Building Small Business Support for Healthcare Reform
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Building Small Business Support for Healthcare Reform. Affordable HealthCare Project. Business Experience. John Arensmeyer – CEO Small Business Majority 15 year as successful Internet entrepreneur Private sector attorney

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Building Small Business Support for Healthcare Reform

Affordable HealthCare Project

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Business Experience

  • John Arensmeyer – CEO Small Business Majority

    • 15 year as successful Internet entrepreneur

    • Private sector attorney

    • Worked for Mayor of Philadelphia and lawmakers on Capitol Hill

  • Terry Gardiner – Herndon Alliance

    • 23 years CEO/Founder – NorQuest Seafoods

    • 5 term state legislator; Speaker of the House

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An Independent Small Business Voice is Needed

  • Political support of small business is critical to legislative success

  • New research shows small business can be an ally with reform advocates

  • Traditional business groups do not represent the majority of small businesses

  • Voter care deeply about small business and want to hear their voice on health care

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Small Business Strategy

  • A national network of state-based groups

  • Working with healthcare reform advocates to achieve comprehensive reform

  • Credible objective poll of small businesses to shift the debate, engage media and organize

Building an independent voice of small businesses that support healthcare reform

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SBM National Research

  • 87% ranked health care as extremely or very important

  • 81% favored access to purchasing pools

  • 63% supported a government sponsored healthcare solution

  • 60% were in favor of mandating that all companies provide health insurance

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2007 California Survey

  • 75% rated the availability of affordable healthcare “Very Important” or “One of the top one or two issues we face in business today.”

  • 80% felt that employers should pay to provide healthcare to their employees.

  • 57% of businesses see healthcare financing as a shared responsibility among individuals, employers and government – almost 3 times as many who do not (19%).

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2007 California Survey

  • 55% were in favor of paying into a statewide pool that would enable their employees to obtain coverage at favorable rates – over 3 times greater than those opposed (17%).

  • Support proposal to require businesses to pay 7.5% of payroll in exchange for employees’ ability to purchase subsidized insurance = 47%-33% in favor.

  • Single Payer = 42%-40% in favor

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Herndon Alliance Research Conclusions

  • Small business is an extremely important and persuasive voice and issue in the healthcare debate

  • It is necessary to give a voice to small business

  • Voters want to help small business

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Give A Voice to Small Business

Voters want to hear directly from small business owners and hear how reforms will impact them

The voice needs to be one that they can connect with and believe in

Multi generational blue collar businesses seem to have strong support. Examples include:

Auto repair shop

Third generation neighborhood hardware store

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Voters Want to Help


Are concerned about impact of health care reform on small business.

Support discounts and sliding scales to help small businesses afford coverage.

Want to hear directly from small business owners.

Even voters who don’t own small businesses are strong advocates for small businesses and worry about their costs.

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Business Owner Profile

  • Optimist with a DREAM

  • The DREAM - successful business and happy employees

  • Good employees are crucial – like family

  • The dream is being undermined

    • Victims of the healthcare cost spiral

    • Tired of being blamed in healthcare debate

    • Frustrated that nothing has been done

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Main St. to Hi-Tech to Startup = Diversity

  • Professional firms – high pay & skilled

  • Main Street retailers – competing with the big boys and globalization

  • Small manufacturers

  • High-tech, bio-tech and knowledge workers

  • Freelancers, consultants and contractors

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Small Business = Backbone of the Economy

  • 26.7 million small businesses

  • 52% of the private sector workforce (vs. 8% union membership)

  • 75% of all net new jobs

  • 14 times more patents per employee than big businesses

  • Central to American global competitiveness

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The Bottom Line

  • 58% of small business employees do not have health insurance.

  • 55% of businesses with under 10 employees cannot afford to offer health insurance

  • The health insurance they do buy costs 18% more than big business.

