Putting small businesses at the center of the health care debate

Whenever Republicans talk about repealing the estate tax, they try to avoid talking about the principal beneficiaries: the wealthiest of the wealthy Americans. Instead, estate-tax opponents focus on figures most likely to appear sympathetic in the eyes of voters — which in this case, means arguing that the estate tax hurts farmers.To the extent that reality matters, the argument is largely bogus, and the number of farms affected by the estate tax is vanishingly small, but when it comes to politics, that’s irrelevant. Republicans want to repeal the estate tax, and to achieve their goal, they want Americans to see Democrats as fighting against some nice person in the heartland driving a tractor on a family farm.Perhaps it’s time for Affordable Care Act proponents to start thinking the same way — by focusing on small businesses.

A piece published by the Department of Health and Human Services this week went on to note, “In fact, small business owners and self-employed individuals were nearly three times as likely to purchase Marketplace coverage as other workers. Nearly 10 percent of small business owners and more than 10 percent of gig economy workers got coverage through the Marketplace in 2014.”The HHS piece added, “These data show that the Affordable Care Act (ACA’s) Health Insurance Marketplaces are playing an especially crucial role in providing health coverage to entrepreneurs and other independent workers.”When making the case to members of Congress who may be inclined to gut “Obamacare,” it’s important to consider what kind of message they’ll find persuasive. There’s no reason “Don’t hurt small-business owners and entrepreneurs” in the health-care debate couldn’t be the progressive equivalent to “Don’t hurt farmers” in the estate-tax debate.Indeed, it’s vastly more accurate given that so many small-business owners and entrepreneurs would actually suffer if/when Republicans gut “Obamacare.”