1. Key Findings From A Survey Among Small Business Owners in Kansas
Kansas Small Business
Survey
Key Findings From A Survey Among Small Business Owners in Kansas

2. Methodology
On behalf of the Robert Wood Johnson Foundation and The Sunflower Foundation, Public Opinion Strategies and Lake Research Partners conducted a statewide telephone survey in Kansas among 200 owners, CEOs, and presidents of businesses with 2-50 employees. This survey was conducted August 22 – September 5, 2008.
On behalf of the Robert Wood Johnson Foundation, in May/July 2008, the research team conducted: 10 triad qualitative discussion groups among small business owners with 2-50 employees and a national telephone survey among 400 small business owners, CEOs, and presidents of businesses with 2-50 employees that pay for at least some portion of their employees’ health insurance benefits.
This presentation will highlight the key findings from the Kansas survey as well as highlighting some comparisons to the triads and the national survey data.

3. Methodology
The table below shows the breakdown of businesses with 2-50 employees in Kansas compared to nationally:
Small Businesses
# Of Businesses
National
% Of Total National
Kansas
% Of Total Kansas
2-50 Employees
5,121,027
57,381
2-9 Employees
3,994,401
78%
46,767
82%
10-24 Employees
819,364
16%
7,512
13%
25-50 Employees
307,262 6%
3,102 5%
The surveys were designed to reflect the proportion of small businesses in Kansas and nationally by company size. We conducted 38 additional interviews in Kansas among companies with employees and 295 interviews nationally among companies with employees in order to have a statistically significant number of cases to make observations about these audiences.

4. Small Business Profile
Comparing Kansas to the National Average
National
Kansas
Gender: Men/Women
76%/24%
73%/27%
Age 18-44
18%
14%
Age 45-54
35%
31%
Age 55-64
36%
41%
Age 65 and over
10%
Member of the Chamber of Commerce and/or the National Federation of Independent Businesses
49%
56%

5. Small Business Profile
Comparing Kansas to the National Average
National
Kansas
Provides and pays at least some portion of health insurance benefits for coverage of full-time employees
100%*
60%
Percent of businesses who do not currently offer coverage who did previously
N/A
31%
Percent of health insurance premiums paid for by employees
17%
20%
Percent of company’s health care costs increase from last year to this year
14%
13%
Feelings about own business’ financial future: Confident/Not Confident
84%/14%
82%/16%
*The National Survey was conducted only among small business owners who pay at least some portion of health insurance benefits for coverage of full-time employees.

6. Small Business Profile
Kansas Small Business Owners
There is a significant difference in whether or not Kansas small business owners offer coverage by company size.

7. The National Environment for Small Business Owners:

8. The Context:
Small business owners are facing health care costs rising at an unpredictable rate;
They are worried about the issue in terms of their families and businesses;
They connect offering health care benefits to retaining quality employees particularly among those companies who offer coverage now; and,
They see a role for government in addressing the issue but do not like mandates.

9. On an open-ended survey question nationally, the issues facing businesses were very similar across each small business segment surveyed. Health care and energy costs dominate as a primary concern for business owners.
What would you say are the one or two most important issues facing your business today?
Categories Of Topics Mentioned
Number Of Mentions
Health care costs 78
Fuel/Energy costs 70
Weak economy 55
Cash flow/Sales 28
Higher prices across the board 24
Finding/Retaining good employees 20
Taxes 19
Housing downturn 18
Government regulation 18
Insurance problems/costs 16
Increased cost of raw materials 15
Finding new customers/business 12
Low consumer confidence 11
Higher food prices 7
Competition, particularly foreign competition 6
Government inaction/incompetency 5
Inflation 5
Layoffs 3
Difficulty getting loans 2

10. Small Business Owners
In Kansas:

11. Kansas small business owners who currently offer coverage are less likely than their national counterparts to say they would consider no longer providing or paying at least some portion of health insurance benefits for their employees.

12. Likelihood Companies Will No Longer Assist With Health Care Coverage – Among Companies Who Currently Offer Coverage
36%
27%
62%
60%
73%
Core
2-9
Employees
10-24
25-50
-26%
-24%
-46%
National
28%
35%
12%
66%
65%
63%
88%
Core
2-9
Employees
10-24
25-50
Likely
Not Likely
-38%
-37%
-28%
-76%
Kansas
Slide 12

13. Small business owners in Kansas who do not currently offer coverage are more likely to say it would help their business if health care legislation was passed.
Perceived Impact Of Health Care Legislation To Help Small Businesses-Kansas
34%
42%
38%
33%
13%
14%
Among Business Who
Currently Offer Coverage
Among Businesses Who
Currently Do Not Offer Coverage
-4%
+9%
Help
Hurt
No Impact
Slide 13

14. In Kansas the top supported policy options we tested are:
Creating a small business tax credit
Making health care coverage portable
Passing medical liability reform
Promoting a government sponsored pool for small businesses

15. Most Helpful Ideas - Kansas
Create a new small business tax credit to make it easier for small businesses to create and offer jobs with health coverage. The government would provide a refundable income tax credit to employers who currently pay at least fifty percent of the cost of group health insurance for their employees.
Total Help
Total Hurt
Net Difference
71% 5%
+66%
70% 6%
+64%
Make health insurance portable so that individuals and families keep their coverage even when they change jobs or employers.
Pass medical liability reform to eliminate lawsuits against doctors who have followed the correct clinical guidelines and have followed the right safety standards in patient care.
66%
+61% 5%
Promote a government-sponsored pool for small businesses that would allow them to purchase insurance at negotiated rates that take advantage of bulk purchasing power.
+52%
66%
14%

