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There remains a lot of uncertainty as to the specific effects of the ACA on small businesses because of the many delays and exemptions in the rollout process and implantation of the ACA’s mandates and provisions. By extrapolating from the status quo and general trends of the health insurance market, the ACA will most likely not turn out to be the “job-killer” or “enemy of small business” it was predicted to be.
In fact, the head of the CBO Douglas Elmendorf said, “We don’t think that the healthcare law is having a significant impact on the economy today… It would reduce the amount of labor used in the economy by about a half a percent at the end of the decade… but, most of that is people choosing not to work because they can obtain health insurance at an affordable price outside of the workforce” ([http://obamacarefacts.com/obamacare-small-business/)]. John Arensmeyer, founder and CEO of the Small Business Majority, even went so far as to say in in a statement, reported by Fox News, that “The Affordable Care Act tackles small business owners’ top priorities when it comes to health-care reform: cost and accessibility. The law will significantly rein in costs while providing more health coverage options for entrepreneurs.” ([http://obamacarefacts.com/obamacare-small-business/)].
So while there is certainly evidence that the ACA has increased burdens and regulations for small businesses, thus slowing or halted hiring by many small employers - and even cut hours for many employees - there is surely not yet enough evidence to suggest that the ACA and its regulations have or will overwhelmingly devastate the small business economy.
If the ACA is amended and improved, as Democratic Candidate Secretary Clinton plans, we will see hopefully an enhancement of the options for small businesses that wish or are required to provide health care insurance its employees. It would be nearly impossible to predict the exact effects of a rollout from our status quo, if the ACA is revamped into a Medicaid-for-all single-payer tax system like Democratic Candidate Senator Bernie Sanders proposes, aside from tax-based predictions. On the other hand, if it is indeed repealed, as our Republican nominees would prefer - although we might see a return to the slow trend of rising health insurance premiums and would certainly witness a massive increase in the number of uninsured Americans - the economy could possibly recover some of the jobs lost to the ACA. The future of the Presidency and composition of the Congress in the United States will entirely determine the fate of the health insurance market and small businesses, and ultimately the fate of the American economy and way of life.
