Small Businesses at Risk: How Entrepreneurs Slip Through the Health Care System's Cracks

2009-10-08

Executive Summary

America’s small businesses stand at the forefront of innovation.  Our entrepreneurs are the first to adopt new technologies and take new approaches in old industries.  As engines of job creation, small businesses are the leading edge that pushes our economy forward. 

They are also, unfortunately, on the front lines of the health care crisis.

Many of the problems faced by small businesses are the same ones that plague our families: premiums that rise far faster than wages, endless red tape, and a bewildering insurance marketplace where consumers have few choices and even less bargaining power.

And where they face problems that differ – a whole business’ premiums going up when one employee gets sick, the difficulty of recruiting and retaining good employees when health care is so expensive – these failures of our health care system can lead to small businesses shutting their doors, killing jobs and harming our economy.

To be sure, small businesses are not the only group who need health care reform.  The unsustainable status quo burdens individuals and families, state and federal governments, as well as large and small businesses.  But over 60 million Americans work for small businesses,[1]and  the problems they encounter are a key component of the case for reform.

This issue brief examines the many ways our health care system fails small businesses across the country.  In addition to drawing on research documenting the scope of these problems, we also include testimonials from small businesses that we have spoken to.  Their stories illustrate the risk that health care poses for small businesses – and what needs to be done to fix it.