THE_AT ECONOMIC_JJ EFFECTS_NN2 OF_IO HEALTH_NN1 CARE_NN1 REFORM_NN1 ON_II SMALL_JJ BUSINESSES_NN2 AND_CC THEIR_APPGE EMPLOYEES_NN2 Small_JJ businesses_NN2 are_VBR an_AT1 important_JJ driver_NN1 of_IO job_NN1 growth_NN1 and_CC innovation_NN1 in_II the_AT United_NP1 States_NP1 ._. 
Unfortunately_RR ,_, the_AT current_JJ U.S._NP1 health_NN1 care_NN1 system_NN1 does_VDZ not_XX work_VVI well_RR for_IF these_DD2 firms_NN2 or_CC their_APPGE employees_NN2 ._. 
Small_JJ businesses_NN2 pay_VV0 significantly_RR higher_JJR insurance_NN1 premiums_NN2 and_CC ,_, as_II a_AT1 result_NN1 ,_, are_VBR far_RG less_RGR likely_JJ to_TO offer_VVI health_NN1 insurance_NN1 to_II their_APPGE workers_NN2 ._. 
Properly_RR designed_VVN health_NN1 care_NN1 reform_NN1 has_VHZ the_AT potential_JJ to_TO improve_VVI the_AT competitiveness_NN1 of_IO small_JJ businesses_NN2 and_CC the_AT economic_JJ condition_NN1 of_IO workers_NN2 in_II this_DD1 crucial_JJ sector_NN1 of_IO the_AT economy_NN1 ._. 
In_II this_DD1 report_NN1 ,_, the_AT Council_NN1 of_IO Economic_JJ Advisers_NN2 (_( CEA_NP1 )_) examines_VVZ the_AT likely_JJ impact_NN1 of_IO health_NN1 care_NN1 reform_NN1 on_II small_JJ businesses_NN2 and_CC their_APPGE employees_NN2 ._. 
We_PPIS2 begin_VV0 by_II documenting_VVG the_AT key_JJ role_NN1 that_CST small_JJ businesses_NN2 play_VV0 in_II job_NN1 creation_NN1 and_CC the_AT difficulties_NN2 they_PPHS2 face_VV0 in_II the_AT current_JJ health_NN1 insurance_NN1 system_NN1 ._. 
We_PPIS2 conclude_VV0 that_CST small_JJ firms_NN2 are_VBR seriously_RR disadvantaged_JJ relative_II21 to_II22 their_APPGE larger_JJR competitors_NN2 because_II21 of_II22 the_AT higher_JJR premiums_NN2 that_CST they_PPHS2 must_VM pay_VVI to_TO provide_VVI health_NN1 insurance_NN1 for_IF their_APPGE workers_NN2 ._. 
Workers_NN2 in_II small_JJ firms_NN2 are_VBR more_RGR likely_JJ to_TO be_VBI uninsured_JJ or_CC ,_, if_CS their_APPGE employers_NN2 do_VD0 provide_VVI insurance_NN1 ,_, to_TO have_VHI less_DAR generous_JJ policies_NN2 ._. 
One_MC1 way_NN1 that_CST small_JJ businesses_NN2 and_CC their_APPGE workers_NN2 will_VM benefit_VVI from_II health_NN1 care_NN1 reform_NN1 is_VBZ that_CST it_PPH1 will_VM improve_VVI the_AT overall_JJ performance_NN1 of_IO the_AT economy_NN1 ._. 
For_IF this_DD1 reason_NN1 ,_, we_PPIS2 review_VV0 the_AT evidence_NN1 that_CST health_NN1 care_NN1 reform_NN1 that_CST slows_VVZ the_AT growth_NN1 rate_NN1 of_IO costs_NN2 and_CC expands_VVZ health_NN1 insurance_NN1 coverage_NN1 will_VM improve_VVI living_NN1 standards_NN2 and_CC take-home_JJ pay_NN1 for_IF families_NN2 ,_, prevent_VV0 unsustainable_JJ increases_NN2 in_II the_AT budget_NN1 deficit_NN1 ,_, and_CC improve_VV0 the_AT efficiency_NN1 of_IO the_AT labor_NN1 market_NN1 ._. 
We_PPIS2 then_RT examine_VV0 the_AT effects_NN2 of_IO health_NN1 care_NN1 reform_NN1 on_II small_JJ firms_NN2 in_RR21 particular_RR22 ._. 
