The Patient Protection and Affordable Care Act exempts companies with fewer than 50 workers from having to provide medical benefits, but small manufacturers are thinking twice before pointing employees to the now-open state or federal exchanges.

Moreover, many of the smallest manufacturers that have never been able to afford health care are, for the first time, finding coverage for employees through PPACA's Small Business Health Options Program, or SHOP, even though that program has yet to be made widely available. Many of these small manufacturers are qualifying for SHOP's tax credits to help get them started.  

About half of all businesses with three to nine workers blame cost as the primary reason for not offering health benefits, according to statistics from the Kaiser Family Foundation, a health policy research organization.       

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