Small Business Groups Aim to Make a Difference in Health Care Reform

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While both organizations agree on most aspects of health care reform, they do differ on one key aspect: the public option. While the Main Street Alliance believes it is a critical component, the Small Business Majority does not, though the group does think reform would be better with a public option.

Here's a look at each organization and their approach to health care reform.

Main Street Alliance

Founded in 2008, MSA is a national network of small business coalitions that came together "in recognition that [the voice of small business] was not being represented" in the health care debate," said Sam Blair, MSA national network director, a former community organizer. "Last summer, we went door-to-door to small business owners and found that there was a disconnect in what they wanted" and what lawmakers thought small business owners needed.

MSA looks to create opportunities for small business owners to speak for themselves about health care and how to fix it, the MSA website notes. The network includes small business coalitions in 15 states: Arkansas, Colorado, Florida, Idaho, Illinois, Iowa, Maine, Montana, Nebraska, New Jersey, New Mexico, New York, Oregon, and Washington. The alliance is governed by a National Advisory Council consisting of 25 small business owners.

MSA surveyed about 1,200 small business owners in 12 states and conducted in-depth interviews with business owners about their experiences in the private health insurance system. The alliance found that small business owners are concerned deeply about the adequacy of insurance, including the breadth and affordability of services covered by their plans; believe government should provide a public alternative to private coverage; and are willing to contribute their fair share toward a system that makes health care work for small businesses, their employees, and the communities they serve.

Based on this information, Blair said, MSA came up with its "'4 C's' of Health Care":

  • Affordable Costs. MSA wants affordable, predictable costs that small business owners can plan and budget for, and wants to level the playing field so small businesses can compete with large corporations that currently can offer better benefits for less.
  • Guaranteed Coverage. MSA wants good health coverage regardless as to whether the insured runs a small business or a Fortune 500 company.
  • Shared Commitment. MSA believes that health care reform can work if "everyone pitches in." Its website notes, "It's got to be a commitment shared with government and employees."
  • Real Choices. MSA wants everyone to have a choice between private and public health insurance plans, which it believes would encourage competition among insurers to drive down costs, and provide a guaranteed backup.

At present, MSA is asking interested small business owners to sign a petition demanding health care reform that includes a choice between private and public options among other things. For more information on MSA and to sign up for e-mail updates and action alerts, go to

Small Business Majority

SBM was founded in 2005 and is run by small business owners. John Arensmeyer, the group's founder and CEO, said his organization looks to be the voice for small business. "We felt there was an opportunity for a non-idealogical voice, and health care was the big issue for small business," Arensmeyer told BTW. The group is currently focused on finding a solution to the health care crisis and believes the time has come to change the way people get and how much they pay for health insurance.

The policy position that SBM has taken in regards to health care is based on scientific research, said Arensmeyer. As part of this research, SBM commissions surveys of randomly selected small business owners across the country. The surveys have shown that small businesses are overly burdened by health care costs, that they want comprehensive reform now, and that they are open to a variety of solutions.

SBM also turned to MIT economist Dr. Jonathan Gruber to project the effects of three different health care reform scenarios on small business profits, jobs, and wages. The analysis found that, compared with no reform, each scenario would dramatically improve the situation for small businesses -- holding down health care cost increases, saving jobs, preserving wages, and bolstering profits.

Now, SBM is trying to get the word out that the status quo is simply unacceptable. "We do our best to project the idea that health care is the most critical issue facing small businesses," Aresnmeyer said. "It is killing small business owners' ability to grow and succeed. It is essential that we get it fixed in order to allow small business to recover and to lead us out of the recession."

SBM's vision of health care reform includes an insurance exchange, insurance reform (for example., no exclusion of coverage for pre-existing conditions and requiring everyone to have health insurance), cost containment, and coverage with adequate subsidies. Currently, all the health care bills that have been introduced contain these solutions, Arensmeyer said. As for a public option, "we agree with the president's position," he said. "The public option is a good thing and it would be better to have it, but it's not the be all and end all of reform."

Noting that there is a lot of "noise out there," Arensmeyer said it's important to keep small business owners focused on the core issues, and not let a few details get in the way of that. "Everything that is currently proposed is vastly superior [to the status quo]," he explained.

Overall, Arsenmeyer is confident that that health care reform, in some form, will be passed by year's end. "The stakes are too high not to do it," he said.

For more information, visit --David Grogan