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Members of Congress will undoubtedly be hearing from small business owners like Jody Hall of Seattle's Cupcake Royale. She pays as much for insurance as she does in rent for four Seattle locations. Hall has been following the national debate, and she's become an outspoken advocate of reform.

NPR's Wendy Kaufman reports.

WENDY KAUFMAN: Jody Hall opened her first cupcake cafe five and half years ago. She baked her cupcakes from scratch with premium ingredients and no preservatives or fillers. She frosted them one at a time by hand. Cupcake Royale was a near instant hit, and her company has grown beyond her expectations. But Hall's approach to making cupcakes hasn't changed.

Ms. JODY HALL (Owner, Cupcake Royale): We have a couple of our bakers here, Shelby and Mia. They're whipping up a batch of - let's see, chocolate cupcakes. Yummy.

KAUFMAN: At her bakery cafes like this one in Seattle's Ballard neighborhood, the baking starts well before dawn and goes all day.

Ms. HALL: And you come around here, we have our ovens over here, the prep table. That's the rack of cakes that they've been whipping up. You've got the Dance Party, the Kate, the Classic, the Triple Threat, our Peppermint Party.

KAUFMAN: Most of the cupcakes sell for $2.50 each. Hall says about 10 percent of that - or a quarter a cupcake - goes to pay for employee health insurance.

Ms. HALL: It's definitely eating a big share of our profit. We don't have to offer health insurance. We could keep that, and - you know, but I feel like it adds value to the people that want to work here, and we can find better people to work here because of that.

KAUFMAN: Employees Jessie Martin and Malika Bert(ph) agree health insurance is a big plus.

Ms. JESSIE MARTIN (Employee, Cupcake Royale): It's really great to work for a small business owner who finds benefits that important and is actually working really hard to make sure we get them.

Ms. MALIKA BERT (Cupcake Royale Employee): It's amazing. It's one of the reasons why I was interesting in coming here - well, along with the cupcakes.

KAUFMAN: Providing insurance for employees is something bakery owner Hall takes seriously. But she says the cost is too high and something needs to be done. She recently went to the White House to attend a small business roundtable on health care reform, and here's what she said. Health care costs are skyrocketing, 20 percent increases in each of the past few years, and a 40 percent increase a couple of years ago.

Ms. HALL: It's unsustainable to manage that kind of expense hike, so we're forced to kind of cut our quality of coverage to make the plan more affordable. But really, that doesn't do much for society. A lot of small businesses are either doing that, or they're cutting insurance altogether.

KAUFMAN: A majority of working Americans are employed by small business, but only six in 10 small businesses provide health care. The National Federation of Independent Business reports that small companies pay substantially more in premiums than large firms do. Hall, for example, has just three or four insurers to choose from. And, she says, they won't negotiate on price.

Ms. HALL: The rate is the rate is the rate. So if, say, right now I shop through a broker and she's like, well, here's what Premera's at. Here's what Regence Blue Cross, etc. So we look through that, and if another broker wants to pitch me, like, well oh, you already got the rate. That's the rate. I can't do anything.

KAUFMAN: And so she supports what's known as the public option, an insurance plan offered by the federal government that would compete with private insurers.

Proponents say it would lower premiums, result in better coverage for more people, and in the long run, lower health care costs. But opponents of the plan - including the nation's largest small-business trade association - dispute that. The NFIB says we should look to the private sector for more competition and lower costs.

Despite heated debate over health care reform, Jody Hall is optimistic that legislation will be passed this year. But she's not sitting by idly. She's spearheading a campaign, launched this week, in which independent coffeehouses here are stamping their cups with the words health care now and a phone number. If they call, they'll be forwarded to members of Congress.

Wendy Kaufman, NPR News, Seattle.

WERTHEIMER: You can follow the health care debate at the new npr.org and find out ongoing coverage at npr.org/health.

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