As a sole proprietor, Mary Phillips cannot qualify for a group insurance plan, nor does she have an employer to help her shoulder the premium cost.  Her budget only allows $100 for premiums, and this limits her options in terms of benefits and cost sharing obligations.  Mary’s only option is a high deductible plan or “HSA” that requires her to pay for all costs up to $7,500 annually.  After that she still pays 30% of her health care costs.  In addition, the plan does not cover pregnancy or prescriptions.

Fortunately, Mary has been healthy and hasn’t had any major medical costs.  In her 8 years of participation on this plan, she’s paid for all of her medical costs out of pocket and never reached the deductible to claim benefits.  However, business has been sluggish in November and December.  “If I was to get sick and need to visit the emergency room or receive other expensive medical services”, says Mary, “I would have to think hard about whether I could afford to go at all.  I fear by delaying care, I’d be putting my health in jeopardy.” 

With concerns like these, it is hard for Mary to focus on growing her business. “I don’t expect health care to be free, but if I’m going to be paying a premium for health insurance, I want it to cover the health care I might need,” says Mary.  

Unfortunately, many small business owners find themselves in Mary’s position: trading quality and peace of mind to control costs.  This short-term trade-off, however, is not a sustainable solution.  The lack of affordable health care leaves many Utahns like Mary precariously underinsured, struggling to keep up with premiums, deductibles, co-pays and other out-of-pocket costs.  Medical bills cause many families to claim bankruptcy, and high costs keep Utahns from getting the right care at the right time and place.  For these reasons, one of the first steps of reform should be to determine a data-driven measure and standard of affordability.

Utah small business owners have spoken in unambiguous terms about the need for comprehensive health reforms. As  the foundation of our economy, they cannot lead the way to economic recovery—as they must—without immediate, lasting relief from rising health care costs.