Opinion: Small businesses are caught in the crosshairs of the health care standoff

Ten years ago, I moved to Anchorage and started working for myself full time, helping families move their homes, apartments and offices. Up until that point, I had never taken the leap to self-employment, in part because I was getting health benefits through another job. The Affordable Care Act (ACA) allowed me to become an entrepreneur full time.

The stalemate in Washington over the enhanced Premium Tax Credits for the ACA is deeply concerning to me as a business owner but also as a citizen. In my view, health care is a right that shouldn’t be tied to your employment. Everyone needs health care, just like everyone needs a fire department, and everyone should have affordable access to it. A universal system, like Medicare for All, where everyone contributes a percentage, would foster innovation by removing the need to stay in a job solely for the insurance benefits.

For self-employed people and small businesses, the expiration of these enhanced tax credits will be a direct financial hit. If Congress doesn’t act, I estimate my own costs could jump by $2,000 to $3,000 per year. And I’m not alone: Some analysts predict the average out-of-pocket premium could more than double for people who currently receive subsidies.

This isn’t a “business-ending” situation for me, but it will be a serious setback. It means taking on more work just to keep up with rising costs, leaving less time and money to grow the business. And that’s the story for countless self-employed Americans. The deeply uncertain future of health insurance costs limits our ability to create a budget, hire employees and invest in expansion.

If ACA tax credits expire, the impact will ripple far beyond individual small businesses. Without the credits, out-of-pocket premiums are expected to double on average. For middle-income, self-employed individuals whose income is just above the cutoff for subsidies, support disappears entirely — leaving them to pay full price for coverage.

This isn’t just a health care issue. It’s an economic one. If Congress lets the enhanced tax credits expire and insurance premiums soar, healthier people will drop out of the insurance pool, which drives premiums up even higher for everyone else. Hospitals, especially in rural areas, will see more uninsured patients, more unpaid bills, and greater financial strain — which can lead to cuts in services or even closures.

These are the real costs of political brinkmanship — and small businesses are caught in the middle.

It’s time for Congress to end the gridlock and permanently extend the enhanced tax credits. Small business owners like me want to focus on building our livelihoods and supporting our communities — not on whether we can afford our next visit to the doctor.

Alan Harris is a small business owner. He lives in Anchorage.

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