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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Rostov's Coffee & Tea | Richmond, VA
Virginia coffee roaster:
Rising costs lead to smaller benefit
Tammy Rostov
Rostov's Coffee & Tea
Richmond, Virginia
Founded: 1979
Employees: 9
Health coverage: high-deductible PPO
Spending more and getting less
Since Tammy Rostov took over the coffee roasting company her father established in 1979, she's maintained his standards for both high-quality coffee and treating employees well. The latter includes offering healthcare coverage as an employment benefit.
"We've always offered health insurance to our employees because this is a family business and I consider my employees part of the family," says Tammy. "No one in your family should go without access to healthcare."
The increasing cost of health insurance is making that more difficult. In 2004 Rostov's Coffee switched to a high-deductible plan to cover the six employees eligible for health insurance, but now, in 2009, the plan carries only three employees and costs 50% more than before.
Tammy expects the 2010 insurance bill to go up again, and she's planning to switch from a plan that provides 100% coverage after the deductible to 70%.
"We've always offered health insurance to our employees because this is a family business and I consider my employees part of the family."
Cost of medical care also needs to come down
Not only are health insurance costs too high, Tammy argues, the cost of medical services has grown out of reach of most people. Since the company adopted a high-deductible health plan in 2004, each employee, including Tammy herself, faces a $2,000 deductible before the plan kicks in. Rostov's Coffee pays the first $1,000 of that for employees, but because she's the owner, that amount essentially comes out of Tammy's own pocket for her own care.
"Medical care is too expensive," she says. "I had 2 CT scans last year and the bill was $8200. My deductible was $2,000 and I was done. But if I didn't have insurance I don't know how I'd pay that."
Healthcare reform needs to ensure that everyone has access to affordable coverage, Tammy says.
"Medical care is too expensive. I had two CT scans last year and the bill was $8200."
Reform would give small businesses 'bargaining power'
Tammy would like to see limits on the amount insurance premiums can go up each year as well as a maximum, to give small businesses a break. "Reform would give us bargaining power," she says.
Tammy argues that increased competition, possibly from a public health plan with relatively low overhead, could help bring health plan prices down. "We need more choice across the board," she says.

