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Health Care Law Helps Entrepreneurs Quit Their Day Jobs

The Affordable Care Act could encourage people to start new businesses by solving an age-old problem: job lock.
The Affordable Care Act could encourage people to start new businesses by solving an age-old problem: job lock.

The Affordable Care Act — which many see creating challenges for businesses — could benefit a particular group of business people: entrepreneurs.

Joshua Simonson was reluctant to give up his job at a Portland, Ore., area grocery store, New Seasons Market, which he says had provided excellent health care for him and his family. He had a pre-existing condition that has prevented him from getting insurance in the private market, but one key development helped convince him to quit and start a farm.

"One of the biggest factors was the Affordable Care Act," Simonson says, "that our family would be able to be covered by health care starting the beginning of 2014."

Now, the young entrepreneur runs a 26-acre farm near Sheridan, Ore., where chickens till through the flower beds and goats graze on the lawn. He has 3,000 egg-laying hens, whose eggs he and his partner will sell in the Portland metropolitan area. Soon, they'll add pigs and raise chickens for meat.

It had been hard to leave a job that provided health care, especially since he had trouble getting coverage in the past.

"I was ineligible for any health care. I'd been denied by five different companies because I have back problems," says Simonson, who's broken three vertebrae in his back. "Nobody wanted to cover me because of that."

Economists call what held Simonson back job lock, or entrepreneur lock.

"Entrepreneur lock has proven to be a significant barrier to potential entrepreneurs," says Dane Stangler, vice president of research and policy at the Kauffman Foundation, which promotes entrepreneurship.

"To the extent the Affordable Care Act unlocks that job lock — that entrepreneur lock — one effect is to provide a boost to entrepreneurship overall," Stangler says.

The U.S. system of employer-provided health care deterred people from quitting a job to start their own business, says Susan Gates, one of the authors of a study by the Rand Corporation in 2011.

"People considering leaving a job with good health insurance faced a daunting challenge in purchasing health insurance on the individual market," Gates says.

The study concluded that this particular challenge was reducing the number of entrepreneurs. The study also calculated that making health insurance more accessible and affordable in the individual market could increase self-employment and entrepreneurship by a third.

"There's no question that the health exchanges provide a set of opportunities that didn't previously exist," Gates says.

Stangler believes the ACA could help boost employment by creating somewhere around 25,000 additional new businesses each year. He's not overly concerned that the employer mandate for companies with 50 or more workers might hurt entrepreneurship: Few companies ever get that big, he says.

The ACA could actually help small firms compete for employees, Stangler says, because they could essentially use the exchanges as their health insurance plan. However, Stangler does worry that by limiting the availability of inexpensive catastrophic policies, the ACA could raise costs too high for some entrepreneurs.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

John Ydstie has covered the economy, Wall Street, and the Federal Reserve at NPR for nearly three decades. Over the years, NPR has also employed Ydstie's reporting skills to cover major stories like the aftermath of Sept. 11, Hurricane Katrina, the Jack Abramoff lobbying scandal, and the implementation of the Affordable Care Act. He was a lead reporter in NPR's coverage of the global financial crisis and the Great Recession, as well as the network's coverage of President Trump's economic policies. Ydstie has also been a guest host on the NPR news programs Morning Edition, All Things Considered, and Weekend Edition. Ydstie stepped back from full-time reporting in late 2018, but plans to continue to contribute to NPR through part-time assignments and work on special projects.
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