Small-Business Owners Face Uninsurance as ACA Subsidies Expire

As the expiration of enhanced subsidies for the Affordable Care Act (ACA) approaches, small-business owners are facing a daunting challenge: uninsurance. Many individuals who rely on ACA coverage will see their premiums soar, forcing difficult financial choices ahead of the open enrollment period, which concludes on January 15 in most states.

Rising Premiums Under the ACA

For example, Eric and Lisa Frankenfeld, who own a chiropractic practice in Point Pleasant, New Jersey, are grappling with the prospect of losing their insurance. Their monthly premium is set to jump from $340 to nearly $1,928, making it unaffordable.

Despite their profession as health care providers, the couple has opted to forgo coverage due to the drastic premium increases. “Purchasing a plan doesn’t make financial sense,” Lisa stressed. Their situation reflects a broader trend affecting millions of ACA enrollees, particularly those linked to small businesses.

The Impact of Subsidy Expiration

More than 22 million people, or about 90% of ACA policyholders, have benefited from enhanced subsidies. However, without these aids, many individuals can expect their premium payments to skyrocket by an average of 114% in the coming year.

Those earning over 400% of the federal poverty level — approximately $62,600 for individuals — will no longer qualify for federal assistance, forcing many to navigate a precarious financial landscape.

Case Studies of Small-Business Owners

• Kathy and Jeffrey Many: This couple from Brandon, Vermont, decided against renewing their ACA coverage for 2026 due to a premium increase to $2,670, up from $625. Kathy acknowledges that living uninsured is “very nerve-wracking,” emphasizing her concerns for her husband’s safety while he works.
• Sonja: A real estate business owner in Minnesota is facing a jump in monthly premiums from around $1,000 to over $2,150. With mounting health care expenses, she is exploring the possibility of joining forces with another company to lower their insurance costs.
• Jeff: A freelance musician from New York City found that his cheapest insurance option would cost $275 a month, prompting him to seek alternative work instead of pursuing coverage.

Potential Legislative Solutions

In January, the House will vote on a proposal to extend enhanced subsidies for three additional years. Some bipartisan support exists for this measure, but its future remains uncertain, particularly after a similar Democratic bill was rejected earlier in the Senate.

As the deadline approaches, many small-business owners are left in a precarious situation, weighing their options for health care coverage. With rising premiums making affordability a significant concern, the impact of uninsurance looms large in 2026.