The report by the National Federation of Independent Business Research Foundation, a nonprofit association of business owners, found that the Health Insurance Tax in the Affordable Care Act will cause a rise in the cost of employer-sponsored insurance to such an extent that the private sector will be forced to cut employment between 152,000 and 286,000 jobs by 2023.

Fifty-seven percent of the job losses, the report predicts, will come from small businesses, or firms with under 500 employees, which are traditionally the engines of innovation and job creation.

The result will also amount to a reduction of U.S. real output, or sales, of between $20 billion and $33 billion over that period.

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