New data has revealed alarming trends in health care costs for small businesses, as Ranking Member Edward J. Markey (D-Mass.) highlights how current policies are negatively impacting their financial stability. A recent report from Co-Equal indicates that from 2025 to 2026, small group employer-sponsored annual health insurance premiums surged significantly, putting additional strain on already struggling small business owners, employees, and their families.
The statistics are staggering: premiums rose by at least $500 for single coverage and a minimum of $1,000 for family coverage in nearly every state. After the elimination of enhanced premium tax credits last year, small business owners utilizing the Affordable Care Act (ACA) Marketplace are seeing their annual premiums jump by an average of $3,150 in 2026. This affects more than 4.2 million small business owners, including approximately 60,000 in Massachusetts alone.
“Trump’s health care affordability crisis is coming into sharper focus, and the prognosis is catastrophic for America’s small businesses,” Markey stated. “Small business owners don’t have many places to turn to get quality, comprehensive, and affordable health insurance coverage for themselves, their families, and their workers."
Key Takeaways:
- The average annual cost for small group single coverage is now $9,333, while family coverage stands at $26,187—up 11% in Massachusetts alone.
- Specific states are feeling the pressure more acutely, with Maine, Delaware, Nebraska, New Mexico, North Carolina, New Jersey, and Rhode Island reporting increases of over 16%.
- With the loss of premium tax credits from the previous year, small businesses are facing significant hikes in their health care expenditures.
Markey continues to advocate for small businesses, critiquing the decisions that have led to these exorbitant health care costs. His remarks emphasize the correlation between current administration policies and financial hardship on Main Street.
In addition to focusing on health care costs, Markey is addressing broader issues affecting small businesses, such as tariffs and immigration policies. Just last week, he introduced the Investing in the American Dream Act, aiming to reinstate previous Small Business Administration (SBA) citizenship eligibility rules that would prioritize support for legal permanent residents, including green card holders, asylees, and refugees.
Moreover, he has been vocal about urging major retailers and shippers to pass on tariff refunds to offset costs for small businesses impacted by recent economic challenges. In April, he reiterated the need for transparency on the economic impacts of tariffs and military actions, stressing that these issues trickle down to hurt everyday small business owners and consumers.
However, small business owners must also navigate the challenges these rising health insurance premiums pose. With the ACA Marketplace coverage becoming increasingly unaffordable, some businesses may consider alternative strategies for providing health care benefits, such as exploring direct primary care agreements, health reimbursement arrangements, or considering health savings accounts for employees.
As small businesses represent a vital component of the American economy, the ramifications of these health care costs could be profound. Markey’s ongoing initiatives and advocacy demonstrate a commitment to improving these conditions, yet the path forward remains complex and uncertain.
For small business owners, monitoring changes in health care policies and cost structures will be crucial in adapting their strategies to maintain both profitability and employee satisfaction. Keeping abreast of potential legislative changes, utilizing available resources, and considering alternative health care models may provide some relief amid rising costs.
This situation continues to evolve, and small business owners are encouraged to stay informed about local and national health care policies. For further details, you can view the original press release here.
