Our Research: Healthcare
Small Business Majority uses extensive scientific and opinion research to provide small business owners, advocates, policymakers and others with the information and tools they need to navigate through complex healthcare-related issues.
Over the past several months, Small Business Majority hosted five roundtable discussions with nearly 50 small business owners in Cortland, Long Island, Queens and Manhattan focusing on many of the biggest challenges small businesses are facing today, including rising healthcare costs, unpredictable tariffs, rising inflation and unaffordable living, difficulty accessing capital, workforce shortages and childcare access. The entrepreneurs also shared how running a business in 2026 can require mental and physical sacrifice as these challenges continue to escalate.
This national opinion poll of likely voters, conducted for Small Business Majority by Lake Research Partners, reveals overwhelming bipartisan support for small businesses and pro-small business policies. Voters believe by dramatic margins that the success of small business is better for their families and the economy than the success of large corporations, and it’s personally important to them that local small businesses in their communities thrive.
The U.S. Supreme Court’s 2022 decision to overturn Roe v. Wade has reshaped access to reproductive healthcare—and small business owners are feeling the effects. Research from Small Business Majority shows that entrepreneurs overwhelmingly view access to reproductive healthcare as critical to workforce participation, economic stability and long-term business success. While some business owners report limited or uncertain impacts so far, more say the decision has harmed their businesses than helped—citing effects on profitability, hiring and workforce stability. Women entrepreneurs, in particular, express deep concern, with many warning that abortion restrictions force women to choose between their careers and reproductive freedom. As access continues to narrow in many states, small business owners are increasingly worried about the long-term economic consequences for their employees, their communities and their bottom lines.
On November 13, 2025, Small Business Majority released a research report examining the challenges small businesses face from rising healthcare premiums and increased immigration enforcement. The survey found that two-thirds of small business owners view higher healthcare costs as a significant financial burden and strongly support extending the Affordable Care Act’s enhanced premium tax credits. Entrepreneurs also reported negative effects from immigration enforcement and expressed strong support for modernizing the legal immigration system and creating pathways to citizenship for qualifying undocumented immigrants.
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.
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.
Since the U.S. Supreme Court overturned Roe v. Wade in 2022, reproductive healthcare access has changed dramatically across the country. These changes aren’t just affecting individuals—they’re also impacting small businesses. To develop a deeper understanding of how access to reproductive health services impacts entrepreneurs, Small Business Majority held three focus group discussions in January 2025 with 16 diverse small business owners from across nine states.
Small businesses are rebounding from issues stemming from the pandemic, but rising healthcare costs are hurting their bottom lines and limiting their growth. New opinion polling reveals that small business owners strongly support bipartisan policy solutions that lower costs by setting price caps, increasing transparency and promoting competition in the healthcare industry.
One year after the U.S. Supreme Court’s decision to overturn Roe v. Wade, Small Business Majority conducted an opinion poll of women small business owners to understand the importance of reproductive rights to their economic well-being and to the entire small business ecosystem. They support improved and expanded access to reproductive healthcare, including birth control and abortion.
As entrepreneurs continue to navigate business and economic challenges stemming from pandemic, Small Business Majority surveyed small business owners and operators in Colorado to assess business conditions and the rising costs of healthcare.