We_PPIS2 find_VV0 that_CST the_AT proposed_JJ legislation_NN1 currently_RR under_II consideration_NN1 in_II the_AT House_NN1 and_CC Senate_NN1 is_VBZ likely_JJ to_TO help_VVI small_JJ businesses_NN2 be_VBI more_RGR competitive_JJ in_II the_AT American_JJ marketplace_NN1 and_CC improve_VV0 the_AT standard_NN1 of_IO living_NN1 of_IO workers_NN2 in_II small_JJ firms_NN2 ._. 
Small_JJ businesses_NN2 play_VV0 an_AT1 important_JJ role_NN1 in_II the_AT U.S._NP1 economy_NN1 ._. 
Two_MC common_JJ measures_NN2 of_IO the_AT size_NN1 of_IO a_AT1 firm_NN1 are_VBR its_APPGE number_NN1 of_IO employees_NN2 and_CC its_APPGE annual_JJ payroll_NN1 ._. 
By_II either_DD1 measure_NN1 ,_, the_AT vast_JJ majority_NN1 of_IO firms_NN2 in_II the_AT United_NP1 States_NP1 are_VBR small_JJ ,_, and_CC these_DD2 firms_NN2 account_VV0 for_IF a_AT1 substantial_JJ share_NN1 of_IO private_JJ sector_NN1 employment_NN1 ._. 
Figure_NN1 1a_FO shows_VVZ that_CST ,_, measured_VVN by_II employment_NN1 ,_, 89_MC percent_NNU of_IO firms_NN2 had_VHD fewer_DAR than_CSN 20_MC employees_NN2 in_II 2006_MC ,_, and_CC these_DD2 same_DA firms_NN2 accounted_VVN for_IF 18_MC percent_NNU of_IO private_JJ sector_NN1 employment_NN1 ._. 
Similarly_RR ,_, those_DD2 with_IW fewer_DAR than_CSN 50_MC employees_NN2 accounted_VVN for_IF 96_MC percent_NNU of_IO all_DB firms_NN2 and_CC 28_MC percent_NNU of_IO private_JJ sector_NN1 employment_NN1 ._. 
Even_RR firms_NN2 with_IW fewer_DAR than_CSN 10_MC employees_NN2 accounted_VVN for_IF more_DAR than_CSN 3_MC out_II21 of_II22 every_AT1 4_MC firms_NN2 in_II the_AT United_NP1 States_NP1 ._. 
A_AT1 similar_JJ pattern_NN1 emerges_VVZ if_CS one_PN1 defines_VVZ firms_NN2 by_II total_JJ payroll_NN1 rather_II21 than_II22 by_II number_NN1 of_IO employees_NN2 ._. 
As_CSA shown_VVN in_II Figure_NN1 1b_FO ,_, 87_MC percent_NNU of_IO firms_NN2 had_VHD an_AT1 annual_JJ payroll_NN1 of_IO less_DAR than_CSN $500,000_NNU in_II 2006_MC ,_, and_CC these_DD2 firms_NN2 accounted_VVN for_IF 19_MC percent_NNU of_IO private_JJ sector_NN1 employment_NN1 ._. 
The_AT figure_NN1 also_RR lists_VVZ the_AT corresponding_JJ shares_NN2 for_IF firms_NN2 with_IW payrolls_NN2 of_IO less_DAR than_CSN $250,000_NNU and_CC less_DAR than_CSN $1_NNU million_NNO ._. 
In_II31 addition_II32 to_II33 being_VBG a_AT1 substantial_JJ source_NN1 of_IO existing_JJ jobs_NN2 ,_, small_JJ businesses_NN2 account_VV0 for_IF a_AT1 disproportionate_JJ share_NN1 of_IO employment_NN1 growth_NN1 ._. 
Firms_NN2 with_IW fewer_DAR than_CSN 20_MC employees_NN2 accounted_VVN for_IF 25_MC percent_NNU of_IO net_JJ employment_NN1 growth_NN1 from_II 1992_MC to_II 2005_MC ._. 
