Changes

One of the most highly publicized criticisms of the <onlyinclude>The Patient Protection and Affordable Care Act was passed by the media Congress and the bill’s adversaries is concerned with this idea that “Obamacare” will kill small businesses. While the ACA is indeed not entirely benign for small businesses, the actual harm of Obamacare regulations and mandates to small businesses, however, depends entirely signed into law by President Obama on how we consider what a small business isMarch 23, as 2010. Together with the effect of Obamacare on small businesses varies vastly between firms on differences composition Health Care and size in their workforces (i.e. number Education Reconciliation Act of full time employees, average wages2010, state where the business is operated). While law completely replaced the cost of providing existing health care insurance has assuredly risensystem in the United States, by expanding Medicaid and Medicare, there is evidence that and mandating all individuals to sign up for health insurance premiums have been on coverage through a Qualified Health Plan (QHP's must be offer affordable and comprehensive coverage - either privately or publicly funded). Here is a link to the complete text of the rise for many years ([http://obamacarefacts.com/obamacarewp-small-businesscontent/uploads/2014/10/)obamacarebill. The most obvious tangible pdf PPACA and visible effect of Obamacare on small businesses is not necessarily in abandonment of plans to grow a business or death of businesses themselves, but, rather, in a slowing or decrease in hiring the Health Care and cutting employee hoursEducation Reconciliation Act].

==How One concern with the ACA really affects Patient Protection and [[Affordable Care Act]] is that “Obamacare” will kill [[Small Business]] [http://www.investors.com/liberal-study-finds-obamanomics-killed-the-american-entrepreneur/]. Obamacare's effect on small businesses==is not necessarily seen in the abandonment of plans to grow businesses or death of businesses themselves, but rather, in a slowing or halting in hiring, as well as a cut in employees hours. According to a Gallup and Wells Fargo survey of 600 small business owners conducted in 2012, 48% of small business owners point toward "potential healthcare costs" as a reason for not hiring more employees [http://www.gallup.com/poll/152654/health-costs-gov-regulations-curb-small-business-hiring.aspx].

The United States has almost 6 million Still, while the ACA may have caused a slowing or ceasing in small businessesbusiness hiring practices, the exact harm of Obamacare regulations and 90% of these mandates to small businesses employ fewer than 20 people (http://obamacarefacts.com/obamacare-depends heavily on small-business/). And for size because the most part, there is not much evidence the provisions effects vary so greatly between firms of the ACA are devastating these small businesses different compositions and startups with fewer than 50 sizes in their workforces (i.e. number of full time equivalent employees, average wages, state of operation).

The Affordable Care Act uses the language “fullSBA has established a summary of size guidelines for small businesses to qualify "as a small business concern for SBA and most other federal programs" [https://www.sba.gov/contracting/getting-started-contractor/make-sure-you-meet-sba-size-standards/summary-time equivalent” (abbreviated FTE); a fullsize-time equivalent employee is the total number of fullstandards-time employees plus the combined number of partindustry-time sector] (500 employees hours divided by 30. Another criterion for determining mandate-exemption mining and manufacturing businesses or tax-credit status in the ACA is the average an annual wage receipt of employees; $7.5 million in average annual wage of a receipts for non-manufacturing firms), but these small business standards vary between industries. The United States has almost 6 million small businesses that fall under small business is calculated by dividing the total wages paid by an employer by the number size classifications; however, 90% of FTEs, rounding down to the nearest $1,000 (small businesses employ fewer than 20 people [http://obamacarefacts.com/obamacare-small-business/)]. More precisely, 61% of firms have between 3 and 9 employees, while 98% of firms employ between 3 and 199 employees. [http://files.kff.org/attachment/report-2015-employer-health-benefits-survey]

Most of the harms of According to the ACA, thus, are passed onto larger companies - firms small businesses with larger fewer than 100 FTE (fifty full -time equivalent employees) - but many of these larger corporations also already offer health insurance coverage for their employees are exempt from the employer mandate. However, companies between 50 and 100 FTE are required to offer At the minimum health insurance coverage accepted by time of the ACA are implicated 'S enactment in a slightly more complex way2012, only 200,000 small businesses would have been affected by the employer mandate, as 96% of the small businesses employed fewer than 50 employees [http://www.forbes.com/sites/groupthink/2012/08/10/will-obamacare-help-or-hurt-small-businesses/2/#49ebac0f31e5].

