As healthcare costs rise, small business owners are taking an interest in 'Medicare for All': survey 

A political sign reading "Medicare for All: Healthcare is a right"
A new study examines how small business owners are adapting to rising healthcare costs. (Senate Democrats/CC BY 2.0)

As small business owners struggle to address rising healthcare costs, many are open to a swath of ideas to mitigate these expenses—including “Medicare for All,” a new study shows. 

A new national survey commissioned by Public Private Strategies and backed by the Commonwealth fund polled 500 small employers—defined as those with 500 or fewer employees—and interviewed small business owners and industry experts by phone or through focus groups.  

They found that healthcare costs are a top issue for these employers—37% said it was their top concern, beating attracting new customers or rising state and federal taxes. 

Two-thirds (69%) of these businesses said the problem is only getting worse, and the smallest businesses tended to feel the strain of healthcare costs the most. Among businesses with two to 25 employees, 45% said healthcare costs are a major problem and 30% said these expenses are a minor problem. 

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And small businesses are passing those costs on to employees as they continue to rise, the study found. Nearly half (48%) said they raised employees’ deductibles or copays, and 25% asked workers to pay higher premiums. In addition, 16% eliminated dependent coverage altogether, the study found. 

But these business owners are open to a wide range of alternatives to avoid continuing to shift costs to their workers, according to the study. 

“Small business owners are taking steps to alleviate the problem. Unfortunately, without policy action their tools remain limited,” the researchers wrote. “They need support from policymakers to address the issue in a way that ensures they can continue to compete and employ millions of Americans in the future.” 

Small business owners support policies from across the political spectrum to ease the burden of healthcare costs, the study found. While they lean toward private sector solutions—60% support bringing more generic drugs to market, for example—more liberal policies also draw support.  

About one-third (34%) said they strongly support “Medicare for All,” 38% said they strongly support the creation of a national government-administered plan and 35% strongly support a Medicare or Medicaid buy-in plan. 

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The study found that 56% strongly support policies that would push drug companies to post their list prices and 50% strongly support caps on patients’ out-of-pocket costs. By contrast, 48% said they support reducing regulations and bureaucracy for health insurance. 

“All options provided to curb costs—both market-based and regulatory options—find support among business owners,” the authors wrote. “This includes solutions considered either conservative or liberal. Indeed, the same constituency that supports cuts in regulations and bureaucracy also supports a national single-payer health plan.” 

One solution of particular interest to these business owners is working together to address healthcare costs, the study found. About two-thirds of those surveyed said they had spoken with another business owner about the cost of healthcare, and 92% said they’re willing to join forces to push for lower costs. 

The majority (78%) said they would be willing to join a volunteer association of business owners on this issue, and 59% said they are open to forming an organization that provides group coverage. 

What the findings boil down to, the researchers said, is that rising healthcare costs are not “sustainable” for small business openers—so they’re willing to try a range of options to ease that burden. 

“They want change and are willing to take pragmatic steps,” the researchers wrote.