THE NATION - Small firms may hold key to healthcare - Their support could lift or sink the next president's reform plans.
WASHINGTON — Pat Lawrence's bustling catering business in San Francisco is so small she doesn't think she can afford health insurance. So when her face suddenly became paralyzed one morning as she was baking muffins, she went to the Internet for a diagnosis -- not to a doctor or a hospital.
She feared she'd had a stroke, Lawrence said later, but also feared the cost of immediate medical attention.
Jim Henderson, the second-generation proprietor of a seven-person construction supply business in St. Louis, prides himself on offering healthcare to his employees. But the premiums cost more than anything in his budget except the payroll. So benefits have been whittled down, and Henderson wonders how long he can keep covering his workers.
As presidential candidates debate what to do about the 47 million Americans without health insurance and the millions more who worry about the rising cost of their insurance, small companies like Lawrence's and Henderson's are at the core of both the policy problem and the thorniest political challenge.
Though most large companies offer coverage, the cost is prohibitive for many small firms. Companies with fewer than 100 workers account for nearly two-thirds of the working uninsured and about 40% of all workers. Even among the small companies that offer coverage, many protect just the worker, not a spouse or children. So in terms of policymaking, it will be almost impossible to reduce the number of uninsured substantially without involving those who work for small firms.
In political terms, small-business owners are a powerful lobbying force, and winning their support for significant changes may not be easy.
Like Democrats, many small-business owners place the lack of affordable healthcare among the top domestic issues, second only to the economy. Like Republicans, however, they are wary of taxes and government-imposed solutions. Once seen as a solid GOP constituency, small business is being wooed by the Democratic candidates, who are offering to tweak their healthcare plans to make them more appealing.
The verdict of small-business owners could lift or sink the next president's healthcare reform plan. They have a grass-roots network in every congressional district in the country. And in 1994, opposition from the National Federation of Independent Business, their chief lobbying group, played a pivotal role in scuttling then-President Clinton's health plan.
