What do the Business Roundtable, the Commonwealth Fund and the New England Journal of Medicine have in common? A consensus that PPACA absolutely saves money, specifically for small businesses.
The Affordable Care Act helps make it easier for employers to provide health benefits. This year, small businesses are eligible for health care tax credits and starting in 2014, small businesses with up to 100 employees will have access to state-based Small Business Health Options Program (SHOP) Exchanges, which will expand their purchasing power.
The NEJM article references a Rand study, which the L.A. Times describes thusly:
Overall, they estimate that the proportion of U.S. workers who will have access to health insurance through their jobs will jump from 84.6% to 94.6%. That works out to 13.6 million additional workers having the option to buy affordable health plans.
Most of that bump is likely to come from smaller businesses with 50 or fewer employees.
A report by the Commonwealth Fund agrees, concluding that millions of small businesses will benefit from the small business tax credits, that PPACA will extend employer-based coverage to up to 7 million people. They note that 16.6 million people work at small businesses that could be eligible for the tax credit, many within the next three years. And an updated report from CMS Office of the Actuary (OACT) further confirms these analyses:
Today’s report by the Office of the Actuary confirms a central point of the Affordable Care Act passed by Congress and signed by President Obama: The Act will make health care more affordable for Americans. In fact, the Actuary’s report indicates that total health care spending per insured American will be more than $1000 lower thanks to the provisions of the new law than it would have been if Congress and the President had not acted.
Specifically, by 2019, overall health spending per insured person will average $14,720 instead of the $16,120 projected by the Actuary before the Act was enacted into law.
...Finally, the Actuary’s report confirms that 33 million Americans who are living without health insurance today will gain coverage
Yes; a lot of that is long-term gain and far too many people need relief right now. Here are some immediate benefits of the law that go into effect for new policies at the end of this month, namely preventive services that must be covered with no out-of-pocket or co-pay expense to the patient:
Autism screening for children at 18 and 24 months
Immunization vaccines for children and adults
Mammography screenings every one to two years for women older than 40. Pap smears for cervical cancer prevention
HIV screening for all adults at higher risk
Blood pressure, diabetes, and cholesterol tests
Cancer screenings
Counseling on smoking cessation, weight loss, healthy eating, depression treatments, and reduction of alcohol use
Screening, vaccines, and counseling for healthy pregnancies. Well-baby and well-child visits up to the age of 21, as well as vision and hearing, developmental assessments, and body mass index (BMI) screenings for obesity.
I think the most undersung provision of PPACA, though, is the one that requires the Health Secretary "to work with states to establish a process for annual reviews of unreasonable increases in premiums." The funding for that review panel/process was one of the immediate provisions of the Act; it's effective date is certainly this year, if not as I type. It may sound unassuming and insignificant, but it definitely is not. PPACA provides for this review process to determine eligibility for participation in the exchanges in 2014.
The law allows states that have, or plan to implement, measures that require insurance companies to justify their premium increases to be eligible for $250 million in new grants. Insurance companies with excessive or unjustified premium increases may not be able to participate in the new health insurance Exchanges in 2014.
The invisible hand of the free market may be maimed and rather ham-fisted, but no insurance company wants to be shut out of that market. It's the leverage Sebelius and HHS have been using to get things like early adoption of the extension to 26-year olds. Or how they quickly gave up the fight about pre-existing conditions for children. Etc.
Information is awesome voter outreach.