For almost a century, Americans lacked a comprehensive health care system. Upon the passage of the Affordable Care Act (ACA) in 2010, politicians, media, and lobbyists provided conflicting and confusing interpretations of the law. With such varied opinions, small business enterprise (SBE) owners became concerned about the potential adverse financial effects of the ACA. In this paper, we researched the problem by applying the Analytic Hierarchy Process (AHP) to create a ranking of the concerns of the SBE owners toward the ACA. A sample of 50 SBE owners representing 5 specific industry groups in Richmond, Virginia, was used to obtain a cross-sectional view of the concerns which allowed us to ascertain their uniformity or variability across these industry groups. The AHP sample data set was obtained via a pairwise comparison questionnaire. The AHP analysis revealed that the topmost SBE owners concerns were insurance premium, quality of care, and tax burden. In addition, these concerns were non-uniformly ranked among the industry groups. However, the highest and lowest concerns in each industry group were the same across the industry groups.
AHP, Affordable Care Act, small business enterprise owners
Aminbakhsh, S., Gunduz, M., & Sonmez, R. (2013). Safety risk assessment using analytic hierarchy process (AHP) during planning and budgeting of construction projects. Journal of Safety Research, 46, 99â€“105. doi:10.1016/j.jsr.2013.05.003
Aull-Hyde, R., Erdogan, S., & Duke, J. M. (2006). An experiment on the consistency of aggregated comparison matrices in AHP. European Journal of Operational Research, 171, 290â€“295. doi:10.1016/j.ejor.2004.06.037
Bhatt, R., & Macwan, J. E. M. (2012). Global weights of parameters for sustainable buildings from consultantsâ€™ perspectives in Indian context. Journal of Architectural Engineering, 18, 233â€“241. doi:10.1061/(ASCE)AE.1943-5568.0000069
Buchmueller, T., Carey, C., & Levy, H. G. (2013). Will employers drop health insurance coverage because of the affordable care act? Health Affairs, 32, 1522â€“1530. doi:10.1377/hlthaff.2013.0526
Cordell, D. M., & Langdon, T. P. (2011). Health care planning and the new reality. Journal of Financial Planning, 24(1), 38â€“40. Retrieved from http://www.fpanet.org/journal/
Cordell, D. M., & Langdon, T. P. (2012). Financial planning under the Affordable Care Act. Journal of Financial Planning, 25(9), 30â€“31. Retrieved from http://www.fpanet.org/journal/
Curfman, G. D., Abel, B. S., & Landers, R. M. (2012). Supreme Court review of the health care reform law. New England Journal of Medicine, 366, 977â€“979. doi:10.1056/NEJMp1114933
Eyal-Cohen, M. (2013). Downsizing the little guy myth in legal definitions. Iowa Law Review, 98, 1041â€“1099. Retrieved from http://www.uiowa.edu/~ilr/
Gable, L. (2011). The patient protection and affordable care act, public health, and the elusive target of human rights. The Journal of Law, Medicine & Ethics, 39, 340â€“354. doi:10.1111/j.1748-720X.2011.00604.x
Gardner, D. B. (2012). The future of the Affordable Care Act: Will we abandon health care reform? Nursing Economics, 30, 40â€“41, 49. Retrieved from http://www.nursingeconomics.net
Geyman, J. P. (2012). Costâ€sharing under consumerâ€driven health care will not reform US health care. The Journal of Law, Medicine & Ethics, 40, 574â€“581. doi:10.1111/j.1748-720X.2012.00690.x
Goepel, K. D. (2013). Implementing the analytic hierarchy process as a standard method for multi-criteria decision making in corporate enterprises: A new AHP Excel template with multiple inputs. Proceedings of the International Symposium on the Analytic Hierarchy Process 2013, 1â€“10. Retrieved from http://www.isahp.org/proceedings/
Healthcare. (n.d.). What is considered a small business? Retrieved from https://www.healthcare.gov/what-is-considered-a-small-business/
Hellander, I., & Bhargavan, R. (2012). Report from the United States: The U.S. health crisis deepens amid rising inequality: A review of data, fall 2011. International Journal of Health Services, 42, 161â€“175. doi:10.2190/HS.42.2.a
Ishizaka, A., Balkenborg, D., & Kaplan, T. (2011). Does AHP help us make a choice? An experimental evaluation. Journal of the Operational Research Society, 62, 1801â€“1812. doi:10.1057/jors.2010.158
Ishizaka, A., & Labib, A. (2011). Review of the main developments in the analytic hierarchy process. Expert Systems with Applications, 38, 14336â€“14345. doi:10.1016/j.eswa.2011.04.143
Jacobe, D. (2013a). Half of U.S. small businesses think health law bad for them. Gallup Economy. Retrieved from http://www.gallup.com/poll/162386/half-small-businesses-think-health-law-bad.aspx
Jacobe, D. (2013b). Health care costs, taxes worry U.S. small businesses most. Gallup Economy. Retrieved from http://www.gallup.com/poll/160100/health care-costs-taxes-worry-small-businesses.aspx
Kapur, K., Karacaâ€Mandic, P., Gates, S. M., & Fulton, B. (2012). Do smallâ€group health insurance regulations influence small business size? Journal of Risk and Insurance, 79, 231â€“260. doi:10.1111/j.1539-6975.2011.01421.x
Lepard, K. (2013). Standing their ground: Corporationsâ€™ fight for religious rights in light of the enactment of the patient protection and affordable care act contraceptive coverage mandate. Texas Tech Law Review, 45, 1041â€“1071. Retrieved from http://texastechlawreview.org