Comparing_VVG this_DD1 with_IW their_APPGE average_JJ share_NN1 of_IO all_DB private_JJ sector_NN1 employment_NN1 during_II this_DD1 same_DA period_NN1 (_( which_DDQ was_VBDZ 19_MC percent_NNU )_) ,_, the_AT rate_NN1 of_IO net_JJ job_NN1 creation_NN1 per_II worker_NN1 in_II firms_NN2 with_IW fewer_DAR than_CSN 20_MC employees_NN2 was_VBDZ 40_MC percent_NNU greater_JJR than_CSN the_AT corresponding_JJ rate_NN1 for_IF all_DB other_JJ firms_NN2 ._. 
Furthermore_RR ,_, the_AT vast_JJ majority_NN1 of_IO new_JJ firms_NN2 ,_, which_DDQ are_VBR a_AT1 critical_JJ source_NN1 of_IO innovation_NN1 and_CC growth_NN1 in_II our_APPGE economy_NN1 ,_, begin_VV0 as_RG small_JJ businesses_NN2 ._. 
Indeed_RR ,_, despite_II their_APPGE size_NN1 ,_, these_DD2 small_JJ businesses_NN2 account_VV0 for_IF a_AT1 substantial_JJ majority_NN1 of_IO jobs_NN2 in_II start-ups_NN2 ._. 
Table_NN1 1_MC1 compares_VVZ the_AT industrial_JJ composition_NN1 of_IO businesses_NN2 by_II size_NN1 ,_, and_CC illustrates_VVZ that_CST small_JJ businesses_NN2 have_VH0 a_AT1 significant_JJ presence_NN1 in_II a_AT1 wide_JJ variety_NN1 of_IO industries_NN2 ._. 
Not_XX surprisingly_RR ,_, small_JJ businesses_NN2 are_VBR somewhat_RR disproportionately_RR located_VVN in_II service_NN1 industries_NN2 ._. 
They_PPHS2 are_VBR ,_, however_RR ,_, widely_RR distributed_VVN within_II the_AT service_NN1 sector_NN1 --_NN1 ranging_VVG from_II accommodations_NN2 and_CC food_NN1 services_NN2 to_II professional_JJ ,_, scientific_JJ ,_, and_CC technical_JJ services_NN2 ._. 
Small_JJ businesses_NN2 also_RR tend_VV0 to_TO be_VBI disproportionately_RR located_VVN in_II construction_NN1 :_: 12_MC percent_NNU of_IO small_JJ firm_JJ employment_NN1 is_VBZ in_II construction_NN1 ,_, compared_VVN with_IW only_RR 5_MC percent_NNU of_IO firms_NN2 with_IW 20_MC or_CC more_DAR workers_NN2 ._. 
The_AT strong_JJ presence_NN1 of_IO small_JJ firms_NN2 throughout_II all_DB industries_NN2 reinforces_VVZ the_AT importance_NN1 of_IO crafting_VVG health_NN1 care_NN1 reform_NN1 that_CST supports_VVZ the_AT unique_JJ needs_NN2 of_IO the_AT small_JJ business_NN1 community_NN1 ._. 
The_AT current_JJ U.S._NP1 health_NN1 care_NN1 system_NN1 is_VBZ not_XX working_VVG well_RR for_IF small_JJ businesses_NN2 ._. 
Most_RGT obviously_RR ,_, small_JJ businesses_NN2 pay_VV0 substantially_RR more_RRR to_TO provide_VVI insurance_NN1 for_IF their_APPGE workers_NN2 ._. 
On_II average_NN1 ,_, small_JJ businesses_NN2 pay_VV0 up_RG21 to_RG22 18_MC percent_NNU more_DAR than_CSN large_JJ firms_NN2 for_IF the_AT same_DA health_NN1 insurance_NN1 policy_NN1 ._. 
There_EX are_VBR three_MC primary_JJ reasons_NN2 for_IF this_DD1 difference_NN1 ._. 
First_MD ,_, small_JJ businesses_NN2 generally_RR pay_VV0 high_JJ broker_NN1 fees_NN2 for_IF their_APPGE policies_NN2 ;_; these_DD2 fees_NN2 typically_RR range_VV0 from_II 2_MC to_II 8_MC percent_NNU of_IO premiums_NN2 ,_, and_CC in_II some_DD cases_NN2 may_VM be_VBI up_RG21 to_RG22 10_MC percent_NNU ._. 
Such_DA commissions_NN2 are_VBR on_II average_JJ greater_JJR than_CSN those_DD2 paid_VVN by_II larger_JJR employers_NN2 ._. 
