Ranking Small Business Resistance Criteria Toward the Affordable Care Act

213 Pages·2017·26.9 MB·English

Walden University
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Walden Dissertations and Doctoral Studies
Walden Dissertations and Doctoral Studies
Collection
2015
Ranking Small Business Resistance Criteria Toward
the Affordable Care Act
Rakesh M K Gupta
Walden University
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Walden University

College of Management and Technology

This is to certify that the doctoral study by

Rakesh Gupta

has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.

Review Committee
Dr. Christos Makrigeorgis, Committee Chairperson, Doctor of Business Administration
Faculty

Dr. Thomas Schaefer, Committee Member, Doctor of Business Administration Faculty

Dr. Steve Roussas, University Reviewer, Doctor of Business Administration Faculty

Chief Academic Officer
Eric Riedel, Ph.D.

Walden University
2015
Abstract

Ranking Small Business Resistance Criteria Toward the Affordable Care Act
by
Rakesh Mike Kumar Gupta

MBA, Strayer University, 2008
Post-Graduate Diploma in Computer Science, Aligarh Muslim University, India, 1974
MSc, Aligarh Muslim University, India, 1970
BSc, Aligarh Muslim University, India, 1968

Doctoral Study Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Business Administration

Walden University
August 2015
Abstract
Following the enactment of the Affordable Care Act (ACA) in 2010, politicians, media,
and lobbyists rendered a number of conflicting and confusing interpretations of its merits
and demerits. Such interpretations intensified the skepticism and concerns of small
business enterprise (SBE) owners. The purpose of this study was to develop a
representative, prioritized list of SBE owners’ concerns or resistance factors. The goal
was to create a useful guide for SBE owners who are seeking ways to reducing the
adverse financial impact of the law. With social choice theory as the theoretical
framework, 50 randomly selected SBE owners across 5 distinct industry groups from
Richmond, Virginia, participated in an online, cross-sectional, pairwise comparison
survey. The overall results of an analytic hierarchy process indicated that the top-ranked
resistance factor of SBE owners was insurance premiums, followed by quality of care and
the tax burden. However, these rankings were not uniform among industry groups. With a
focus on these crucial concerns, SBE owners could benefit by seeking approaches to
reduce the business costs of health care. The implications for positive social change
include the potential for business organizations, researchers, and policymakers to channel
SBE owners’ voice for a socioeconomic growth by addressing their concerns in seeking
improvements from the ACA.
Ranking Small Business Resistance Criteria Toward the Affordable Care Act
by
Rakesh Mike Kumar Gupta

MBA, Strayer University, 2008
Post-Graduate Diploma in Computer Science, Aligarh Muslim University, India, 1974
MSc, Aligarh Muslim University, India, 1970
BSc, Aligarh Muslim University, India, 1968

Doctoral Study Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Business Administration

