While most parts of a sweeping national health care reform won’t take effect until 2014, the government is giving small businesses incentives this year to get people on the insurance rolls.

Many employers are already taking advantage of a tax credit they can get for 2010 if they offer their employees insurance, according to small business advocates.

The employers have to have fewer than 25 full-time employees with annual salaries of less than $50,000 to qualify. They also must contribute at least 50 percent of each employee’s premium.

The smallest businesses often struggle the hardest to offer their employees health insurance — even if they’d like to. In Maryland, just 56 percent of firms with fewer than 50 employees offer workers health benefits, according to the Kaiser Family Foundation.

The subject was part of the discussion during a health care forum held last week at Johns Hopkins University. Among the representatives fielding questions was the group Small Business Majority, which advocates for firms with fewer than 100 employees.

"Small businesses want their workers to have health insurance," said Terry Gardiner, national policy director for Small Business Majority. "They just have to be able to afford to do it."

The tax credit for small businesses is one of the first pieces of the reform law to take effect. The credit is offered on a sliding scale basis of up to 35 percent of the employer’s eligible premium expenses through 2013. The credit will be taken on the annual tax return.

Small Business Majority has a nifty tax credit calculator on their website: http://smallbusinessmajority.org/tax-credit-calculator/

After 2014, the maximum credit increases to 50 percent of premium expenses, but coverage must be purchased from state health insurance exchanges.

Small businesses will pool their buying power in these exchanges to negotiate better rates. Right now small businesses pay premiums that on average are 18 percent higher than large businesses, and the smaller firms pay administrative costs built into their health plans that can be three to four times as much, according to the Small Business Administration. All because they don't have enough clout with insurers.

Nearly 13 percent of workers at U.S. firms with fewer than 10 employees paid annual premiums of $7,200 or more for coverage for a single person in 2008, according to the Agency for Healthcare Research and Quality. The national average was about $4,700.

The new law also will prohibit insurers from charging higher rates to small businesses with sick employees or raising rates when somebody gets sick.

Advocates of health reform also believe more people may be willing to work for small companies after the changes. Small businesses may not have been able to compete for the top workers because they can't offer competitive health benefits.