Economic Justice

Lawmakers who dream of gutting the Affordable Care Act (ACA) do not seem to care about its importance to small business owners, particularly those who are solo entrepreneurs. What these politicians fail to understand is that the health care law is the first meaningful insurance reform available to entrepreneurs in decades. In fact, for many self-employed business owners, their firms would not exist without it. That’s why repealing the law is going to be a sizable setback for entrepreneurship.

One of the most popular and best-known provisions of the ACA has been particularly important to solo entrepreneurs: the prohibition against denying coverage to anyone because they have a pre-existing condition. Before the ACA, many aspiring entrepreneurs were unable to leave their jobs and start new ventures because a pre-existing condition meant they could not get coverage on their own, so they were stuck working for someone else. Others simply went without insurance. According to the Employee Benefit Research Institute, 30 percent of the nation’s 22 million self-employed were uninsured in 2011 — a rate more than double that of the general population.

The ACA has been (and should continue to be) particularly impactful for entrepreneurs. A report issued recently by the Treasury Department and the U.S. Department of Health and Human Services found that one out of every five ACA marketplace enrollees in 2014 was a small business owner, self-employed, or both. Two years later, the numbers continued to improve: a survey conducted by the Kaiser Family Foundation in early 2016 found that 31 percent of non-group health insurance enrollees were self-employed. What’s more, in 2013, The Robert Wood Johnson Foundation estimated that the number of self-employed Americans would increase by 1.5 million, thanks to the ACA.