Maryland auto shop owner Brian England offers health care coverage to his 18 employees, including part-time staff. He calls it "the right thing to do," and besides, he knows taking care of his employees makes good business sense.
But every year his insurance premium costs rise another 10 or 20 percent, and England worries about the day when the fees will overwhelm him. After payroll and rent, health care is his largest business expense.
"A business down the road could have their labor rate $5 cheaper than us because that's how much it costs for us to provide health care," England said, referring to the hourly rates his business and competitors might offer customers.