Small businesses are facing significantly higher health insurance premiums in 2026. Most small businesses that offer health coverage to their employees buy coverage through small group health plans. Premiums for these plans have increased by at least $500 for single coverage in 44 states and by at least $1,000 for family coverage in 47 states. These increases reflect a range of factors, including tariffs, inflation, and rising medical costs.
Many small business owners, including the self-employed, buy coverage for themselves and their families through the ACA individual marketplace. The Trump Administration and Congress have adopted policies that make these plans more expensive while allowing the enhanced subsidies to expire. Nationwide, small business owners are paying $13.3 billion more in premiums in 2026 due to the expiration. That means the average small business owner who received a tax credit in 2025 will pay $3,150 more in premiums in 2026.
Note: Estimates were updated on May 5, 2026.
