Voices from Main Street: We Must Protect People with Pre-Existing Conditions

Health care is deeply important to people across the country. This is no less true for the millions of small business owners who now count on the Affordable Care Act (ACA) for themselves, their families, and their employees. And, with insurance markets advantaging big employers over small business, ensuring quality, affordable health care for all is a crucial part of leveling the playing field between large corporations and Main Street.

For many entrepreneurs with pre-existing conditions, the day the ACA went into effect was the day they had the freedom to strike out on their own and start their businesses. And for many others, although not perfect, the ACA did offer stable, single-digit increases in premiums from year to year and protected entrepreneurs forced to choose between sustaining a business and keeping their health care. By making health care more affordable, the ACA allowed many small business owners to invest in their companies and in their employees.

For the communities these Main Street businesses serve, the ACA and other key health care programs may mean the difference between a thriving small business sector and shuttered firms, empty storefronts, and lost jobs. Last year, it was estimated that repealing the ACA’s premium tax credits and Medicaid expansion would cost 2.6 million jobs in 2019 and $2.6 trillion in business output from 2019 to 2023.

Despite the importance of affordable health care to the small business sector, the Trump Administration and some elected officials, from members of Congress to state attorneys general, have endeavored to undermine the ACA and Medicaid and Medicare. These attacks have included withholding of cost-sharing funds, eliminating the individual mandate, and circumventing pre-existing condition rules by expanding junk plans. This year, the Trump Administration argued in court that key pre-existing condition requirements should be eliminated. If confirmed, Trump’s Supreme Court nominee, Brett Kavanaugh, could provide the final vote to dismantle the ACA.

This attack on health care comes at a great cost to the Main Street businesses that form that backbone of our local economies and communities. New analysis shows that the steps taken by Congress and the Trump Administration to dismantle the ACA, piece by piece, have resulted in premiums that are higher than they would have been absent these actions.

Main Street business owners feel these costs acutely and worry for their future. The health care system in the United States was grossly unequal before the ACA, favoring large corporations over small businesses and compromised by racial and gender inequity. The ACA has been a step in the right direction for Main Street. That is why thousands of small business owners have come together to protect and expand health care for themselves, their employees, and the people of all races who make up their customer base and their communities.

Hear more of the voices of Main Street in our recent collection of health care stories from small business owners across the country.


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