Second_MD ,_, the_AT fixed_JJ costs_NN2 to_II a_AT1 private_JJ insurer_NN1 of_IO setting_VVG up_RP and_CC administering_VVG a_AT1 firm_NN1 's_GE health_NN1 insurance_NN1 policy_NN1 can_VM be_VBI spread_VVN over_II many_DA2 more_DAR employees_NN2 in_II large_JJ firms_NN2 ,_, and_CC thus_RR administrative_JJ costs_NN2 per_II covered_JJ individual_NN1 are_VBR up_RG21 to_RG22 three_MC times_NNT2 higher_JJR for_IF small_JJ firms_NN2 ._. 
Finally_RR ,_, small_JJ firms_NN2 pay_VV0 an_AT1 additional_JJ amount_NN1 per_II covered_JJ individual_NN1 because_II21 of_II22 the_AT phenomenon_NN1 of_IO "_" adverse_JJ selection_NN1 ._. "_" 
Private_JJ insurers_NN2 know_VV0 that_CST ,_, among_II small_JJ firms_NN2 ,_, those_DD2 with_IW workers_NN2 who_PNQS have_VH0 high_JJ health_NN1 care_NN1 needs_NN2 are_VBR more_RGR likely_JJ to_TO seek_VVI insurance_NN1 ,_, which_DDQ raises_VVZ rates_NN2 for_IF other_JJ small_JJ businesses_NN2 and_CC prices_NN2 many_DA2 firms_NN2 out_II21 of_II22 the_AT market_NN1 ._. 
Largely_RR due_II21 to_II22 the_AT higher_JJR costs_NN2 they_PPHS2 face_VV0 ,_, small_JJ businesses_NN2 are_VBR far_RG less_RGR likely_JJ than_CSN large_JJ businesses_NN2 to_TO provide_VVI health_NN1 insurance_NN1 for_IF their_APPGE workers_NN2 ._. 
Figure_NN1 2_MC shows_VVZ the_AT fraction_NN1 of_IO firms_NN2 providing_VVG health_NN1 insurance_NN1 by_II firm_JJ size_NN1 ._. 
Just_RR 49_MC percent_NNU of_IO firms_NN2 with_IW 3_MC to_II 9_MC workers_NN2 and_CC 78_MC percent_NNU of_IO firms_NN2 with_IW 10_MC to_II 24_MC workers_NN2 offered_VVD health_NN1 insurance_NN1 to_II their_APPGE employees_NN2 in_II 2008_MC ,_, compared_VVN with_IW 99_MC percent_NNU of_IO firms_NN2 with_IW 200_MC or_CC more_DAR employees_NN2 in_II the_AT same_DA year_NNT1 ._. 
Approximately_RR half_DB of_IO firms_NN2 with_IW fewer_DAR than_CSN 200_MC employees_NN2 not_XX offering_VVG health_NN1 insurance_NN1 cite_VV0 high_JJ premiums_NN2 as_II the_AT most_RGT important_JJ reason_NN1 for_IF not_XX doing_VDG so_RR ._. 
The_AT fraction_NN1 of_IO small_JJ firms_NN2 offering_VVG health_NN1 insurance_NN1 to_II their_APPGE employees_NN2 has_VHZ also_RR been_VBN declining_VVG in_II recent_JJ years_NNT2 ._. 
From_II 2002_MC to_II 2008_MC ,_, the_AT fraction_NN1 of_IO firms_NN2 with_IW 3_MC to_II 9_MC workers_NN2 offering_VVG health_NN1 insurance_NN1 declined_VVN from_II 58_MC percent_NNU to_II 49_MC percent_NNU ._. 
Health_NN1 insurance_NN1 offer_NN1 rates_NN2 also_RR vary_VV0 substantially_RR with_IW the_AT average_JJ wages_NN2 of_IO employees_NN2 ._. 
For_REX21 example_REX22 ,_, among_II establishments_NN2 with_IW 10_MC to_II 24_MC employees_NN2 in_II 2006_MC ,_, 76_MC percent_NNU of_IO those_DD2 paying_VVG an_AT1 average_JJ hourly_JJ wage_NN1 over_RG $10.50_NNU offered_JJ health_NN1 insurance_NN1 ,_, versus_II just_RR 34_MC percent_NNU of_IO those_DD2 paying_VVG an_AT1 average_JJ hourly_JJ wage_NN1 below_RG $10.50_NNU ._. 
