NEW YORK -- Stay in business for yourself or go back to working for someone else?
That's the choice some small business owners and freelancers are worried they may have to make, depending on what changes Congress makes in the health care law.
With Republicans working on legislation to repeal and replace the Affordable Care Act, people who traded a full-time job for entrepreneurship are concerned that new insurance policies may be too expensive or not available at all -- and possibly force them to find new jobs that offer cheaper and more comprehensive plans.
"From a safety and stability standpoint, I have to look for a job now," says Michael Duffield, owner of Fruition, a marketing business based in Palm Springs, California, that he started in 2011.
Duffield, who has high blood pressure and a pacemaker, buys individual coverage that he's happy with on the state insurance exchange. He's worried that under a new health care law, coverage might cost more than he can afford. And while GOP lawmakers and President Donald Trump have said they want a new law to keep the ACA's requirement that insurers cover pre-existing medical conditions, Duffield is anxious about what coverage might look like in the future.
Health insurance is one of several considerations when people think about starting a business. For many, leaving a job with a group insurance plan, especially one that their employers contribute to, means they'll have to buy individual policies that are more expensive and may cover less.
The ability to buy individual insurance on exchanges in each state helped some of Merredith Branscombe's clients decide to leave their jobs for entrepreneurship.
"They felt like it emboldened them a bit. They had a safety net," says Branscombe, a consultant to small businesses who's based in Boulder, Colorado.
The law also has made it possible for new business owners to attract employees when they couldn't yet afford to provide coverage, Branscombe says.
While Branscombe is concerned for her clients, insurance is also a personal issue. Her husband, who has coverage through his full-time job in the food industry, wants at some point to start his own business. If the couple can't get affordable and adequate insurance, his dream may have to stay on the back burner.
Members of the National Association for the Self-Employed have been calling in recent weeks, asking if the advocacy group will reinstate the health insurance plan it discontinued when the ACA went into effect, says Katie Vlietstra, the organization's vice president for government relations and public affairs. So far, the group has no plans to revive its coverage.
It's not known how many freelancers and small business owners in the U.S. buy individual health insurance, but the number is likely well into the millions -- about 80 percent of the nation's nearly 29 million small companies don't have employees and therefore don't buy group coverage. But some of the nation's largest small business advocacy groups, including the National Federation of Independent Business and the National Small Business Association, oppose the ACA at least in part because of the costs of complying with the law.