Why Health Care

Government-run health coverage, no matter what form it takes (“single-payer,” Medicare for All, public option), does not and cannot provide the same quality of coverage as employer-sponsored coverage. Government policies are making it more difficult for Americans to access care and needed medications.

States are actively targeting employee health coverage through legislation that includes creating single-payer health care systems, drug importation, and Prescription Drug Affordability Boards (PDABs), among others.

PDABs represent a government-driven system, likely leading to significant market disruptions and chaos. Seen as a government “knows best” effort, these boards could interfere with legal agreements across the entire drug supply chain and lead to fewer options for patients and their health care needs. Eight states have approved PDABs, with six others having introduced legislation. Small employers do not support these boards as they could limit access to lifesaving or life-changing medications employees may need.

In the case of single-payer health care systems, more than half a dozen states have either had legislation introduced or passed legislation that begins the process of creating a single-payer system. These efforts are an insult to the small business community’s determination to offer quality care to their employees. Lawmakers often tout low costs, but history has shown at the federal level that government-run systems like Obamacare and Medicare participants often see an annual increase in costs with a decrease in plan options and lower quality care. For these reasons, small employers have been fighting against their employees being pushed into government-run health care and asking Congress to provide them with the same opportunities as large employers when offering health coverage.

The idea of importing prescription drugs from other countries has long been discussed. Still, with the January 5, 2024, FDA approval of Florida’s request to import certain prescription drugs from Canada, it is becoming a dangerous reality.

Small employers want to ensure that their employees can access medications at a reasonable cost, but they don’t want their employees to be exposed to potentially harmful or even fake drugs. The amount of time and money a state would spend on testing and ensuring that the drugs it intends to import are authentic and comply with the FDA’s specifications and standards would negate any savings and delay residents from receiving access to those medications. Importation is not the answer to reducing costs; it will only lead to a sicker workforce.

Health care coverage is a top reason why employees want to work and stay working for an employer. Research reveals many workers would prefer to work at a small business if the wage and benefit (health care) packages were the same as those offered by large employers. However, it is difficult and expensive for small businesses to provide private health care because of affordability or their small-group-size policies.

But the truth is – many small businesses want to provide it anyway. Small businesses do not want their employees to resort to government-run health care plans, like the ACA, Medicare, or Medicaid, with fewer benefits. Americans on government-run plans face extremely high deductibles with fewer options for care. For example, ACA deductibles are twice as high as those in the small group market and three times more than the large employer plan average.

Small businesses believe private sector health coverage works best, and employees and jobseekers agree.

Gallup asked employees what was most important to them when changing jobs. The study revealed that pay and wellbeing-related issues have risen significantly in recent years, clinching the first and second spots as the most important factors for accepting a job elsewhere.

Small business owners know this. They are just asking our government to allow them to choose what health coverage is best for their business, which enables them to provide benefit packages that compete with those of big businesses and that makes it affordable for them to provide.

Speaking for more than 60 million employees of small businesses, we agree.