Because_CS offer_NN1 rates_NN2 are_VBR so_RG much_DA1 lower_JJR at_II small_JJ firms_NN2 ,_, workers_NN2 in_II small_JJ firms_NN2 are_VBR significantly_RR more_RGR likely_JJ to_TO be_VBI uninsured_JJ than_CSN their_APPGE counterparts_NN2 at_II larger_JJR firms_NN2 ._. 
Specifically_RR ,_, 29_MC percent_NNU of_IO non-elderly_JJ adult_NN1 workers_NN2 in_II firms_NN2 with_IW fewer_DAR than_CSN 25_MC employees_NN2 were_VBDR uninsured_JJ in_II 2007_MC ,_, versus_II just_RR 10_MC percent_NNU of_IO non-elderly_JJ adult_NN1 workers_NN2 in_II firms_NN2 with_IW 500_MC or_CC more_DAR employees_NN2 ._. 
For_IF those_DD2 small_JJ firms_NN2 that_CST do_VD0 offer_VVI coverage_NN1 ,_, the_AT generosity_NN1 of_IO coverage_NN1 is_VBZ much_RR lower_JJR than_CSN in_II large_JJ firms_NN2 ._. 
As_CSA Figure_NN1 3_MC shows_NN2 ,_, workers_NN2 in_II small_JJ firms_NN2 have_VH0 higher_JJR deductibles_NN2 than_CSN workers_NN2 at_II large_JJ firms_NN2 ,_, and_CC the_AT difference_NN1 has_VHZ been_VBN growing_VVG over_II time_NNT1 ._. 
Workers_NN2 in_II small_JJ firms_NN2 are_VBR also_RR less_RGR likely_JJ to_TO have_VHI a_AT1 choice_NN1 of_IO plan_NN1 and_CC tend_VV0 to_TO have_VHI less_DAR generous_JJ coverage_NN1 for_IF numerous_JJ services_NN2 ._. 
This_DD1 difference_NN1 in_II plan_NN1 generosity_NN1 is_VBZ the_AT predictable_JJ response_NN1 to_II the_AT higher_JJR price_NN1 that_CST small_JJ firms_NN2 must_VM pay_VVI for_IF any_DD given_JJ level_NN1 of_IO coverage_NN1 ._. 
Put_VV0 simply_RR ,_, the_AT current_JJ U.S._NP1 health_NN1 care_NN1 system_NN1 imposes_VVZ a_AT1 heavy_JJ tax_NN1 on_II small_JJ businesses_NN2 and_CC their_APPGE employees_NN2 ._. 
Those_DD2 small_JJ firms_NN2 that_CST do_VD0 offer_VVI coverage_NN1 have_VH0 to_TO pay_VVI a_AT1 higher_JJR cost_NN1 than_CSN their_APPGE larger_JJR competitors_NN2 ._. 
To_II the_AT degree_NN1 that_CST higher_JJR costs_NN2 are_VBR passed_VVN on_II21 to_II22 workers_NN2 ,_, small_JJ firms_NN2 pay_VV0 lower_JJR take-home_JJ wages_NN2 to_II their_APPGE employees_NN2 ._. 
Those_DD2 small_JJ firms_NN2 that_CST do_VD0 not_XX offer_VVI coverage_NN1 have_VH0 employees_NN2 who_PNQS do_VD0 not_XX receive_VVI the_AT substantial_JJ tax_NN1 benefits_NN2 of_IO employer-provided_JJ health_NN1 insurance_NN1 that_CST their_APPGE counterparts_NN2 at_II large_JJ firms_NN2 enjoy_VV0 ._. 
These_DD2 employees_NN2 are_VBR more_RGR likely_JJ to_TO purchase_VVI policies_NN2 in_II the_AT individual_JJ market_NN1 ,_, where_CS they_PPHS2 pay_VV0 much_RR higher_JJR rates_NN2 ._. 
In_II either_DD1 case_NN1 ,_, small_JJ firms_NN2 are_VBR likely_JJ to_TO be_VBI at_II a_AT1 competitive_JJ disadvantage_NN1 in_II the_AT market_NN1 for_IF hiring_VVG workers_NN2 ._. 
Small_JJ firms_NN2 are_VBR likely_JJ to_TO have_VHI a_AT1 more_RGR difficult_JJ time_NNT1 than_CSN larger_JJR firms_NN2 recruiting_VVG potential_JJ employees_NN2 who_PNQS do_VD0 not_XX have_VHI health_NN1 insurance_NN1 from_II another_DD1 source_NN1 ._. 
