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What health reform means for the people of Illinois

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Tuesday, February 5, 2013

Why Obamacare will ignite your startup life

This post originally appeared on Crain's Chicago Business.
Written by Coco Soodek
Obamacare is going to set you free to pursue your startup dreams. Why? Because finally you won't be chained to a big company for your health insurance.

If you want affordable, reliable health insurance in America, you have had to be over 65 so you can get Medicare, work for the government or work for a big company. That's because big companies, government and Medicare have enough people in their plans to improve the insurance companies' odds of making money. Small companies and solopreneurs don't, so their insurance rates are high or they can't get coverage at all.

As a result, business owners often don't have health insurance. Only 19 percent of business owners get insurance through their own companies. And 25 percent of small-business owners don't even have health insurance, according to the Kaiser Family Foundation.

The stakes of not having health insurance are catastrophic. You may not be able to get health care if you get sick or are in an accident. That means you or your loved one could die or suffer. If you do get care, the bills may drive you into bankruptcy — half of all personal bankruptcies result from huge medical bills. We're not talking people who live above their means. We're talking people who went to the doctor to stay alive until they cry uncle.

So, leaving your big employer to start your own business can be a life-or-death decision. If you have a spouse or kids, the decision could be downright stupid. So, you stay with your big company, you follow its rules and hope for good fortune from the layoff gods. It's a terrible, ugly, stupid, myopic system and it deserves to die an unpaid-for death.

Obamacare is coming. Imperfect, complicated, rough on midsize companies, sure. But it's the grace of God for your startup hopes. For the first time in American history, your health insurance is going to get unhitched from your oversized, shuffling, bureaucratic employer. You're going to be able to visit a virtual supermarket of health insurance plans and pick the plan you want, which probably won't cover less than 60 percent of your health costs. That supermarket of health insurance is going to pool you with thousands of others to improve the odds that the insurer will make money.

If you have a company of 25 employees or fewer, and you pay half of the premiums for your employees, you can deduct 35 to 50 percent of the premiums. If you make less than $92,000-ish for a family of four, you could get government help to buy your health insurance at the supermarket. Freeloaders on the health care system have to pay up, liberating the rest of us from paying for their emergencies and lowering costs. (If you're one of those freeloaders, you have it coming.) You never have to go back to work for someone just to get insurance.

Obamacare will be the difference that creates entrepreneurs out of thousands of people like you. Scholars have known for years that the lack of affordable, reliable or even available health insurance keeps people chained to their employers. In fact, when individual states create avenues for people to get affordable health insurance, the number of entrepreneurs increases. When New Jersey reformed its health insurance laws to create markets for individual insurance and guaranteed policy renewals and limited exclusions for pre-existing conditions, entrepreneurial activity soared. And so it will in the rest of the country. Because the United States is — by history and by nature — a land of shopkeepers, not shop workers. We dream, innovate, strike out, fail, try again and prosper. The health insurance market has incentivized people to live at the mercy of someone else's vision. Obamacare is going to tilt the market back to center.


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