In a recent report, the Biden administration highlighted how the Affordable Care Act (ACA) has provided health insurance to over 4.2 million entrepreneurs, helping fuel a record surge in new business applications. However, ongoing Republican efforts to repeal the ACA raise critical questions about the future of healthcare access for small business owners. As the administration emphasizes its commitment to affordable coverage, what implications do these political battles have for the stability and growth of small businesses in New York and beyond?
FACT SHEET: New Report Shows 4.2 Million Entrepreneurs Get Health Insurance Through the ACA Marketplaces
Congressional Republican efforts to repeal the ACA would have a devastating impact on small businesses across the country
President Biden and Vice President Harris believe that health care is a right, not a privilege, and their administration has driven the uninsured rate to the lowest point in history. New data released today by the Treasury Department illustrates just how critical those steps have been to America’s small businesses – and how devastating it would be if Congressional Republicans succeed in their efforts to repeal the ACA, roll back protections for people with pre-existing conditions, and increase American’s health care costs by failing to extend the ACA premium tax credits that President Biden and Vice President Harris passed, that are lowering health care costs by hundreds of dollars per year for millions of Americans. The fact is that millions of small business owners would lose health insurance if the ACA is repealed.
Statement from the President: “Every time someone starts a new small business, it’s an act of hope and confidence in our economy. Thanks to my and Vice President Harris’s work to protect and build on the Affordable Care Act, more Americans have the freedom to start small businesses and chase their dreams – without having to worry about how they receive health insurance for their family. As a result, more Americans – and more small business owners – have signed up for health care coverage through the Affordable Care Act Marketplace than ever before. That’s 618,590 small business owners in Florida, 450,010 in California, 423,790 in Texas, and 168,070 in Georgia who have benefited from this quality, affordable health coverage. Congressional Republicans have a different vision and have voted more than 50 times to repeal the Affordable Care Act. Their agenda would strip millions of small business owners of their health coverage, gut protections for pre-existing conditions, and threaten the small business boom seen under my Administration. Vice President Harris and I won’t let it happen on our watch.”
Statement for the Vice President: “Small business owners and entrepreneurs are the engine of America’s economy. We are ensuring small businesses have access to affordable health care so they can focus on starting and growing businesses, not on whether they can afford health coverage. I’m proud that over 4 million small business owners and self-employed workers have coverage through the ACA, up from 3.3 million in 2022. I will always support small businesses and invest in entrepreneurs by strengthening and expanding the ACA, and by rejecting Republican efforts to repeal it.”
The Treasury Department’s report shows that 4.2 million small business owners and self-employed workers have coverage through the ACA Marketplaces, up from 3.3 million in 2022 and 1.4 million in 2014. In fact, entrepreneurs are about three times as likely as other Americans to have health insurance in the Marketplace, with nearly 1 in 5 getting coverage there. The vast majority of these entrepreneurs – 82% in 2022 – claim the ACA premium tax credit to reduce their cost of coverage by an average of about $700 each year. The ACA was designed to finally provide a reliable source of health insurance for people who don’t get coverage through their jobs – after decades of facing high health care prices or outright coverage denials based on pre-existing conditions – and this report makes clear that system is working to support American entrepreneurship.
Ensuring American small business owners can access affordable health insurance is yet another example of the many ways that the Biden-Harris Administration has supported a small business boom. Since President Biden took office, Americans have filed more than 19 million new business applications, the most on record. This small business boom has been powered by landmark investments in infrastructure, clean energy, and domestic manufacturing made through the Biden-Harris Investing in America agenda, expanding access to capital and enabling all-time high levels of federal contracting with small businesses
But Congressional Republicans continue their efforts to strip this progress away. They have voted more than 50 times to repeal the ACA. They continue advance proposals that would strip coverage away, and undermine protections for people with pre-existing conditions. Millions of America’s small businesses owners and self-employed workers would find their health insurance disrupted if those plans succeed. And their plan to end the expansion of the ACA premium tax credits would raise taxes and heath care costs for millions of small business owners, including middle-class small business owners. Unlike Congressional Republicans, President Biden and Vice President Harris have committed to never raising taxes on households making less than $400,000, and are fighting to extend the premium tax credit enhancements.
Number of small businesses owners and self-employed workers with Marketplace coverage in each state in 2022:
| State | Entrepreneurs with Marketplace Coverage | State | Entrepreneurs with Marketplace Coverage |
| AK | 4,820 | MT | 12,500 |
| AL | 49,020 | NC | 134,260 |
| AR | 18,490 | ND | 7,550 |
| AZ | 41,550 | NE | 23,240 |
| CA | 450,010 | NH | 14,650 |
| CO | 42,750 | NJ | 72,890 |
| CT | 28,340 | NM | 8,860 |
| DC | 4,120 | NV | 24,350 |
| DE | 6,200 | NY | 59,200 |
| FL | 618,590 | OH | 51,520 |
| GA | 168,070 | OK | 39,040 |
| HI | 8,060 | OR | 34,200 |
| IA | 18,740 | PA | 88,700 |
| ID | 13,880 | RI | 6,230 |
| IL | 76,920 | SC | 59,160 |
| IN | 32,650 | SD | 9,770 |
| KS | 23,870 | TN | 66,270 |
| KY | 16,480 | TX | 423,790 |
| LA | 26,780 | UT | 36,320 |
| MA | 50,130 | VA | 66,110 |
| MD | 38,240 | VT | 7,170 |
| ME | 15,460 | WA | 53,130 |
| MI | 65,490 | WI | 45,790 |
| MN | 25,730 | WV | 5,040 |
| MO | 56,070 | WY | 7,120 |
| MS | 27,130 | Other | 1,100 |
| Total | 3,285,550 | ||
September 25, 2024 White House Washington, DC
Here are three critical questions from a Republican perspective and one from a Democratic perspective regarding the information provided in the White House fact sheet:
Republican Perspective Questions:
- Economic Burden on Businesses: Given that the ACA has led to increased healthcare costs for small businesses, how do you justify the claim that it has supported small business growth when many entrepreneurs are facing rising premiums and deductibles that threaten their bottom line?
- Tax Increases and Financial Responsibility: If the Biden administration’s proposed expansions of the ACA and its premium tax credits lead to increased spending, how can you ensure that these financial burdens won’t ultimately translate to higher taxes for all Americans, including those earning less than $400,000?
- Market Alternatives: Why should small business owners rely on the ACA marketplaces for health insurance when Republican proposals emphasize the need for a more competitive, market-driven approach to healthcare that could potentially lower costs and increase choices for consumers?
Democratic Perspective Question:
- Equity and Access: How do you respond to criticisms that the ACA, despite its successes, still leaves a significant number of individuals without health insurance, particularly in underserved communities, and what measures are being taken to ensure that these groups have equal access to affordable healthcare options?
Sources: Midtown Tribune. White House WH.gov
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