16. Second Tier - Most Helpful Ideas - Kansas
Total Help
Total Hurt
Net Difference
Expand and encourage the use of health savings accounts - that is a tax-free medical savings account coupled with a high-deductible health insurance plan. The money consumers put into these Health Savings Accounts would roll over year to year to help build a source of funds that can only be used to cover out- of-pocket health care expenses.
+47%
58%
11%
Require by law that all insurers can not deny coverage, including for pre-existing conditions, refuse renewal of coverage, unfairly charge for coverage, or force those they cover to pay excessive premiums for age, illness, or other discriminating factors.
51%
21%
+30%

17. Less Helpful Ideas - Kansas
Total Help
Total Hurt
Net Difference
Allow trade or professional organizations, churches, and unions to offer health insurance plans to their members around the country.
43% 7%
+36%
Eliminate the current tax credit employers receive for providing health coverage to their employees and instead provide all Americans with a tax credit to select and buy their own health insurance. This individual tax credit would reduce Americans’ taxes by two thousand five hundred dollars for singles and five thousand dollars for families.
47%
19%
+28%
Repeal the tax cuts that have been enacted over the past few years for Americans who make over two hundred and fifty thousand dollars a year in order to help employers be able to offer health coverage to their employees.
32%
29%
+3%
Guarantee all Americans a choice of health plans, either from a private insurer, or from a new public government plan offered at a sliding scale cost based on income. Employers would be required to offer a choice of the public plan and at least one private plan to all employees and small businesses would receive discounts based on a sliding scale.
41%
39%
+2%

18. The One Statement Where A Majority Of Respondents Say This Will Hurt
A majority of respondents in Kansas say an employer mandate would hurt their small business.
The One Statement Where A Majority Of Respondents Say This Will Hurt
Net Difference
Require employers who have ten or more employees who today do not provide health coverage to their employees to NOW pay four percent of their payroll to help cover the uninsured.
20%
40%
-20%
Help
Hurt
National
Net Difference
Require employers who have ten or more employees who today do not provide health coverage to their employees to NOW pay four percent of their payroll to help cover the uninsured.
13%
56%
-43%
Help
Hurt
Kansas

19. Ideas Most Important To Focus On First - Kansas
On an open-ended survey question, only five of the proposals received a double-digit mention as the one or two proposals that would help their businesses the most in Kansas.
Ideas Most Important To Focus On First - Kansas
Kansas
Core
2-9 Employees
10-24 Employees
25-50 Employees
Create a new small business tax credit
22%
23%
23%
12%
12%
13% 7% 7%
Make health insurance portable
Promote a government-sponsored pool for small businesses
12%
12%
13%
13%
Provide all Americans with a tax credit to select and buy their own health insurance
11%
11%
10% 7%
Expand & encourage health savings accounts
10%
10% 9%
15%

20. After testing each idea individually, we created policy bundles to combine different policy ideas into three different policy approaches. Support is higher for a more market based reform approach or a government sponsored pool/tax credit reform approach.

21. OPTION 1: Market Based Reform Approach
Would provide all Americans with a tax credit to select and buy their own private health insurance that they could keep and take with them between jobs. This would eliminate the current tax credit employers receive for providing health insurance to their employees. It would expand and encourage the use of tax-free health savings accounts to cover out-of-pocket health care expenses, while allowing organizations, churches, and unions to offer health insurance plans to their members around the country. Medical liability reform would be passed to eliminate lawsuits against doctors who have followed correct guidelines and safety standards in patient care.
+40%
+38%
68%
68%
30%
28%
Strongly Favor
26%
Strongly Oppose 13%
Strongly Favor
23%
Strongly Oppose 15%
National
Kansas
Favor
Oppose

22. OPTION 2: Government Sponsored Pools And Tax Credits Approach
With the four percent employer mandate proposal…
53%
61%
45%
39%
National
Kansas
Favor
Oppose
+8%
+22%
Would promote a government-sponsored pool for small businesses to purchase insurance at bulk purchasing rates. Small businesses would get a new tax credit to make it easier to offer health coverage if they pay at least fifty percent of the cost of employee health insurance. This proposal would require employers with ten or more employees who today do not provide health coverage to pay four percent of their payroll to help cover the uninsured.
Strongly Favor
23%
Strongly Oppose 25%
Strongly Favor
15%
Strongly Oppose 23%
Without the four percent employer mandate proposal…
+58%
+32%
78%
Would promote a government-sponsored pool for small businesses to purchase insurance at bulk purchasing rates. Small businesses would get a new tax credit to make it easier to offer health coverage if they pay at least fifty percent of the cost of employee health insurance.
66%
Strongly Favor
37%
Strongly Oppose 12%
34%
20%
Strongly Favor
32%
Strongly Oppose 21%
National
Kansas
Favor
Oppose

23. OPTION 3: Guaranteed Government Approach
Would guarantee all Americans a choice of public or private health plans that they could keep and take with them between jobs. Employers would be required to offer a choice of the public plan and at least one private plan. Insurance companies would not be allowed to deny people coverage due to age or pre-existing conditions. This proposal would be paid for by repealing the tax cuts enacted over the past few years for Americans making more than two-hundred and fifty-thousand dollars.
53%
50%
44%
48%
National
Kansas
Favor
Oppose
+9%
+2%
Strongly Favor
26%
Strongly Oppose 33%
Strongly Favor
22%
Strongly Oppose 35% .

24. The Robert Wood Johnson Foundation & The Sunflower Foundation
Turning Questions into Answers ● ●