  • Small businesses pay twice as much in taxes and regulatory costs

  • Entrepreneurs struggle to obtain needed capital

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Business Attitudes

  • Generally oppose government mandates and requirements -- though there are signs that this may be changing

  • Generally oppose new business taxes – though rising deficits may be changing this

  • Generally support incentives for business to provide health care benefits

  • Generally support government-sponsored healthcare pooling solutions

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Business Fears = Barriers

  • Higher taxes

  • Loss of control of their business

  • Loss of ability to recruit and retain employees

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Fragmentation of Small Business Voices

  • Traditional national organizations

    • NFIB, Chamber, NSBA

  • Industry groups

    • Farm bureau, mining, restaurants, franchisees

  • Leadership policy groups

    • Business Roundtable

    • Committee for Economic Development (CED)

    • National Coalition on Health Care (NCHC)

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Fragmentation of Small Business Voices

  • “New” national health care reform groups

    • Better Health Care Together

    • Divided We Fail (NFIB and Business Roundtable are members)

  • State groups supporting healthcare reform

    • California

      • Small Business California

      • California Business Roundtable (Safeway)

    • BALCONY (New York)

    • Oregon

      • Small Business for Responsible Leadership

      • Oregon Business Association

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Our Principles

  • Guaranteed coverage for all

  • Affordability for businesses and individuals

  • No discrimination based on health risk or type/size of business

  • Shared, equitable responsibility by all stakeholders

  • Cost reduction within the entire system

  • Improved, measurable quality

  • Portability of a base level of quality affordable care from job to job

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Reform Policies Benefit Small Business


  • Shared Responsibility

  • Government Insurance Option/Purchasing Pools

  • Elimination of Discrimination (“Guaranteed Issue” and “Community Rating”)

  • Controlling healthcare costs

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Effective Language

“Businesses are not used to working with social justice advocates.”

Herndon Alliance Survey

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Effective Language

  • Talk in plain language – not “policy speak”

  • Play to business pride

  • Acknowledge business role as source of employment for the community

  • Speak in "business" language - not "nonprofit" language

  • Never use "lefty speak”

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Effective Communication

  • Peer to Peer

    • Trusted and credible relationships

    • Business frame and context

    • Business language

  • One on One

    • Existing business hierarchy is not the path

    • Meeting on their turf is important

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Respectful Approach

  • Small Business is a victim, too.

  • Business tries and wants to do the right thing.

  • Employees are like extended family.

  • Owners are very short on time and busy -- no time for long speeches and meetings.

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Messages that Resonate

  • Reduced employer health care costs

    • Repeatedly emphasized as the essential message to enter the conversation and get business attention

  • Business competitiveness is being undermined by our current system, and healthcare reform can help reestablish competitiveness

  • A healthier workforce has business benefits

  • Responsibility to employees

  • We understand business needs

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Messages that DO NOT Resonate

  • Moral issues such as “It is the right thing to do.”

  • “Health Care is a Right.” – Justice arguments are not effective

  • Government run health care messages

  • “We need to help the uninsured and the poor that cannot afford health care.” does not engage

  • Universal Health Care – this is not a winning message. Guaranteed Affordable Choice works better.

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Small Business Narrative

  • Backbone and engine of the US economy:

  • The ability to start a business is a cherished freedom

  • Skyrocketing health care costs have made it increasingly difficult for small businesses to survive

  • We need a health care system that guarantees access to quality affordable health care so that small businesses can continue to thrive and propel our economy, job growth and innovation.

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The Value of Research

  • Critical component early in the campaign

    • Counteracts prevailing view & changes the debate

    • Offsets early lack of members

    • Key to credibility

    • Drives media coverage

    • Drives small business recruiting

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Building Membership Through Partnerships

  • Seek out non-traditional business groups. Examples:

    • AARP – many members own a business

    • Women’s groups – Women “get” health care issues

    • Public and Farmers Markets

    • Consultants, Freelancers and self-employed

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Checklist for Building a Small Business Voice

  • Develop principles that business can identify with

  • Recruit peer to peer in non-traditional business groups

  • Use a business survey to shift the debate

  • Partner with other business groups

  • Work with the advocacy community

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SBM-HA Assistance for States

  • Sharing best practices & offering advice

  • Providing tools based on state experiences

  • Sharing research results – national and state

  • Providing national legislative information

    • Example: New small business “SHOP” legislation authored by Durbin. Lincoln, Snowe & Coleman

    • Example: Planned Senate Finance Committee hearings on health care reform

  • Providing national infrastructure for advocacy

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Affordable HealthCare Project

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Presentation created with funding from

Robert Wood Johnson Foundation through

Consumer Voices for Coverage is a joint initiative of Robert Wood Johnson and Community Catalyst to strengthen the consumer voice to promote innovative and comprehensive health care coverage for everyone.