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What’s on the mind of the small-to-medium sized business owner when asked to forecast business conditions in 2014? Health coverage, above all else.

Research by Principal Financial drew a picture of these business owners as fairly optimistic about 2014, but concerned about health insurance. Asked to rank what they felt would be the issues that would have the greatest effect on their businesses next year, 36% listed either health care costs or health care reform as the No. 1 factor. Second? The impact of economic growth their business.

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