Small Businesses Under Siege
Washington’s small business owners are bracing for a financial disaster. A proposed 21.2 percent health insurance premium hike for 2026 looms large, threatening to crush entrepreneurs and self-employed workers already stretched thin. With the Affordable Care Act’s enhanced premium tax credits set to expire on December 31, 2025, the 309,000 Marketplace enrollees—77 percent of whom depend on these subsidies—face a brutal reality. Premiums could jump 72 percent, pushing 80,000 residents toward a heartbreaking choice: pay up or lose coverage.
These entrepreneurs are the heart of Washington’s economy, yet the healthcare system seems designed to punish them. Enrollment in the small-group insurance market has collapsed, dropping from 15 million in 2014 to 8.5 million in 2023. Premiums for firms with fewer than 50 employees have soared—120 percent for individual plans and 129 percent for family plans over two decades. Today, only 30 percent of small employers offer coverage, down from 50 percent in 2000. The system favors red tape over resilience, and it’s breaking the backs of those who dare to dream big.
Self-employed workers face even tougher odds. With limited plan options and tax deductions restricted to net business profit, many can’t afford coverage without sacrificing their livelihoods. For small firms earning under $600,000, health insurance consumes 12 percent of payroll—nearly double the burden of larger companies. This reality forces nearly half of small businesses to raise prices or cut profits just to survive. Why should Washington’s risk-takers face such a punishing system?
Some argue that extending federal subsidies will fix this mess. They highlight a 44 percent drop in benchmark premiums since 2020 and record Marketplace enrollment of 21 million. But more government cash only papers over the cracks of a broken system. Subsidies hide the real problem: a healthcare market choked by regulations and mandates that stifle competition. The expiration of these credits is a wake-up call to rethink healthcare, not prop up a failing framework.
What’s on the line? The survival of Washington’s small businesses, the well-being of their families, and the strength of our communities. If we let this crisis fester, the fallout will hit hard—higher costs, fewer jobs, and weaker local economies. Will we stand by as bureaucrats suffocate our entrepreneurs, or will we demand a system that puts individuals first?
Why Government Solutions Keep Failing
The evidence is undeniable: heavy-handed government intervention in healthcare has let small businesses down. Since the ACA took effect in 2010, small firms have grappled with skyrocketing costs and regulatory hurdles. The SHOP exchanges, meant to simplify coverage, have flopped—only a third of small businesses offer plans due to unpredictable expenses. Self-employed workers are twice as likely to be uninsured compared to those at larger firms, a gap that grows wider every year.
Across the country, healthcare affordability is in free fall. Over one-third of Americans can’t access quality care, and 11 percent are “cost desperate.” Premiums have surged 160 percent over two decades, with employers facing an 8 percent cost increase in 2025. In Washington, a $15 billion state deficit limits the impact of the $150 million allocated for subsidy replacements. These stopgap measures can’t replace the bold reforms needed to fix a system that’s failing the people it’s meant to serve.
Lawmakers like Senators Shaheen and Baldwin push to make ACA subsidies permanent, citing enrollment spikes and CBO projections of millions keeping coverage. They note that 88 percent of new enrollees since 2020 come from states that backed Trump, suggesting broad support. But this approach ignores the bigger picture: subsidies fuel deficits and distort markets, creating dependency rather than solutions. Past subsidy expirations, like the 2010 COBRA lapse, triggered enrollment drops and strained providers. Repeating this cycle is reckless.
A smarter path exists. Conservative ideas like block grants, Medicaid work requirements, and deregulated insurance markets could cut premiums by 15 to 32 percent, as pre-ACA reforms showed. Health sharing ministries and short-term plans offer affordable options, while easing provider taxes and administrative rules frees up resources for care. These solutions empower states and individuals, not distant federal agencies.
Time for Real Change in Washington
Washington’s small businesses need relief now, not more empty promises. The state’s insurance commissioner has rolled out “Silver Load” adjustments to cushion the subsidy expiration, but these are short-term patches. Without sweeping change, the 80,000 residents at risk of losing coverage face dire consequences. Hospitals will grapple with higher uncompensated care costs, public health programs will strain under budget cuts, and taxpayers will foot the bill.
The federal government must loosen its grip and let markets thrive. Allowing insurance sales across state lines, encouraging private risk pools, and giving states more flexibility can spark competition and drive down costs. Project 2025’s proposals—such as eliminating mandatory Medicaid benefits and expanding state waiver authority—provide a blueprint for local innovation. Washington’s lawmakers should embrace these ideas instead of leaning on federal subsidies that come with heavy strings.
To those who insist subsidies are the answer, history tells a different story. Decades of federal overreach have delivered soaring costs and shrinking access. Washington’s entrepreneurs deserve a system that rewards their hard work, not one that penalizes it. We have a chance to build a healthcare market that prioritizes choice, affordability, and innovation. Let’s seize it and give small businesses the fighting chance they need to thrive.