ISSUE. For years, small-business owners have faced rapidly escalating health care coverage costs, which affects their employees, their business, and the economy. GOALS. To better understand employers' perspectives on health care costs and to develop a targeted strategy for engaging and mobilizing to drive down costs and improve health outcomes. METHODS. Key informant interviews, focus groups, and a nationwide survey. KEY FINDINGS. Despite a healthy economic period, rising health care costs represent a major burden for small-business owners. As a result, most are taking steps to cut costs and would look favorably on policy changes that would help curb the cost of providing health care coverage to employees. Their preferences are not ideological; policy prescriptions across the spectrum find favor. There is significant interest in banding together with other business owners to advocate for a different approach to health care. CONCLUSION. The weight of health coverage and costs threatens the competitiveness of small businesses. There are many health policy solutions that would help small businesses.
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