The Healthcare Bill: What’s In It for Small Businesses? Marianne Markowitz SBA Regional Administrator IL, IN, MI, MN, OH, WI 1

Small Businesses Concerns Healthcare is the Number One concern for small business owners – in fact according to an NFIB study it’s been the number one concern of small business owners every year since Small businesses currently pay as much as 18 percent more for the same coverage as big companies under the current system. 2

Affordability and Accessibility Tax Credits Insurance Market Reforms State Exchanges 3

Creation of New Marketplaces: State Exchanges Who Can Participate: small businesses (includes non-profits), the self- employed, individuals, and Members of Congress and their staff Small Business and Non-Profit Eligibility: Up to 100 full-time employees State Exchanges All 50 states required to establish state-based exchanges States may form regional exchanges or allow more than one exchange to operate in a state Exchanges include: Private insurance plans At least 2 multi-state health plans (negotiated by OPM) Consumer Operated and Oriented Plans (CO-Ops) 4

Assistance to Small Businesses to Reduce Coverage Costs: Tax Credits Small Business and Non-Profit Eligibility: Businesses and non-profits up to 25 employees and average wages below $50,000 Maximum credit to businesses with 10 or fewer employees with average wages below $25,000 and indexed thereafter Employers must contribute at least 50% of the total premium cost Tax Credit: Small Businesses: maximum tax credit of 35% of the employer’s contribution toward the employee’s health insurance premium Non-profits: maximum tax credit of 25% of the employer’s contribution In 2014 Tax Credit for purchase of coverage through exchanges: Small Businesses: maximum tax credit of 50% of the employer’s contribution Non-profits: maximum tax credit of 35% of the employer’s contribution 5

Insurance Market Reforms September, 2010 (Six Months After Enactment) The law: Requires coverage of adult children up to age 26 Prohibits pre existing condition exclusions for children under 19 Prohibits individual and group health plans from placing lifetime limits on coverage Prohibits rescinding coverage, except in case of fraud Prohibits deductibles greater than $2,000 for individuals and $4,000 for families January 1, 2014 The law: Requires that you cannot be denied coverage and you cannot be dropped from your coverage Prohibits pre-existing condition exclusions Eliminates annual limits on coverage 6

7 SBA’s 3 C’s Credit Contracts Counseling

Opportunities in Healthcare Electronic Records Security Network Services Mobile Apps “Cloud” hosting Information Exchange Data Analysis, Forecasting, & Management Training 8

The Healthcare Bill: What’s In It for Small Businesses? Marianne Markowitz SBA Regional Administrator IL, IN, MI, MN, OH, WI 9