As the “final” extension on individual open enrollment closes, there is an opportunity to formulate preliminary evaluations of how Obamacare is – or is not – making a difference for Americans when it comes to health care insurance and costs. While final numbers won’t be available until late spring, the preliminary tally can provide a fairly close assessment. First, let’s look at the impact of Obamacare on individuals. According to the Department of Health and Human Services, the exchanges have enrolled more than 8.1 million people, including nearly 800,000, and climbing, in California. The 8.1 million people include up to 6 million individuals that lost their coverage when their plans were canceled and who needed to re-enroll in an Obamacare compliant plan. The majority of enrollees are choosing silver plans (63 percent), which provide premium subsidies. The number of young and healthy enrollees remains at about 25 percent of total enrollment despite the fact that this group represents about 40 percent of the uninsured. A recent survey by consulting firm McKinsey & Co. found affordability to be a primary concern of 50 percent of individuals who had not enrolled. Without significant subsidies, premiums under the law are significantly higher than what was offered in the individual market before, and the lower-cost penalty for the first year is not proving to be much of an incentive among this group of the population. The skewed adoption rates underscore the need for changes. To attract younger Americans, Obamacare must be less expensive and burdensome, especially for those who do not qualify for subsidies. Adding more plan options, decreasing minimum benefits and lowering the actuarial values are three areas that could go a long way in making Obamacare more attractive to younger Americans. An estimated 18 million to 24 million people in the United States have insurance through employers with fewer than 50 workers, and about 40 million have coverage through firms with fewer than 100 workers. Already, for small businesses, Obamacare has signaled a rise in health care costs and higher premiums for employees. In addition, industry analysts, insurers and state regulators are anticipating a new spate of policy cancellations from insurance companies by the end of 2014 that could affect millions of people who receive insurance through small employers. While some of these are necessary because the policies don’t meet the law’s basic coverage requirements, many are moves by insurance companies who are trying to maximize profits by offsetting the financial and administrative risks associated with the health care overhaul. To review, the Obamacare employer mandate requires small businesses with more than 100 full-time equivalent employees to provide health coverage to full-time employees beginning in 2015. Starting in 2016, employers with 50 to 99 full-time equivalent employees will have to insure their full-time workforce as well. Beginning in 2015, any business that is supposed to insure its full-time workers but does not will have to make a $2,000 shared responsibility payment – read penalty – for all employees after the first 30 employees. That fee is $3,000 if the employee gets health insurance subsidies through the marketplace because the employer did not either offer compliant coverage or the cost of coverage was over 9.5 percent of the employee’s income. So, what are the positive implications for small businesses? Obamacare provides small businesses with health insurance options and increased buying power via the Small Business Health Options Program, or SHOP exchange. Because small businesses can shop for group health plans through Covered California via the SHOP, they will have, in theory, the same buying power as larger firms. Along with tax credits, increased buying power helps small businesses afford to provide benefits to their employees. The same plans offered via the SHOP are also offered outside Covered California at the same price so the only reason a small business would go to the SHOP is for the small business tax credit. In addition, small businesses with fewer than 25 full-time equivalent employees with average annual wages below $50,000 can get tax credits, adjusted for inflation, to help pay for employee premiums. The key words here are “tax credits,” which means if the small business does not have profits or large enough profits there is no small business tax credit. Most companies have found that taking the full deduction for health insurance as an expense is a better financial move. Unfortunately, in anticipation of changes and astronomically increasing premiums from insurance companies, many small businesses are cutting employee hours, passing on costs to consumers and shareholders, and reducing their expenses by eliminating spending and postponing hiring initiatives. The true test of the cost of health care reform for small businesses will be seen in 2015 and 2016 since 70 percent to 90 percent of small businesses took advantage of early renewal on Dec.1 and do not have to deal with the issue until next December. Until then, the fear, uncertainty and doubt that abounds will continue to have a negative impact on how companies manage, staff and run their businesses. Barry Cohn is founder and chief executive of RGEB Really Great Employee Benefits, a group insurance and employee benefits firm in Canoga Park. – How to reach us Guest Opinions: Op-ed pieces must be 700 to 800 words and on topics about the San Fernando Valley business community. 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