===For small businesses with fewer than 50 employees===Despite all of the backlash the Patient Protection and Affordable Care Act, or ObamacareFurthermore, has received for its perceived potential destruction on small businesses, for while the most part, small businesses with under 50 full time employees are not greatly devastated by the Act. In fact, companies with fewer than 50 employees, which make up a large portion cost of small businessesinsurance premiums and plans have assuredly risen post-ACA, are not penalized at all for not providing comprehensive and affordable health care to their employees. Thus, if employers with less than 50 FTE find themselves unable or unwilling insurance premiums have been increasing due to accommodate the rising costs of health care, they can simply opt out of providing employeecosts for many years (prior to the act's enactment) [http://obamacarefacts.com/obamacare-small-sponsored health insurancebusiness/] [http://jhppl.dukejournals.org/content/36/3/539. Those who do decide to provide employer-sponsored health insurance will have to deal with the issue of rising premiums and other slightly increased regulationsshort].</onlyinclude>

===Between 50 '''The ACA and 99 Employees===Small businesses with fewer than 50 FTE are exempt from the penalties of ACA; however, as soon as a company reaches the 50th employee mark, the hire becomes much more expensive, thus dis-incentivizing small businesses from expanding their labor force. Firms that employ 50 or more workers and donBusiness''t provide health insurance must pay a tax penalty of $2,000 for each uninsured employee beyond the first 30. Furthermore, firms with 50+ workers are required to contribute at least 60 percent of the cost for individual minimum essential coverage. (http://www.ncpa.org/pub/st356). This 50th employee marker serves as the reason why many critics of the ACA believe that Obamacare is killing jobs, as well as the reason why many small business owners have concerns about expanding their businesses. “A survey of more than 600 small business owners by the Society for Human Resource Management found that more than four-in-10 small business owners have delayed hiring due to uncertainty about the effects of the Affordable Care Act. One in five reported they have cut the number of workers they employ. The Society for Human Resource Management also found about one in five small businesses are reducing workers' hours to part time because they are not required to offer coverage for employees who work less than 30 hours per week.41 Those employees will be eligible for subsidized coverage in a new health insurance exchange.” (http://www.ncpa.org/pub/st356)Companies with between 50 to 99 employees are required to provide insurance, but the penalties imposed for not complying with the ACA requirements were delayed until 2016, while the penalty for companies with > 99 employees was delayed until 2015. Because of these delays it is not entirely possible to fully understand and analyze the exact effects of the ACA on small businesses that are required to provide health insurance to its employees.==SHOP Exchange==

==Tax Credit==There is a temporary health insurance tax credit available to firms with 25 or fewer employees and making less than $50,000 in annual wages, but many firms will not meet the strict requirements necessary for obtaining the generous tax credit. To qualify for The Affordable Care Act uses the small business tax credit, employers have to cover at least 50% of employeeterminology “full-only health care coverage for every employee. Additionally, there are further stipulations and qualifications, such as employers with 10 or fewer time equivalent” (abbreviated FTE with annual wages ) when calculating the number of less than $10,000 can qualify for the full tax credit for up to 50% of their share of employee premiums. The health insurance tax credit became available to firms in 2014. (http://obamacarefacts.com/insurance-exchange/shop-exchange/)time employees. However, this tax credit is extremely under-inclusive, and according to the National Federation of Independent Businesses, only one in three small businesses qualify (http://www.ncpa.org/pub/st356). ==2016 Election Candidates’ Positions on the ACA==

The four remaining Republican candidates remaining in Calculation for finding the 2016 Presidential Election, Ted Cruz, John Kasich, Marco Rubio, and Donald Trump are largely united on the issue number of health care reform in that they all have plans to appeal the Affordable Care Act if elected President, opting for free market tactics in the health insurance industry – allowing individuals and employers to continue to opt in or out full-time equivalent employees: # of privately offered health insurance. Using vague language, they promise to expand coverage, improve health care quality, lower drug and other medical costs, and even increase transparency in the health care market, Meanwhile on the other end FTE's = '''Total Number of the spectrum, Democratic Candidate Bernie Sanders actually goes so far as to say that he wants to expand the ACA into a MedicaidFull-for-all system, which could completely remove employertime Employees''' + '''[Combined Number of Part-sponsored health care from the equation. Democratic Candidate Secretary Hillary Clinton has been an advocate of universal health care ever since she proposed her own health care reform plan in the 90’s and is now running with the intention of defending and building upon the ACA. In an interview with AOL.com on January 27, 2016, she expressed that“Health care is a basic right. We are 90 percent covered, we gotta get to 100 percent, and then we gotta get cost down and make it work for everybody. And even though we didntime Employees Hours 't get it then, we've got it now and I'm going to defend it and improve it." (https:)//ballotpedia.org/2016_presidential_candidates_on_healthcare)''' 30]'''

