Kathie Leonard thinks about the cost—and value—of the health insurance she provides her employees a lot. And the manufacturing CEO says the debate in Washington over whether and how to replace the Affordable Care Act ignores an important perspective—how small businesses would be affected if Congress and the Senate vote to repeal or minimally replace the law. She shares her views in an op-ed published today in the Portland Press Herald, Maine’s most widely circulated newspaper.

Kathie is the CEO of Auburn Manufacturing, Inc., based in Mechanic Falls, a town of 3,000 people in South-Central Maine. The company’s 50 employees make advanced textiles for extreme-heat environments.

For Kathie, offering health care to her employees enables her to hire the best workers and ensure that they are healthy and productive. She argues that eliminating access to expanded Medicare and care at Planned Parenthood would have a negative effect on her business and the overall economy:

“[Slashing Medicaid] would be disastrous for Maine and the nearly 270,000 Mainers who rely on Medicaid (also known as MaineCare). Eliminating expanded Medicaid coverage would also raise premiums for the rest of us, including the health insurance I offer my employees.

“Health care costs operate like a balloon: If you poke a balloon in one place, the air goes somewhere else – it doesn’t go away. The cost of providing care to individuals without insurance doesn’t go away if we eliminate expanded MaineCare. It just goes somewhere else – into our insurance premiums. When more individuals go without health insurance, they get care in the most expensive way possible – at the emergency room.

“Then, that care the hospitals provide without compensation is paid for by the rest of us through increased insurance premiums.

“Second is the proposal to block individuals on Medicaid from going to Planned Parenthood for preventive care. Planned Parenthood plays an outsized role in Maine, and this would undermine access to basic care for the 10,000 Mainers who rely on Planned Parenthood. Eliminating another provider that takes Obamacare plans will just make it harder for all of us to get into the doctor’s office.

“In addition, it would be a drag on our economy. A recent Maine Center for Economic Policy study found that the preventive care, such as birth control and cancer screenings, provided by Planned Parenthood created a net savings of nearly $8 million for the state. That’s both a fiscal and a health savings.”

Yesterday, the Senate narrowly passed a procedural vote to formally debate repealing the Affordable Care Act, but a vote on the actual repeal failed. The legislation exists in various forms, and the Senate will continue its work on the effort over the next few days. Alvin Change at Vox created an informative flow-chart that outlines the various procedural and legislative options the Senate could use.

Business Forward hosted a conference call on Monday to discuss some new proposals to address the challenges of the ACA – to  stabilize the individual marketplace – while leaving the bulk of the law in place. Congressman Kurt Schrader, Co-Chair of the New Democrat Coalition’s Affordable and Accessible Health Care Task Force.

Read Kathie’s op-ed at the Press Herald or below and let us know what you think about repealing the Affordable Care Act.

I’ve been a small-business owner in Maine for more than 35 years. We started out as a two-person operation and now employ about 50 people in two manufacturing plants in Maine. We are successful because of our innovative approach to manufacturing, marketing, administration and employee benefits. (We even built fitness centers in both our plants to improve employee health.)

As a small-business owner, I worry about health care – from researching the right health plans for my employees, to worrying about premium costs, to making sure health care expenses don’t cripple my bottom line. But I take pride in offering coverage to my employees and believe it helps me hire the best people and maintain a productive, stable and healthy workforce.

We haven’t heard much about the business case for access to health insurance. That’s why I think it is important to speak out about the current Senate health care repeal bill.

First, I applaud both Sen. Susan Collins and Sen. Angus King for standing up for people in Maine and opposing the Senate health care bill. It will do more harm than good. While I believe Obamacare requires some changes, it is not what is responsible for increasing health costs.

In her discussions about her position on the Senate bill to repeal or change the Affordable Care Act, Sen. Collins rightly points out two provisions that will take away people’s access to affordable care, especially those who need it the most.

• One is the effort to slash Medicaid. Such a move would be disastrous for Maine and the nearly 270,000 Mainers who rely on Medicaid (also known as MaineCare). Eliminating expanded Medicaid coverage would also raise premiums for the rest of us, including the health insurance I offer my employees.

Health care costs operate like a balloon: If you poke a balloon in one place, the air goes somewhere else – it doesn’t go away. The cost of providing care to individuals without insurance doesn’t go away if we eliminate expanded MaineCare. It just goes somewhere else – into our insurance premiums. When more individuals go without health insurance, they get care in the most expensive way possible – at the emergency room.

Then, that care the hospitals provide without compensation is paid for by the rest of us through increased insurance premiums.

• Second is the proposal to block individuals on Medicaid from going to Planned Parenthood for preventive care. Planned Parenthood plays an outsized role in Maine, and this would undermine access to basic care for the 10,000 Mainers who rely on Planned Parenthood. Eliminating another provider that takes Obamacare plans will just make it harder for all of us to get into the doctor’s office.

In addition, it would be a drag on our economy. A recent Maine Center for Economic Policy study found that the preventive care, such as birth control and cancer screenings, provided by Planned Parenthood created a net savings of nearly $8 million for the state. That’s both a fiscal and a health savings.

It’s true that our health care system needs to be fixed. The solution is not to repeal Obamacare, but to thoughtfully repair it.

As a small-business owner, I approach this problem from the numbers front. Everyone needs to contribute to the pool in order to effectively lower costs. Maybe the pool can have a “deep end” with higher premiums and a “baby end” with lower premiums, but everyone needs to learn to swim.

Obamacare is heading in that direction, giving my employees and me some hope for some relief for the future. It just needs a little fixing. These are the puzzle pieces that we haven’t talked about in the public realm.

However, the current Senate health care repeal bill would be a big U-turn, sending us in the opposite direction.

Sen. Collins said it best when she tweeted: “I want to work w/ my GOP & Dem colleagues to fix the flaws in ACA.” I hope she continues to oppose efforts to eliminate the Affordable Care Act.

The Senate should come together in a bipartisan way to help Maine, small businesses and all of America.