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There are 63.7 million people who are self-employed or work for small businesses, accounting for 42 percent of the US workforce.

Small Business Profiles

Small business owners and entrepreneurs throughout the US are facing impossible choices because of the skyrocketing costs of health insurance premiums, and, in many cases, the lack of access to coverage. Here are some of their stories.


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Cary Madison Partners: Morrisville, NC

Ashley Ascott
North Carolina insurance agency:
Employees feel pinch of higher health premiums

Ashley Ascott
Cary Madison Partners
Morrisville, North Carolina

Founded: 2008
Employees: 7 full-time
Health coverage: High-deductible plan

Economy, health insurance costs squeeze business

Ashley Ascott, owner of an insurance agency in the Durham, North Carolina area, is ambitiously making her own mark on the local business community while building on the insurance brokerage her father established 27 years ago. The rising cost of health insurance is making that task more challenging.

Within a year of starting her firm, spun off from her father's brokerage, she got a health insurance bill with a premium 30 percent higher than in 2008. Forced to tighten the agency's collective belt, Ascott and her staff are pinching pennies, down to watching how often they hit the "print" button. "We cut back on supplies like paper," she says. "We try to make sure we're using both sides or we think twice about making a copy."

Extras are out, such as the holiday lunch for the staff. "It's hard," Ascott says. "We've cut hours this year and we've cut staff."

The health plan was also changed so that the five full-time employees who use the plan pay a $3,500 deductible before any medical care is covered. "That's a high deductible to meet, especially if you've got children," she notes.

Ascott is grateful that her staff members are loyal and find ways to cope while both high health premiums and a shrunken economy prevail. "We've got really good people because they're just very flexible," she says. "They know it's hard out here for everybody. They're just hanging in there with us until we can do better."

"We need an easier way to find affordable coverage that fits our situation."

Health insurance system needs to be easier to use

A more affordable health insurance plan for the five full-time employees who use the coverage would be ease the financial pressure on everyone, as would a system that makes it easier to shop for the best plan. "We need an easier way to find affordable coverage that fits our situation," says Ascott, herself a broker focusing mostly on personal, home, auto and business insurance.

"It's simple: health insurance is expensive and people need it."

Congress needs to make healthcare reform happen

Ascott supports healthcare reform, seeing as the only way to shake up the marketplace enough to get real relief for small business owners and the employees who depend on them. Reform needs to cover everyone and it needs to eliminate the insurance company practices that exclude so many people with health problems.

"I just wish somebody would stand up and take a stand on it and stop trying to get around it," she says. "It's simple: health insurance is expensive and people need it. Either you're going to give it to us or you're not."


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