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Universal Health Coverage

Our home based business experts take a closer look at a California bill that could offer hope to uninsured home based business owners nationwide.
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Universal Health Coverage
Our home based business experts take a closer look at a California bill that could offer hope to uninsured home based business owners nationwide.

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The entire nation, including politicians, judges and national trade associations, study with interest--and sometimes apprehension--every new California law, initiative and referendum, for California has long been a bell-weather state. In the case of a recently released bill regarding universal health insurance, those who yearn to be their own boss can look to California with hope.

Why? First, because more than one in four self-employed individuals and their families in the United States don't currently have health insurance. Many who go "bare" can't afford the high cost of premiums; others are gambling that their medical expenses will be less than what they'd pay for health insurance. Second, for people with a preexisting illness or injury, cost is not the only barrier. Being able to get it at all is an even larger hurdle to following their entrepreneurial dreams.

Of course, the self-employed aren't alone in having concerns about the cost of health care. In April, Gallup asked the general population how worried they are about being able to pay medical costs for normal health care and found that 42 percent of us are moderately or very worried compared to only 31 percent who aren't worried at all. Thus, public support for universal health care is high: A 2003 Pew poll found that 72 percent of Americans favored government-guaranteed health insurance for all.

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But Californians are particularly hard hit by rising health-care costs, experiencing a 61 percent increase in health-care insurance premiums from 2000 to 2004. So on May 31 of this year, California took a step, that while not yet law, would bring guaranteed health care closer to a reality for every California resident. Senate Bill 840, sponsored by Senator Sheila Kuehl, would create a statewide health-care system for all Californians. To date, it's passed the State Senate and is now pending in the House.

If passed, how will this bill affect home businesses? For most, it will be a godsend, but others with higher incomes may look at the costs and have the opposite reaction.

First, let's consider what's covered. The bill provides coverage of almost every type of medical need you have: medical care, hospitalization, dental care, vision care, chiropractic treatment and prescription drugs. It's a comprehensive plan that leaves out only a few things, such as procedures primarily done for cosmetic purposes and, as you'd expect, payments to providers that aren't licensed or accredited.

How much would health insurance cost under SB 840? We can't know for sure yet because it's not specified in the bill. The bill provides for an elected Health Insurance Commissioner who, together with a new Health Insurance Policy Board, would set premiums on a statewide basis.

To give you some idea of what universal health care might cost, we contacted Senator Kuehl's staff and were referred to a report released in January, 2005 entitled The Health Care For All Californians Act: Cost and Economic Impacts Analysis. It was prepared by the Lewin Group, an organization that's been analyzing the pricing of health-care options for almost 20 years.

The report calls for a "tax on net business income for the self-employed of 11.95 percent." We understand this to mean your business income after business tax deductions, including the home office deduction.

How might this translate for you? Let's say your net business income is $30,000. Then your annual cost under this plan would be $3,585 or about $300 a month, which these days looks like a bargain. Even with a $50,000 net income, the cost would be $5,975 or about $500 a month, which still looks pretty good. But someone in the top bracket of $200,000 would be paying a whopping $23,900 annually. Income above $200,000 would drop to a simple 1 percent surcharge.

Would you have your choice of doctors? Yes, and health-care providers would receive fair compensation without the overhead-raising cost of paperwork. Who, then, are the losers if California adopts universal health care? The predator corporations that suck money out of our bank accounts and those among the self-employed who earn the most.

We'll keep an eye on this bill's progress and let you know what happens.


Authors and career coaches Paul and Sarah Edwards are Entrepreneur.com's "Homebased Business" columnists. Their latest book is The Best Home Businesses for People 50+. Contact them at www.workingfromhome.com.



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