Changes

One concern with the 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].

Furthermore, while the cost of insurance premiums and plans have assuredly risen post-ACA, health insurance premiums have been increasing due to rising health care costs for many years (prior to the act's enactment) [http://obamacarefacts.com/obamacare-small-business/] [http://jhppl.dukejournals.org/content/36/3/539.short].

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=='''The ACA and Small Business'''==

The Affordable Care Act uses the terminology “full-time equivalent” (abbreviated FTE) when calculating the number of full-time employees.

The employer mandate of the ACA applies to relatively larger small businesses - firms with greater than 50 FTE employees - but many of these larger businesses offer health insurance coverage for their employees already.

=='''Small Businesses with Fewer than 50 FTE'''==

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 increased regulation, as a result of the ACA's minimum standards for Qualified Health Plans (increased comprehensiveness and affordability).

===Regulations on Health Care Coverage===

===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.

SHOP allows for increased employer choice functions, enabling employers to choose from 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, and workers using the 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 increased buying power in the group-plan market (an advantage only larger firms used to possess) and a simpler 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 for obtaining the tax credit that would cover up to 50% of employer contributions to employees' health insurance premiums (up to 35% for tax-exempt employers):

According to Holly Wade, the director of research and policy analysis for the NFIB Research foundation, "the small business tax credit is a better talking point than it is a financial incentive for small businesses" [http://www.bizjournals.com/bizjournals/washingtonbureau/2016/03/why-obamacares-tax-credits-failedsmall-businesses.html].

=='''Conclusion'''==

15. [https://ballotpedia.org/2016_presidential_candidates_on_healthcare Ballotpedia]