ACA Repeal Would Put Entrepreneurs, Employees at Risk

As Congress moves forward to vote to repeal significant portions of the Affordable Care Act without any defined replacement plan, West Virginia small business owners and their employees face an uncertain future.

Access to affordable health insurance is vital to a stable workforce and workplace. It's also a key factor for West Virginians as they decide whether to leave a job with health benefits and go to work for a small business, start their own small businesses or work independently. Stripping the current generous premium subsidies, which lower the cost of 80 percent of the plans sold in the Marketplace, is reckless and puts an unfair economic burden on already overburdened employers and an underpaid workforce.

Without the ACA, these hard-working West Virginians - particularly those with a pre-existing health condition - wouldn't have had any guarantee of finding an affordable, comprehensive insurance plan. Employers of all sizes struggle to find affordable health care options for themselves and thenemployees. Prior to the ACA, small to mid-sized businesses found it almost impossible to offer affordable health insurance benefits to their workers and families.

The ACA also has expanded Medicaid benefits to qualified entrepreneurs and small business employees with lower incomes. Repeal of the Medicaid expansion could leave 175,000 working West Virginians out in the cold. Repeal of the Medicaid expansion also will drain millions of federal dollars from our state economy - over the course of a year and half alone, the Medicaid expansion brought $755 million in new federal dollars into West Virginia.

Between the ACA's inception in 2013 and 2015, the number of working West Virginians without health insurance declined 55 percent. The majority gaining coverage was small business owners and their employees. Without the ACA, employers and individuals would carry the sole burden of covering the entire crippling cost of health care premiums.

Today, the ACA marketplace sells plans without discrimination on the basis of health status and provides generous premium subsidies to many West Virginia entrepreneurs and small business employees. Repeal without any defined simultaneous replacement plan, and the state's individual insurance marketplace that serves these workers and employers is at serious risk of collapse. Insurance companies most likely won't offer coverage in the resulting state of limbo without clear rules and guidance. Without the assistance of premium subsidies, fewer healthy people will buy insurance and, as a result, premiums will go higher. In turn, even fewer healthy people will pay to join the remaining pool of insured and premiums escalate again. The market could collapse.

Small businesses are the backbone of our West Virginia economy There are more than 23,000 small businesses with fewer than 20 employees and more than 88,000 self-employed entrepreneurs. The vast majority of these West Virginia workers must purchase individual market insurance for themselves and their families, and the ACA has given them affordable options. Businesses with fewer than 500 employees account for 96 percent of all businesses in West Virginia (with more than 50 percent of the employees in the state). Even these mid-size businesses are moving away from offering health insurance benefits at all or eliminating benefits for family members of the employee. Again, the ACA's new insurance options have provided peace of mind and financial security for these workers.

West Virginia business owners and their valued employees and their families diversify and strengthen our state economy Our lawmakers are using these worthy citizens as pawns in their political game. It's disrespectful to thrust business owners and their employees into limbo wondering what will come after the repeal of the ACA. Broad political rhetoric and promises without concrete details is an irresponsible and rash misuse of power that creates an unstable economy for us all.