Litwin, S., & Phan, P. H. (2013). Quality over quantity: Reexamining the link between entrepreneurship and job creation. Industrial & Labor Relations Review, 66, 833â€“873. Retrieved from http://www.ilr.cornell.edu/ilrreview/ doi: 10.1177/001979391306600405
Loewentheil, K. (2014). When free exercise is a burden: Protecting "third parties" in religious accommodation law. Drake Law Review, 62, 433â€“502. Retrieved from http://works.bepress.com/kara_loewentheil/1
McMorrow, S., Blumberg, L. J., & Buettgens, M. (2011). The effects of health reform on small businesses and their workers. The Urban Institute Publications. Retrieved from http://www.urban.org/
Miller, A. R., Eibner, C., & Gresenz, C. R. (2013). Financing of employer sponsored health insurance plans before and after health reform: What consumers donâ€™t know wonâ€™t hurt them? International Review of Law and Economics, 36, 36â€“47. doi:10.1016/j.irle.2013.04.005
Miller, E. (2011). Affordability of health insurance to small business: Implications of the Patient Protection and Affordable Care Act. Journal of Health Politics, Policy & Law, 36, 539â€“546. doi:10.1215/03616878-1271225
Oberlander, J. (2012). Unfinished journey: A century of health care reform in the United States. New England Journal of Medicine, 367, 585â€“590. doi:10.1056/NEJMp1202111
Parks, D. (2011). Health care reform simplified. doi:10.1007/978-1-4302-3699-3
Ramanathan, R. (2001). A note on the use of the analytic hierarchy process for environmental impact assessment. Journal of Environmental Management, 63, 27â€“35. doi:10.1006/jema.2001.0455
Saaty, T. L., & Shang, J. S. (2011). An innovative orders-of-magnitude approach to AHP-based multi-criteria decision making: Prioritizing divergent intangible humane acts. European Journal of Operational Research, 214, 703â€“715. doi:10.1016/j.ejor.2011.05.019
Saaty, T. L., & Vargas, L. G. (2012). The possibility of group choice: Pairwise comparisons and merging functions. Social Choice and Welfare, 38, 481â€“496. doi:10.1007/s00355-011-0541-6
Tacchino, A. (2013a). A new way of thinking about employer-sponsored health care coverage strategies. Journal of Financial Planning, 26(7), 48â€“55. Retrieved from http://www.fpanet.org/Journal
Tacchino, A. (2013b). The Affordable Care Actâ€™s â€˜play or payâ€™ tax: Determining coverage alternatives. Journal of Financial Planning, 26(2), 38â€“42. Retrieved from http://www.fpanet.org/Journal
Talib, F., Rahman, Z., & Qureshi, M. N. (2011). Prioritising the practices of total quality management: An analytic hierarchy process analysis for the service industries. Total Quality Management & Business Excellence, 22, 1331â€“1351. doi:10.1080/14783363.2011.625192
U.S. Department of Health and Human Services. (n.d.). Key features of the Affordable Care Act by year. Retrieved from http://www.hhs.gov
U.S. Small Business Administration. (n.d.). Frequently asked questions. Retrieved from https://www.sba.gov/advocacy/frequently-asked-questions-about-small-business doi: 10.18356/79c110b0-en
Wilensky, G. R. (2012). The shortfalls of â€œObamacare.â€ New England Journal of Medicine, 367, 1479â€“1481. doi:10.1056/NEJMp1210763
Copyright of all articles published in IJAHP is transferred to Creative Decisions Foundation (CDF). However, the author(s) reserve the following:
- All proprietary rights other than copyright, such as patent rights.
- The right to grant or refuse permission to third parties to republish all or part of the article or translations thereof. In case of whole articles, such third parties must obtain permission from CDF as well. However, CDF may grant rights with respect to journal issues as a whole.
- The right to use all or parts of this article in future works of their own, such as lectures, press releases, reviews, textbooks, or reprint books.
- The authors affirm that the article has been neither copyrighted nor published, that it is not being submitted for publication elsewhere, and that if the work is officially sponsored, it has been released for open publication.
The only exception to the statements in the paragraph above is the following: If an article published in IJAHP contains copyrighted material, such as a teaching case, as an appendix, then the copyright (and all commercial rights) of such material remains with the original copyright holder.
CDF will receive permission for publication of copyrighted material in IJAHP. This permission is not transferable to third parties. Permission to make electronic and paper copies of part or all of the articles, including all computer files that are linked to the articles, for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage.
This permission does not apply to previously copyrighted material, such as teaching cases. In paper copies of the article, the copyright notice and the title of the publication and its date should be visible. To copy otherwise is permitted provided that a per-copy fee is paid.
To republish, to post on servers, or redistribute to lists requires that you post a link to the IJAHP article, which is available in open access delivery mode. Do not upload the article itself.
Authors are permitted to present a talk, based on a paper submitted to or accepted by IJAHP, at a conference where the paper would not be published in a copyrighted publication either before or after the conference and where the author did not assign copyright to the conference or related publisher.