The following report was conducted by the Virginia Main Street Alliance, a small business initiative of Virginia Organizing.

As the new health care law goes into effect at the state level, small businesses are key stakeholders whose views should inform the implementation process. Small businesses are the engine of the Virginia economy, creating jobs and delivering essential services; implementing the health law to maximize benefits for small businesses will help ignite that engine and drive the economic recovery forward.

As real-life experts on the problems in the current health care and health insurance systems, small business owners have important perspectives on how to make health care work for businesses and the economy. This report focuses on the experiences and views of Virginia small business owners as documented in a survey conducted in 2011.

Compared to large employers, small employers and self-employed entrepreneurs are at a particular disadvantage in the small group and individual health insurance markets. Small businesses have limited means for purchasing insurance and also have limited bargaining power. As a result, small businesses frequently go without coverage for their employees (and owners, too) or receive less coverage in the plans they are able to afford, placing their health and financial security at risk.

The results presented in this report were gathered through a survey of 430 small business owners in 28 cities and towns across Virginia. Surveys were collected primarily through face-to-face and one-on-one interactions with business owners between February and December 2011.

KEY FINDINGS