There remains a lot of uncertainty as to the specific effects of the ACA on small businesses because of the many delays and exemptions in the rollout process and implantation of the ACA’s mandates and provisions. By extrapolating from the status quo and general trends of the health insurance market, the ACA will most likely not turn out to be the “jobAnother criterion for determining mandate-killer” exemption or “enemy of small business” it was predicted to be.In fact, the head of the CBO Douglas Elmendorf said, “We don’t think that the healthcare law tax-credit status is having a significant impact on the economy today… It would reduce the amount average annual wage of labor used in the economy employees: '''Average Annual Wage = Total Wages Paid by about a half a percent at the end an Employer '''/''' Number of the decade… butFTEs''', most of that is people choosing not rounding down to work because they can obtain health insurance at an affordable price outside of the workforce” (nearest $1,000 [http://obamacarefacts.com/obamacare-small-business/)]. John Arensmeyer, founder and CEO The employer mandate of the Small Business Majority, even went so far as ACA applies to say in in a statement, reported by Fox News, that “The Affordable Care Act tackles relatively larger small business owners’ top priorities when it comes to healthbusinesses - firms with greater than 50 FTE employees -care reform: cost and accessibility. The law will significantly rein in costs while providing more but many of these larger businesses offer health insurance coverage options for entrepreneurs.” (http://obamacarefacts.com/obamacare-small-business/)their employees already.

