carriers determine rates are going to make employer-sponsored healthcare cost-prohibitive for small businesses—which, remember, make up 96% of businesses in America.
Dropping coverage will inevitably lead to a migration of talent to large corporation, at the expense of the little guy and the American dream.