Can you guess which group has been all but silent in this latest health-care debate?
(This post originally appeared on The Washington Post)
Can you hear it? No, you can’t.
Ever since the Republicans released their health-care plan, there’s been a lot of noise. Of course, the Democratic opposition has been crying foul. Right-wingers are saying it doesn’t go far enough. Free marketers and the insurance industry worry that it doesn’t give enough freedom to insurance companies. Doctors are complaining that there won’t be enough insurance money available to pay their bills. Medical students think we should have a single-payer system. Some believe the legislation is being pushed through too fast. Others lament the lack of bipartisanship in the bill. The Congressional Budget Office concludes that millions will be left without coverage. Everyone seems to have a big problem with it.
Except for one group of about 20 million people. You don’t hear much from them. These are my clients. They are business owners and executives. They are not necessarily cheering, nor are they panicking. But they are not unhappy. Why?
For those I know who employ more than 50 full-time people, the Affordable Care Act was a major and expensive pain in the neck. The law required that those employers provide adequate health care for their full-time employees. Many of my clients hire part-timers and many others run seasonal businesses. Those owners were forced to understand (or pay an accountant to understand) the complex calculations for figuring out the number of “full-time equivalent” employees. They were forced to evaluate an ever-changing array of new health-care plans with Olympic sounding names — bronze, silver, gold, etc. — to figure out what was best. In many cases, they were forced to know way more about the American health-care system than their own businesses.
Their reward? A continuation of double-digit annual increases in health-care expenses. Irritation from their employees when told their plans would require more and more out-of-pocket expenses and higher deductibles. Lost recruitment opportunities to larger companies with deeper pockets and benefit plans that no small business could afford. Penalties for providing no insurance. Penalties for not providing adequate insurance. Penalties for reimbursing employees who found better insurance. Questions from confused employees. Oh, and higher taxes on the “wealthy” to specifically fund the legislation.
With all its best intentions, the Affordable Care Act has been a huge, no-win headache for the business community. It’s been six years. We gave it a shot. It hasn’t been working very well. It’s actually been worse than the status quo from 2009. So now that the Republicans are preparing to scrap the employer mandate, my clients will happily go back to that status quo. They will start over with this new plan.
Yes, we’re all concerned with some of the potentially big issues. No employer wants anyone to go without coverage. We all want a better, more affordable health-care system. We really do care. But much of that burden to deliver those goals has been placed on the backs of the insurance industry and those employers who must ensure that their employees have coverage. Assuming this new legislation passes Congress and becomes law, that burden will be no more.
My wife, who is British and a schoolteacher, always wondered why U.S. employers had to be involved in their employees’ health care at all. Many of my business clients have wondered the same thing. The Republican plan may be a step in the right direction. Whether it solves our long-term cost-and-care problems remains to be seen. At the very least, it gives the business community more options to control their health-care costs and the potential for lower future premiums. That’s why you’re not hearing a lot of complaining from these people right now.