National Small Business Association
America's Small Business Advocate |
Plan StatusOngoing advocacy.Number of People CoveredAll Americans.
Estimated CostNot addressed.
Payment Scheme NSBA’s plan would limit health care coverage to a basic level available via employer-based coverage, individually purchased coverage, or government programs and would provide federal need-based subsidies. Savings would come from better consumer decision making about care, pay for performance, and improved health care quality achieved via electronic advances. |
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Plan in Brief
- NSBA advocates on issues important to the success of small businesses and provides news, education, and leadership opportunities to its small business members.
- Broad health care reform is one of NSBA’s current top priorities.
- NSBA has determined that its position on health care must address health care in general; improvements for small businesses cannot be achieved otherwise.
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Impact on Federal Government
- Insurance policies would be federally regulated to ensure fair pricing.
- Federal funds would be available to subsidize coverage based on income.
Impact on States
Impact on Insurers
- Insurance policies would be federally regulated to ensure fair pricing.
- NSBA’s plan includes an individual mandate and guaranteed issue.
Impact on Providers
- NSBA’s plan advocates pay-for-performance based on outcomes rather than procedures.
- NSBA supports implementation of evidence-based guidelines.
Impact on Employers
- NSBA’s plan maintains employer-based coverage but advocates greater involvement of consumers via higher deductibles and the use of employer-based plans that provide basic coverage only and require consumers to purchase additional coverage on their own.
- NSBA believes that small businesses should be able to form pools to purchase health insurance more economically.
Impact on Individuals
- NSBA’s plan includes an individual mandate and guaranteed issue.
- NSBA proposes that all individuals would have health care coverage through employer-based, individual, or government insurance programs and would all have equivalent tax deductions for that insurance.
- Insurance policies would be federally regulated to ensure fair pricing.
- Federal funds would be available to subsidize coverage based on income.
- By establishing a basic level of coverage and requiring individuals to choose and purchase additional coverage on their own, NSBA’s plan aims to increase individual consumers’ awareness and control of health care costs.
Proponents/Opponents
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Small businesses and the self-employed rally around the idea of making tax deductions for health care more equitable. Currently, only those with employer-based insurance get a tax deduction, but many support the idea of extending the deduction to those who purchase coverage on their own.
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NSBA’s plan includes an individual mandate, something that many are opposed to, some because they regard it as inappropriate regulation and some because they believe certain individuals simply can’t afford to purchase coverage. Although NSBA’s plan includes need-based subsidies, it is unclear how much funding is required and how it would be supported.
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Key Targets for InvestmentHealth IT.
Health Savings Accounts.
Notable Feature
- One aim of NSBA’s plan is to share costs fairly. Currently, uncompensated care is actually covered by inflated premiums paid by those with health care coverage. NSBA’s plan would ensure a basic level of coverage for all, with needed subsidies coming from a central federal fund.
- NSBA comments that medical malpractice contributes to the lack of transparency about health care providers and approaches and that it fails to provide the right incentives to deliver quality care at appropriate cost.
- NSBA’s recent membership survey finds that health care reform is the second most important issue to small businesses. Also, 70% of surveyed members oppose an employer mandate to provide health care, and 66% support an individual mandate.
- NSBA research indicates that in 2007, 47% of businesses with fewer than 500 employees offered health insurance, down from 58% in 1997.
Experts' Comments“With everyone in the country talking about the need for health care reform, Congress should see this as a very important, very doable reform. This simple correction in the tax code would have broad implications—more than 21 million entrepreneurs would have greater access to affordable health insurance under this legislation.”
-- Todd McCracken
NSBA President, on The Equity for Our Nation’s Self-Employed Act of 2007
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For Further Information
National Small Business Association
Small Business Health Care Reform: Small Businesses Deserve Access to Affordable, Quality Health Care
Coalition Supporting Equity for Our Nation’s Self-Employed
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Plan Briefs 
