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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Factor 4 Life: Nashville, TN
Tennessee pharmaceutical supply firm:
Unaffordable insurance puts it out of business
Louise Hardaway
Factor 4 Life
Nashville, Tennessee
Founded: 2008
Employees: None
Health coverage: unavailable at a reasonable price
Advocate for patients can't get coverage for her startup
Louise Hardaway sees her job as more than providing hemophiliacs with their medicine and medical supplies. She also helps her clients navigate the healthcare system and pay for care.
So it was sadly ironic when Hardaway herself ran into an insurmountable problem with insurance coverage. Despite her in-depth knowledge of health plans, she wasn't able to solve her own dilemma, and lost her new business as a result.
Hardaway and her business partner left jobs with a financially failing pharmaceutical supply company and decided to hang out their own shingle, naming their new enterprise Factor 4 Life. Within six months, though, they were forced back into regular employment with a large firm because of the high cost of health insurance. "We were forced to give up the dream of having our own business in order to have an affordable, comprehensive health insurance plan," Hardaway explains.
Despite having no history of major illness for any family member, Hardaway and her business partner were quoted a premium of almost $13,000 a month. "I just felt like it was legal highway robbery that a major insurance company could even offer a premium that high," says Hardaway, still amazed by the incident.
"We were forced to give up the dream of having our own business in order to have an affordable, comprehensive health insurance plan."
Dream of independence deferred
Despite the shock, Hardaway used her background working with the Tennessee healthcare community and researched every possible option, including health savings accounts and a state program for small businesses, but found the benefits too limited. "It took a whole lot of time and effort and was frustrating that we couldn't come up with something that really met our needs," she recalls.
After hitting a wall on finding health insurance, Hardaway and her partner shelved their business plan. They accepted an offer to affiliate with a large pharmaceutical products company that offers health benefits. While glad to have a job in today's economy, "it's just not the same as having your own business," Hardaway laments.
"Access to healthcare is truly a life and death issue to this community."
'Affordable healthcare for all'
With her now encyclopedic knowledge of the health insurance landscape, Hardaway is adamant about the need for reform. The specifics need to be worked out, she says, but the best chance for success lies in building on the current system and "making incremental changes that are doable."
Most important to her are principles that protect people from the vagaries of the dizzyingly complex healthcare system. "There needs to be affordable healthcare for all, and people should have the ability to choose between an employer plan and a public plan," Hardaway argues.
But even more important than her own experience are those of the chronically ill people she serves and advocates for. "There should not be any limitations based on preexisting conditions or lifetime limits. All those things are such big issues for people with costly health problems," Hardaway says. "Access to healthcare is truly a life and death issue to this community."

