DALLAS If you have health insurance through a large employer, very little may change for you. But for small businesses and the uninsured, health insurance reform could lead to some tough choices.

Rising insurance premiums over the years forced more and more small businesses in North Texas drop coverage for employees. Yet small firms remain skeptical this bill is going to put the brakes on their health costs.

Mike Slaton's bookkeeping and tax service business looks after the finances of other small businesses. But the health care bill has him looking at the impact on his own enterprise.

I don't feel like anything in this bill is going to do anything to cause our monthly premium as business owners to go down, to provide health insurance for our employees, he said.

Slaton's view reflects that of the National Federation of Independent Business, which has 25,000 members in Texas averaging 10 employees each. The NFIB opposed the health care bill, although congressional Democrats say it will help small businesses.

Beginning this year, firms with 25 or fewer workers qualify for tax credits to provide coverage. State exchanges must be set up by 2014 for small companies to buy insurance.

But also in 2014, employers with 50 or more workers must offer insurance or pay a penalty.

Slaton offers coverage to his 11 workers, but questions if the exchanges will offer a more inexpensive option. And he expects to hear from his client businesses with about 50 employees concerned about the cost of growing.

Businesses that wouldn't choose to grow because once they go across that point then they've got to provide it as it's mandated, Slaton said.

Slaton believes that letting insurance companies sell policies across state lines would create the competition to cut costs. But with premiums going up and up, even Slaton realizes something had to be done.

There's no doubt there needs to be some reform with our health care system, he said.

There are 2.1 million small businesses in Texas including those self-employed all looking to see if this bill can really control spiraling costs.


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