Even_CS21 if_CS22 a_AT1 small_JJ firm_NN1 provides_VVZ the_AT best_JJT fit_JJ for_IF a_AT1 worker_NN1 's_GE skills_NN2 and_CC interests_NN2 ,_, the_AT individual_NN1 may_VM choose_VVI not_XX to_TO work_VVI there_RL given_VVN the_AT implicit_JJ tax_NN1 ._. 
To_II the_AT degree_NN1 that_CST small_JJ firms_NN2 providing_VVG health_NN1 insurance_NN1 can_VM not_XX pass_VVI on_RP the_AT costs_NN2 to_II workers_NN2 ,_, the_AT firms_NN2 will_VM earn_VVI lower_JJR profits_NN2 and_CC be_VBI at_II a_AT1 competitive_JJ disadvantage_NN1 relative_II21 to_II22 large_JJ firms_NN2 in_II the_AT markets_NN2 for_IF their_APPGE products_NN2 ._. 
A_AT1 recent_JJ study_NN1 by_II the_AT Small_JJ Business_NN1 Majority_NN1 concludes_VVZ that_CST small_JJ business_NN1 profits_NN2 will_VM shrink_VVI over_II time_NNT1 because_II21 of_II22 rising_VVG health_NN1 care_NN1 costs_VVZ that_CST firms_NN2 can_VM not_XX fully_RR pass_VVI on_RP to_II workers_NN2 ._. 
Figure_NN1 4_MC reproduces_VVZ the_AT study_NN1 's_GE estimates_NN2 of_IO small_JJ business_NN1 profits_NN2 lost_VVN per_II year_NNT1 due_II21 to_II22 rising_VVG health_NN1 care_NN1 costs_VVZ without_IW reform_NN1 ._. 
In_II31 light_II32 of_II33 these_DD2 findings_NN2 ,_, it_PPH1 is_VBZ perhaps_RR not_XX surprising_JJ that_CST recent_JJ surveys_NN2 of_IO small_JJ business_NN1 owners_NN2 have_VH0 found_VVN widespread_JJ support_NN1 for_IF health_NN1 care_NN1 reform_NN1 that_CST reduces_VVZ health_NN1 care_NN1 costs_NN2 ._. 
At_II the_AT most_RGT fundamental_JJ level_NN1 ,_, health_NN1 care_NN1 reform_NN1 will_VM benefit_VVI small_JJ businesses_NN2 and_CC their_APPGE employees_NN2 in_II the_AT same_DA way_NN1 that_CST it_PPH1 helps_VVZ all_DB American_JJ firms_NN2 and_CC households_NN2 ._. 
By_II slowing_VVG the_AT growth_NN1 rate_NN1 of_IO costs_NN2 and_CC expanding_JJ coverage_NN1 ,_, it_PPH1 will_VM raise_VVI living_NN1 standards_NN2 ,_, spur_VV0 economic_JJ growth_NN1 ,_, help_VV0 tame_VVI the_AT budget_NN1 deficit_NN1 ,_, and_CC improve_VV0 the_AT efficiency_NN1 of_IO the_AT labor_NN1 market_NN1 ._. 
These_DD2 effects_NN2 will_VM be_VBI felt_VVN throughout_II the_AT economy_NN1 and_CC will_VM help_VVI all_DB businesses_NN2 thrive_VV0 ._. 
Therefore_RR ,_, before_II detailing_VVG the_AT ways_NN2 that_CST reform_NN1 will_VM particularly_RR ease_VVI the_AT burden_NN1 on_II small_JJ businesses_NN2 ,_, it_PPH1 is_VBZ useful_JJ to_TO summarize_VVI the_AT overall_JJ economic_JJ benefits_NN2 of_IO reform_NN1 ._. 
In_II a_AT1 report_NN1 issued_VVN in_II June_NPM1 2009_MC ,_, the_AT CEA_NN1 provided_CS projections_NN2 of_IO health_NN1 care_NN1 expenditures_NN2 ,_, insurance_NN1 premiums_NN2 ,_, and_CC other_JJ key_JJ variables_NN2 if_CS current_JJ trends_NN2 in_II the_AT health_NN1 care_NN1 sector_NN1 continue_VV0 ._. 
