Region – With health care reform efforts in legislative limbo, small business owners and lobbying groups in central Pennsylvania and nationwide are at odds over how to proceed.

Currently, the Patient Protection and Affordable Care Act, as the reform bill is known, has passed the House and Senate in different versions but still needs to be reconciled and voted on once again by both chambers. Scott Brown’s recent win in the special election for Ted Kennedy’s Senate seat in Massachusetts has stalled those efforts, as Brown, who represents the deciding vote in the Senate, has sworn to vote against the bill in its current form. That has left the health care reform movement as at a crossroads, as legislators decide whether to renegotiate the bill or forsake it and move on to other affairs.

Some small business lobbying groups, including the National Federation of Small Business, which represents 350,000 small businesses nationally and 14,000 in Pennsylvania, have pushed for leaving the current bill behind and focusing instead on the more pressing priority of fixing the weak economy.

“The legislation did very little to address the problems and concerns of small business-people. It really failed to address those concerns of cost and competition,” Pennsylvania Director of the National Federation of Small Business Kevin Shivers said. “The number one concern of small business people is now the loss of sales. We need to figure out a way to solve this economic crisis, and that should not include a new extraordinary health care mandate and tax increases on small businesses.”

In the current legislation, small businesses of 50 employees or less would not be required to buy health insurance for employees, but would face potential penalties if their employees use federal subsidies to purchase health care for themselves. In exchange, businesses with fewer than 50 employees that pay for at least half of their employees’ premiums would receive a tax credit for 35 percent of their health insurance costs.

Though small business groups are divided on whether the current bill represents effective reform, practically all are in favor of changing the current system. Small businesses owners and workers are charged more per person, have less choice and are more likely to be uninsured than their counterparts at larger companies. Their tiny risk pools are the cause, as they make their premiums higher and less stable, and increase their administrative costs. In recent years, huge cost increases have forced some small business owners to terminate their employee health plans, as 59 percent of small firms now offer a health plan, down from 68 percent in 2000. High costs have also prevented many start-ups from instituting one in the first place.

Small business owners surveyed by both the NFIB and by Small Business Majority name increasing health care costs as the biggest problem facing their businesses. According to Small Business Majority, the cost of health care has increased 119 percent since 2001, outpacing inflation by 90 percent. Since 2005, more than one-fifth of small businesses reported annual premium increases in excess of 20 percent and in 2008, 28 percent reported an increase in excess of 20 percent.

Despite the “broadest coalition in history” in favor of health care reform, Terry Gardiner, a lobbyist in Washington for Small Business Majority, said he is frustrated the delay of the legislation and the degeneration of the debate over reform into partisanship.

“Small businesses can’t afford to wait any longer for health care reform. America as a country can’t wait any longer – all the experts running projections say the system is going to crash if we don’t do anything to fix it,” Gardiner said. “The best way to get the economy back on track is to get health care reform passed.”

An ABC News/Washington Post survey released Feb. 9 showed that 63 percent of Americans think federal lawmakers should keep trying to pass a comprehensive health care reform plan. That opinion is shared by Matt Carey, owner of Muncy-based wooden pallet and crate manufacturer Palcon LLC, which has 20 employees. He said health care was the number one issue for him when he considered hiring an employee. He said his premiums had gone up 10 percent on average annually, and 16 percent this year.

“It’s a huge factor as far as getting new employees and being able to keep them. It limits the amount of money we can pay them,” Carey said. “I think our legislators should continue working on health care reform, because it’s a vital piece to helping small businesses.”

Carey said he thinks more competition could lead to lower costs and is in favor of being able to look outside the state for a less expensive plan. While opposed to a government-run plan, he does support “group-type insurances where small businesses can come together and pool their purchasing power.”

Patty DeForrest, who runs the Four Seasons Florist in Huntingdon, supported a single-payer government option, but now that it has been taken out of the bill and is unlikely to return, said she also supports creating group-type insurance for small businesses.

“The amount of reform legislation that’s trying to get through, I don’t believe is sufficient to take care of the problem,” she said.

DeForrest, 54, said she and her partner have been without health care for seven years because they could not afford it. Her company does not offer insurance to its three part-time employees.

“I think the government needs to play at least some role in keeping insurance companies honest,” DeForrest said. “It will get worse if we let insurance companies have free reign.”

Dan Carr, co-owner of the software solutions company Ethix Systems in Latrobe, is the rare small business owner who won’t stand much to gain from health care reform. He and the company’s other two full-time employees are all young and their bills are not exorbitant.

“Still, something needs to be done,” Carr said.

While Carr and Ethix Systems may not see any benefit out of reform now, if Carr’s vision for a larger, even more successful company comes true, reform will be a necessary component of that growth, he said.  Even short term, the company is getting ready to hire a new employee, for one. And, as Carr said, “We realize the bills will only get larger as we get older.”

Whether Washington politicians go another round with health care reform will likely be decided on Feb. 25, when President Obama will meet with Democratic and Republican congressional leaders to discuss the issue.  There remains much disagreement between the two sides, and even if negotiations lead to the eventual passage of reform, few small business owners in the region may be entirely happy with the final product. But fewer still, it seems, will be able to go back to business as usual if reform efforts fail.