Last week, a group of small business owners crashed a major health insurance industry conference in Chicago, demanding to know why the big insurers continue to fight meaningful health care reform in Washington.  These entrepreneurs have good reason to be concerned. Crain's Mike Colias reports today that local insurance brokers estimate many small employers will experience health care premium spikes of  20 percent or more next year. For companies already faced with tight operating margins and hefty health care liabilities, that's an unmanageable jump. Here's Colias' take:

Local companies seeking to protect bottom lines battered by the economy are foisting much of the extra costs onto their workers. Some are mulling over benefit reductions or dropping coverage altogether, which could hurt their ability to keep or hire employees. And rising health care costs are sucking away cash that could be plowed back into the business.

David Borris, the proprietor of Hell's Kitchen Catering in Northbrook who explained his business' health care struggles to the House Ways and Means Committee earlier this year, told Colias that premiums for his 14 workers are scheduled to rise 49 percent next year. As a result, the deductible on their coverage will be larger in 2010 and his workforce will be forced to kick in more of their earnings to cover the $143,000 annual cost, thereby keeping the business afloat. "This is the most helpless feeling you can imagine," Borris adds.

Democrats in Congress are hoping to extend a helping hand by implementing a reform package this year that will assist small businesses substantially. Republican opponents like to characterize it as a job killer, but health care reform as currently written would benefit employers with small payrolls in a few important ways. First, small businesses will have access to the health insurance exchange, which will allow them to compare benefit levels and prices for a variety of competing (and regulated) plans. Both the House and Senate versions would also offer between $2.5 and $2.7 billion per year in tax credits to small businesses to pay for coverage while exempting those with less than 25 workers from the employer mandate or those with less than 50 from the "free-rider" penalty. And because the revenue mechanisms and delivery system reforms would ultimately "bend the curve," premiums will drop over time. Health care economist Jon Gruber estimates that reform could save businesses as much as $855 billion during the next decade, money that will hopefully be redistributed to their workers.  After watching their earnings remain stagnant for most of the past decade, they certainly deserve a boost.