Even though it's been three years since President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law, most small business owners say they still don't get how the law affects them.

The majority incorrectly believe health reform requires them to provide health insurance for employees in 2014, or that they'll be taxed if they don't offer health insurance next year, according to a new survey by eHealth, the parent company of eHealthInsurance.

The survey of 259 small business owners shows that awareness has improved slightly since last year, but 56% still misunderstand the employee mandate (down from 69% of survey respondents who misunderstood the mandate when eHealth conducted a parallel survey in August).

Beginning next January, PPACA requires businesses with 50 or more full-time employees to offer their employees health insurance or pay additional taxes. The rule doesn't apply to businesses with less than 50 employees.

Another point of confusion among small business owners are exchanges.

The survey reveals that only 18% of small employers believe they can confidently define or explain what a health insurance exchange is. Nearly two-thirds (62%) admit to not understanding exchanges at all, while 20% say they have only a vague understanding of the role exchanges are expected to play.

The majority also say they don't want to be forced to buy health insurance through any single source, whether through a government exchange or a private exchange. Most (71%) say they want the option to buy their health coverage through the source of their choice.

The survey also found that nearly a third of small businesses (27%) will consider dropping coverage for their employees in 2014. The majority, at 67%, say they don't have plans to do so, while 6% say they plan to stop offering coverage.

As for what impact they think reform will have on health insurance costs, 59% expect costs to go up. Just 11% expect costs to decrease, while 21% aren't sure.

Most small employers say they may turn to brokers and agents for help understanding reform as 72% say they most trust them as information sources. Others say they will turn to small business associations, insurance companies and government agencies for help.

This article was originally posted at LifeHealthPro.com, a sister site of Credit Union Times.

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