Enhanced premium tax credits have helped millions of small business owners afford health coverage—but their expiration could sharply raise costs and put coverage at risk. This fact sheet outlines what’s at stake for entrepreneurs, their employees and the small business economy.
If the enhanced premium tax credits (PTCs) expire at the end of this year, millions of small business owners and employees who rely on Affordable Care Act (ACA) Marketplace coverage will face steep premium increases. To learn more about why these enhanced credits are critical to the small business community, check out Small Business Majority’s new fact sheet.
As Congress and the administration consider 2025 policies, small business owners are raising concerns about rising tariffs, slowing growth, immigration policy impacts, and threats to healthcare from Medicaid cuts and ACA changes. Many are responding by raising prices or pausing expansion. They also oppose increasing the federal deficit to fund tax cuts for the wealthy and large corporations.
On August 7, the Small Business Tax Reform Coalition (SBTRC)—a joint initiative of Small Business Majority and Main Street Alliance—submitted a statement for the record in response to a recent U.S. House Ways & Means Committee hearing on the One Big, Beautiful Bill Act.
On August 4, Small Business Majority Founder & CEO John Arensmeyer submitted a statement for the record in response to a recent U.S. House Committee on Ways & Means field hearing in Simi Valley, California regarding the passage of the ‘One Big, Beautiful Bill’ (OBBB). The statement outlines how the over $1 trillion in cuts to Medicaid and the Affordable Care Act enacted in OBBB will strip affordable healthcare coverage from millions of small business owners and employees.
When John Arensmeyer launched Small Business Majority in 2005, he was trying to fill a gap in the advocacy space. As a former small business owner himself, he recognized that the overwhelming majority of entrepreneurs didn’t have the resources to receive meaningful attention from their elected officials. He also saw that most of the small business advocacy groups at the time tended to conflate the needs of big businesses with the needs of small firms.
On July 16, Small Business Majority sent a letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) in opposition to the Association Health Plans Act (S. 1847), which would destabilize small business health insurance markets by broadening access to Association Health Plans (AHPs) for small businesses and entrepreneurs. The expansion of AHPs, which are not subject to many Affordable Care Act (ACA) regulations, would result in higher premium costs for small group markets and leave small business owners and employees with inadequate coverage.
This issue brief, developed in partnership by Small Business Majority and the Georgetown University Center for Children and Families, examines the prevalence of Medicaid as a source of insurance for small business owners, employees, and their family members using 2024 data from the Census Bureau’s Current Population Survey Annual Social and Economic Supplement (CPS ASEC). Small businesses are defined as those with under 100 employees. Our analysis of 2019 data prior to the pandemic revealed similar shares.
On June 18, Small Business Majority Senior Public Policy Director Awesta Sarkash sent a letter to the Pennsylvania Senate Committee on Health & Human Services urging them to pass HB79, legislation that would help to prevent medical debt by reducing red tape, increasing transparency and awareness and creating a streamlined process for accessing health coverage and free or discounted care.
On April 24, Small Business Majority Colorado Director Hunter Nelson testified before the Colorado House Finance Committee on HB25-1297, legislation that would increase funding available to the Health Insurance Affordability Enterprise to sustain the positive relief from the Reinsurance Program, to continue covering Coloradans through the OmniSalud program and to provide subsidies to low-income Coloradans.
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