The Patient Protection and Affordable Care Act (PPACA), arguably President Obama's greatest domestic policy achievement so far, sets up health insurance exchanges in each state where small businesses and individuals can compare policies and buy insurance. It offers incentives -- including subsidies and tax credits -- to employers to increase the ranks of the insured. It provides firms with fewer than 25 full-time workers earning less than $50,000 annually a temporary tax credit of up to 35% of an employer's contribution toward employees' health insurance premiums through 2013. That rises to a 50% credit in 2014. It also sets a mandate that all employers with 50 or more employees provide health insurance coverage for all employees, or else pay a penalty of $2,000 per worker.
Romney believes the Affordable Care Act relies on a web of regulations that gives the federal government control over every corner of the health care system. He pledges to repeal it, and issue waivers to all 50 states making sure they have the flexibility to help the uninsured and critically ill. He says he will give each state the power to craft its own health reform plan. He is advocating for the creation of a national marketplace for buying health insurance across state lines to foster competition; purchasing pools to give employers more control over prices and plans; freeing up Health Savings Accounts, so holders can use those funds to pay for insurance premiums; and a cap on non-economic damages in medical malpractice lawsuits.
Reality Check: While the principles of universal health care are in the best interests of all Americans, small employers are sitting on the sidelines waiting to see how PPACA plays out. "Many feel PPACA is too complex, and the tax credits are not a large enough incentive," says Karen Kerrigan, president of the Small Business and Entrepreneurship Council. The biggest concern is that the small business health care tax and employer mandate provisions for businesses with over 50 employees will actually increase a company's out-of-pocket health insurance costs. There are provisions in the reform that would help, though, like the Optional Free Choice Voucher, which would allow employers to give pre-tax dollars to their workers so they could purchase the plan that best fits their needs, and larger small business insurance group plans that pool across state lines to gain economies of scale and lower costs.
From home improvement stores to insurance short-sellers, some parts of the economy are seeing a bump from Sandy's punch.