So while there is certainly evidence that =='''Small Businesses with Fewer than 50 FTE'''==Despite all of the backlash the ACA Patient Protection and Affordable Care Act, or Obamacare, has increased burdens and regulations received for its perceived potential destruction of small businesses, thus slowing or halted hiring for the most part, small businesses with under 50 full time equivalent employees are not unavoidably burdened by many the ACA. In fact, companies with fewer than 50 FTE, which make up a large portion of small businesses, are not penalized at all for choosing not to provide employer-sponsored health care. If employers with fewer than 50 FTE find themselves unable or unwilling to accommodate the rising costs of health care, they can simply opt out of providing employer-sponsored health insurance. Those who do decide to provide employer- sponsored health insurance will face the rising premiums and even cut hours increased regulation, as a result of the ACA's minimum standards for many Qualified Health Plans (increased comprehensiveness and affordability). ===Regulations on Health Care Coverage===Although small businesses with fewer than 50 employees - there is surely are not yet enough evidence mandated by the ACA for to provide health care insurance to suggest its employees, there are additional regulations and provisions associated with the ACA that increase the cost of providing health insurance for the firms that do choose to do so. The ACA : *requires employers to provide their employees with a Summary of Benefits and its regulations have or will overwhelmingly devastate the small business economyCoverage Disclosure Rules (SBC’s), a standard form that explains to employees what their plan entails (noncompliance may result in a further penalty).If *caps the ACA is amended maximum contribution an employee can make toward a flexible spending arrangement at $2500*increases Medicare withholdings on employees with wages over $200,000 and $250,000 for married joint filers*assesses net investment income for Medicare (taxable capital gains, dividends, rents, royalties, and interests) for single filers with a Modified Adjusted Gross Income of $200,000 for a single filer (and improved $250,000 for married joint filers)*institutes a 90-day maximum waiting period for employees to provide health care coverage employees who are eligible, as Democratic Candidate Secretary Clinton well as penalties for exceeding the 90-day period. *incentivizes employers, using inducements, such as as subsidies on health insurance plans, we will see hopefully to offer Workplace Wellness Programs that satisfy the federally accepted requirements. * for employers that sponsor self-insured plans, requires another information reporting that is separate from the information reporting required for employers with more than 50 FTE [https://www.sba.gov/content/employers-with-up-to-50-employees]. ===Options for Small Businesses===Health care is not a mandatory service for small businesses with fewer than 50 FTE, but many small businesses still provide health insurance to their employees. These companies, along with large companies, are seeing steeper premium prices on their insurance due to the ACA stipulation that health care companies cannot deny or charge coverage based on an enhancement individual's health or risk factors, pre-existing conditions, or sex. However, options to compensate with the increased cost of providing health care, the most obvious of which are opting out and increasing employees' contribution (if possible), include: *participating in the SHOP Exchange*negotiating on private insurance plan prices*converting their employee group plans into individual employer-sponsored plans, such as Health Savings Accounts or Health Reimbursement Accounts (HSA’s and HRA’s)*switching to direct primary care*using Workplace Wellness Programs  While some of these options may be accompanied by risks, they can serve as cheaper employer coverage alternatives. [http://www.cnbc.com/2015/01/08/5-smart-ways-small-firms-can-slash-health-care-costs.html]. ===Increased Marginal Cost for 50th Employee===Small businesses with fewer than 50 FTE are exempt from the penalties of ACA; however, as soon as a company reaches the 50th employee mark, the hire becomes much more expensive, potentially dis-incentivizing small businesses from expanding their labor force.  Firms that wish employ 50 or more workers and do not provide qualified health insurance coverage must pay a tax penalty of $2,000 for each uninsured employee beyond the first 30 employees. Furthermore, firms with more than 50 workers must contribute, at a minimum, 60 percent of the cost for employees' coverage. [http://www.ncpa.org/pub/st356]. This increased marginal cost for the 50th employee serves as a reason why many critics of the ACA believe that the ACA is killing jobs and also why many small business owners may have concerns about expanding their businesses. According to a survey conducted by the Society for Human Resource Management of more than 600 small business owners:*More than four out of ten small business owners have delayed hiring due to uncertainty about the effects of the ACA [http://www.ncpa.org/pub/st356].*One in five small business owners reported that they have cut their number of employees [http://www.ncpa.org/pub/st356] The Society for Human Resource Management's study also found that about one in five small businesses are reducing workers' hours to part time because they are not required to offer coverage for employees who work less than 30 hours per week. These part-time employees are eligible for subsidized coverage in the new health insurance exchanges offered through the ACA [http://www.ncpa.org/pub/st356]. Companies with 50 to 100 FTE employees are required to provide health insurance coverage to their employees, but the penalties imposed for not complying with the ACA requirements for these companies were delayed until 2016. Companies with up to 100 FTE employees can purchase insurance through the employer-only insurance exchanges, were are run by the states; these exchanges could possibly result in lower health care insurance its costs for small businesses by pooling customers [http://www.forbes.com/sites/groupthink/2012/08/10/will-obamacare-help-or-hurt-small-businesses/2/#49ebac0f31e5]. The employer mandate penalty for companies with more than 99 employeeswas delayed until 2015. It would be nearly impossible With all of the delays in penalties, it is difficult to predict fully understand and analyze the exact effects of the ACA on small businesses (especially those that are required by the law to provide health insurance to its employees). =='''SHOP Exchange'''==The SHOP Marketplace or Exchange (Small Business Health Options Program, is a rollout provision of the ACA designed to get small businesses lower health insurance rates using group plans and tax credits for providing employee-sponsored health coverage.  