In_II the_AT absence_NN1 of_IO reform_NN1 ,_, we_PPIS2 found_VVD that_DD1 health_NN1 care_NN1 expenditures_NN2 would_VM likely_RR rise_VVI from_II their_APPGE current_JJ level_NN1 of_IO 18_MC percent_NNU of_IO GDP_NN1 to_II 28_MC percent_NNU in_II 2030_MC and_CC 34_MC percent_NNU in_II 2040_MC ._. 
For_IF families_NN2 ,_, this_DD1 trend_NN1 would_VM show_VVI up_RP in_II steeply_RR rising_VVG insurance_NN1 premiums_NN2 and_CC stagnating_VVG take-home_JJ wages_NN2 ._. 
Figure_NN1 5_MC shows_VVZ our_APPGE projections_NN2 of_IO total_JJ compensation_NN1 and_CC compensation_NN1 net_NN1 of_IO health_NN1 insurance_NN1 ._. 
Without_IW reform_NN1 ,_, essentially_RR all_DB of_IO the_AT rise_NN1 in_II average_JJ compensation_NN1 due_II21 to_II22 increasing_JJ productivity_NN1 over_II time_NNT1 would_VM go_VVI to_II health_NN1 insurance_NN1 ,_, and_CC essentially_RR none_PN would_VM go_VVI to_II take-home_JJ wages_NN2 ._. 
For_IF the_AT government_NN1 ,_, rising_VVG health_NN1 care_NN1 costs_NN2 would_VM show_VVI up_RP in_II steeply_RR rising_VVG Medicare_NP1 and_CC Medicaid_NP1 spending_NN1 and_CC unsustainable_JJ increases_NN2 in_II the_AT budget_NN1 deficit_NN1 ._. 
Finally_RR ,_, we_PPIS2 projected_VVD that_CST the_AT number_NN1 of_IO uninsured_JJ people_NN in_II the_AT United_NP1 States_NP1 would_VM rise_VVI from_II 46_MC million_NNO in_II 2007_MC to_II 72_MC million_NNO in_II 2040_MC ._. 
The_AT CEA_NN1 report_NN1 showed_VVD that_CST successful_JJ reform_NN1 that_CST genuinely_RR slows_VVZ the_AT growth_NN1 rate_NN1 of_IO health_NN1 care_NN1 costs_NN2 would_VM have_VHI tremendous_JJ benefits_NN2 for_IF American_JJ workers_NN2 ,_, businesses_NN2 ,_, and_CC the_AT government_NN1 ._. 
Figure_NN1 6_MC shows_VVZ our_APPGE estimates_NN2 of_IO the_AT impact_NN1 of_IO slowing_VVG the_AT annual_JJ growth_NN1 rate_NN1 of_IO health_NN1 care_NN1 costs_VVZ by_II different_JJ amounts_NN2 on_II median_JJ income_NN1 for_IF a_AT1 typical_JJ family_NN1 of_IO four_MC over_II time_NNT1 ._. 
We_PPIS2 found_VVD that_CST reducing_VVG the_AT growth_NN1 rate_NN1 of_IO health_NN1 care_NN1 costs_VVZ by_II 1.5_MC percentage_NN1 points_NN2 per_II year_NNT1 would_VM raise_VVI family_NN1 income_NN1 relative_II21 to_II22 what_DDQ it_PPH1 otherwise_RR would_VM have_VHI been_VBN by_II nearly_RR $2,600_NNU in_II 2020_MC and_CC by_II almost_RR $10,000_NNU in_II 2030_MC ._. 
Figure_NN1 7_MC shows_VVZ our_APPGE estimates_NN2 of_IO the_AT effects_NN2 of_IO slowing_VVG the_AT growth_NN1 rate_NN1 of_IO health_NN1 care_NN1 costs_VVZ on_II the_AT budget_NN1 deficit_NN1 ._. 
Reducing_VVG the_AT growth_NN1 rate_NN1 of_IO costs_NN2 by_II 1.5_MC percentage_NN1 points_NN2 per_II year_NNT1 would_VM reduce_VVI the_AT government_NN1 budget_NN1 deficit_NN1 relative_II21 to_II22 what_DDQ it_PPH1 otherwise_RR would_VM have_VHI been_VBN by_II roughly_RR 3_MC percent_NNU of_IO GDP_NN1 in_II 2030_MC and_CC 6_MC percent_NNU of_IO GDP_NN1 in_II 2040_MC ._. 