Walden University
August 2015
Dedication
To those, striving to reach puberty of their soul (Dr. Asha Mishra).
I reached this pinnacle of my life with the strength and support of many. I elicited
inspiration from Sant Kabir Das, Pope Francis, President Barack Obama, President
Nelson Mandela, and Prime Ministers Indira Gandhi and Narendra Modi. My dedication
is for their vision and guiding light of social change.
Acknowledgments
I am thankful to my doctoral committee chaired by Dr. Christos Makrigeorgis and
supported by Dr. Thomas Schaefer and Dr. Steve Roussas. Dr. Makrigeorgis provided
superb leadership, guidance, and expertise throughout the arduous research tasks of the
doctoral study. Dr. Reginald Taylor evaluated the research work as a methodologist. Dr.
Freda Turner, DBA program director, and Walden University staff provided excellent
program support. Al Sabado contributed her proficient editing skills. Dr. Hari Sharma
filled the role of my extreme coach. I acknowledge the support of IAVA led by Dr.
Dhakar; CCI, Pramod Amin and the core team; HCV, Sanjay and Rambabu; and SACVI,
Bhai Sahib. Westend Indies led by Elliott; Tennis Maniacs, Anil; Sargam, Manju dee;
WeSargam, Probodh; and Richmond Strings, Naveen C and Naveen V formed a part of
my support group. I also thank AA, Adish, Neil, Omprakash, Simon, Izak, Marianna,
Aimable, Spence, Saravanan, Debra, Samy, Venkat, Sridhar, Jey, Selva, Mahesh, Ravi,
Sathiya S, Sathiya T, Shekhar, G Venkat, Gopal, Anu, and friends and coworkers at
Federal Reserve Board (FRB). FRB provided the encouragement, support, and academic
assistance, I needed. I sorely miss Loga. I thank Mata Parivar led by the Anands; Mata
Chowki, the Sappals; Golden Boys, Ram; Vaish Samaj, Sanjay; and international group
of friends. My thanks also go to Kannada-, Tamil-, Telugu-, Punjabi-, Sindhi-, Marathi-,
Gujarati-, Bengali-, Malayali-, Hindi-, and Urdu-speaking group of friends. Finally, I
profoundly, profusely, and proudly thank my parents and my family—Usha, Ritija,
Himanshu, and Aparna—for their sacrifices.
Table of Contents
List of Tables ..................................................................................................................... iv
List of Figures .................................................................................................................... vi
Section 1: Foundation of the Study ......................................................................................1
Background of the Problem ...........................................................................................1
Problem Statement .........................................................................................................3
Purpose Statement ..........................................................................................................4
Nature of the Study ........................................................................................................4
Research Question .........................................................................................................6
Hypotheses .....................................................................................................................6
Theoretical Framework ..................................................................................................8
Operational Definitions ..................................................................................................9
Assumptions, Limitations, and Delimitations ..............................................................10
Assumptions .......................................................................................................... 10
Limitations ............................................................................................................ 13
Delimitations ......................................................................................................... 13
Significance of the Study .............................................................................................14
Contribution to Business Practice ......................................................................... 14
Implications for Social Change ............................................................................. 15
A Review of the Professional and Academic Literature ..............................................16
Literature Search Process ...................................................................................... 17
Theme 1: Health Care Reform and the Affordable Care Act ............................... 18
i
Theme 2: Small Business and the Affordable Care Act ....................................... 35
Theme 3: Analytic Hierarchy Process .................................................................. 52
Transition .....................................................................................................................66
Section 2: The Project ........................................................................................................68
Purpose Statement ........................................................................................................68
Role of the Researcher .................................................................................................69
Participants ...................................................................................................................70
Research Method and Design ......................................................................................70
Research Method .................................................................................................. 71
Research Design.................................................................................................... 81
Population and Sampling .............................................................................................86
Ethical Research...........................................................................................................89
Data Collection Instruments ........................................................................................90
Data Collection Technique ..........................................................................................93
Data Analysis .............................................................................................................102
Study Validity ............................................................................................................108
Transition and Summary ............................................................................................109
Section 3: Application to Professional Practice and Implications for Change ................110
Introduction ................................................................................................................110
Presentation of the Findings.......................................................................................111
Analysis of a Sample Response .......................................................................... 114
Synthesis of a Sample Response ......................................................................... 116
ii
Results of Data Analysis ..................................................................................... 117
Discussion of the Findings .................................................................................. 126
Summary ............................................................................................................. 138
Applications to Professional Practice ........................................................................139
Implications for Social Change ..................................................................................139
Recommendations for Action ....................................................................................140
Recommendations for Further Research ....................................................................141
Reflections .................................................................................................................141
Summary and Study Conclusions ..............................................................................142
References ........................................................................................................................144
Appendix A: SBE Owners’ Resistance Survey ...............................................................167
Appendix B: Saaty Permission License ...........................................................................175
Appendix C: Permission Letter from Dr. Goepel ............................................................179
Appendix D: Ishizaka Permission License ......................................................................180
Appendix E: Aull-Hyde Permission License ...................................................................187
Appendix F: Aggregated Local Priorities by Industry Groups ........................................194
Appendix G. Synthesis of Aggregated Priorities by Industry Groups .............................198

iii