The SHOP exchange did not open up to employers with fewer than 50 FTE until 2015 and only just opened up in 2016 to businesses with 100 FTE or less. SHOP allows for increased employer choice functions, enabling employers to choose from our a larger pool of available coverage options for employees [http://digital.library.unt.edu/ark:/67531/metadc501935/m1/1/high_res_d/R43181_2015Jan15.pdf] The financial advantage of purchasing insurance trough the SHOP exchanges is uncertain, as insurers in the marketplace cannot charge premiums based on health status quo, if and workers using the ACA SHOP exchanges, will become ineligible for subsidies when they buy their own insurance [http://www.ncpa.org/pub/st356]. What SHOP does offer small businesses is revamped into increased buying power in the group-plan market (an advantage only larger firms used to possess) and a Medicaidsimpler way to compare prices, coverage, and quality of plans [http://obamacarefacts.com/insurance-exchange/shop-exchange/]. ===Small Employer Health Insurance Tax Credit=== There is also a temporary health insurance tax credit available to firms with 25 or fewer employees and making less than $50,000 in annual wages. However, many firms do not meet the strict requirements necessary forobtaining the tax credit that would cover up to 50% of employer contributions to employees' health insurance premiums (up to 35% for tax-exempt employers): *1) Firms must employ fewer than 25 full-time equivalent (FTE) employees*2) Have an average employee salary of less than $50,000 per year (adjusted for 2014 inflation rates)*3) Employer must pay for at least 50% of all singleFTE employees' premium costs *4) Employee Coverage must be through Qualified Health Plans, purchased through the SHOP Marketplace*5) Only employers with 10 or fewer FTE with annual wages of less than $10,000 can qualify for the full tax credit ( "the smaller the business, the bigger the credit" [https://www.healthcare.gov/small-businesses/provide-shop-coverage/small-business-tax-payer credits//])*6) Employers cannot claim the tax credit for more than two consecutive and taxable years (starting in the first taxable year after 2014) The health insurance tax system like Democratic Candidate Senator Bernie Sanders proposescredit became available to firms in 2014 [http://obamacarefacts.com/insurance-exchange/shop-exchange/]. After 2014, aside the maximum credit amount increases from 35% to 50% of employers' share of premiums. The taxcredit is quite under-based predictionsinclusive, though, and according to the National Federation of Independent Businesses, only one in three small businesses qualify [http://www.ncpa.org/pub/st356]. Of the estimated 1. On 4 to 4 million small businesses that were eligible for the other handwide range of tax credits, if it is indeed repealedonly 181, as our Republican nominees would prefer - although we might see a return 000 actually claimed the Small Employer Health Insurance Tax Credit in 2014.  According to Holly Wade, the slow trend director of rising health insurance premiums research and would certainly witness policy analysis for the NFIB Research foundation, "the small business tax credit is a better talking point than it is a massive increase in financial incentive for small businesses" [http://www.bizjournals.com/bizjournals/washingtonbureau/2016/03/why-obamacares-tax-credits-failedsmall-businesses.html]. =='''Conclusion'''== Uncertainty surrounds the number effect of uninsured Americans - the economy could possibly recover some ACA on small businesses because of the jobs lost to many delays and exemptions in the rollout process and implantation of the ACAACA’s mandates and provisions. The future of Considering the Presidency status quo and composition general trends of the Congress in health insurance market, the United States ACA seems it will entirely determine likely turn out not to be the fate “job-killer” or “enemy of small business” it was predicted to be. And largely, while insurance premiums will continue to rise for the firms, which have to provide employer-sponsored health insurance market and to its employees, the bill should not seriously harm small businessesand startups with fewer than 50 full time equivalent employees. In fact, and ultimately the fate head of the CBO Douglas Elmendorf said, “We don’t think that the healthcare law is having a significant impact on the economy today… It would reduce the amount of labor used in the American economy by about a half a percent at the end of the decade… but, most of that is people choosing not to work because they can obtain health insurance at an affordable price outside of the workforce” [http://obamacarefacts.com/obamacare-small-business/]. John Arensmeyer, founder and way CEO of lifethe Small Business Majority, in a statement reported by Fox News, said that “The Affordable Care Act tackles small business owners’ top priorities when it comes to health-care reform: cost and accessibility. The law will significantly rein in costs while providing more health coverage options for entrepreneurs.” [http://obamacarefacts.com/obamacare-small-business/]. ==References==1. [http://www.gallup.com/poll/152654/health-costs-gov-regulations-curb-small-business-hiring.aspx Gallup] 2. [http://obamacarefacts.com/obamacare-small-business/ Obamacarefacts] 3. [http://obamacarefacts.com/obamacare-small-business/ Obamacarefacts] 4. [http://obamacarefacts.com/obamacare-small-business/ Obamacarefacts] 5.[https://www.sba.gov/content/employers-with-up-to-50-employees SBA] 6. [http://www.cnbc.com/2015/01/08/5-smart-ways-small-firms-can-slash-health-care-costs.html CNBC] 7. [http://www.ncpa.org/pub/st356 NCPA] 8. [http://www.ncpa.org/pub/st356 NCPA] 8. [http://digital.library.unt.edu/ark:/67531/metadc501935/m1/1/high_res_d/R43181_2015Jan15.pdf Congressional Research Service] 10. [http://www.ncpa.org/pub/st356 NCPA] 11. [http://obamacarefacts.com/insurance-exchange/shop-exchange/ Obamacarefacts] 12. [http://obamacarefacts.com/insurance-exchange/shop-exchange/ Obamacarefacts] 13. [http://www.ncpa.org/pub/st356 NCPA] 14. [https://ballotpedia.org/2016_presidential_candidates_on_healthcare Ballotpedia] 15. [https://ballotpedia.org/2016_presidential_candidates_on_healthcare Ballotpedia] [[Category: Public]][[Public Classification::Legislation| ]]