NFIB Affordable Care Act Repeal and Replace Principles

Date: March 03, 2017

Small businesses deserve health insurance that is affordable, flexible, and predictable. Repeal of the ACA is not enough; a replacement that repairs the health insurance markets is the only suitable outcome for small businesses.

The principles here detail the path to affordability, flexibility, and predictability. 


  • Do away with taxes and mandates that drive up the cost of health insurance and inhibit job creation
    • Repeal taxes on health insurance products and mandate penalties
    • Reconsider benefit mandates and health insurance requirements with a focus on affordability
  • Equalize the tax treatment of health insurance for small business owners and self-employed individuals
    • Allow self-employed individuals and business owners the same tax treatment as business owners and employees who receive health insurance through their employers
    • Lift or remove contribution caps for small businesses that help employees who purchase insurance on their own
  • Eliminate unnecessary compliance burdens
    • Eliminate the employer mandate compliance requirements after penalties are repealed
    • Eliminate outdated paperwork burdens and prevent new paperwork requirements



  • Increase health insurance options for small businesses
    • Enhance the ability of small businesses to help employees purchase health insurance on their own
    • Allow small businesses the same health insurance opportunities as large businesses
  • Permit innovative pooling arrangements
    • Enable groups of individuals and employers to band together to form larger, more stable risk pools with negotiating power
  • Improve Americans’ ability to save and pay for healthcare with tax-favored health accounts
    • Eliminate Affordable Care Act restrictions on tax-favored health accounts
    • Enhance tax-favored health accounts to make them more accessible and useful



  • Allow individuals and businesses to keep the health insurance they currently enjoy
    • Relax grandfathered plan regulations
    • Extend the Obama Administration’s transitional plan policy
  • Prevent disruption of markets where individuals and small business owners purchase health insurance
    • Build a stronger market that services business owners and employees who purchase health insurance on their own

NFIB sent a letter to Speaker Ryan in support of H.R. 1101, the Small Business Health Fairness Act, which creates an Association Health Plan option that allows small businesses to band together across state lines to form larger risk pools with increased negotiating power and decreased administrative costs.

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