{"id":689147,"date":"2025-09-10T08:00:00","date_gmt":"2025-09-10T12:00:00","guid":{"rendered":"https:\/\/www.kff.org\/?p=689147"},"modified":"2025-09-10T13:18:04","modified_gmt":"2025-09-10T17:18:04","slug":"about-half-of-adults-with-aca-marketplace-coverage-are-small-business-owners-employees-or-self-employed","status":"publish","type":"post","link":"https:\/\/www.kff.org\/affordable-care-act\/about-half-of-adults-with-aca-marketplace-coverage-are-small-business-owners-employees-or-self-employed\/","title":{"rendered":"About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed"},"content":{"rendered":"<div\n\tclass=\"wp-block-kff-shared-content--standard-layout wp-block-kff-shared-content\">\n\t\n\n<section class=\"wp-block-kff-shared-content-main\">\n\t\t\t<div class=\"post-header\">\n\t\t\t\t\t\n\t<h1 class=\"post-header__title\">About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed<\/h1>\n\n\t\n\t\t\t<div class=\"post-header__meta\">\n\t\t\t\t\t<div>\n\t\t\t\t<span class=\"post-header__meta-label\">\n\t\t\t\tAuthors:\t\t\t\t<\/span>\n\t\t\t\t<a href=\"https:\/\/www.kff.org\/person\/matt-mcgough\/\">Matt McGough<\/a>, <a href=\"https:\/\/www.kff.org\/person\/gary-claxton\/\">Gary Claxton<\/a>, <a href=\"https:\/\/www.kff.org\/person\/matthew-rae\/\">Matthew Rae<\/a>, and <a href=\"https:\/\/www.kff.org\/person\/cynthia-cox\/\">Cynthia Cox<\/a> \t\t\t<\/div>\n\t\t\t\t<div>\n\t\t\t<span class=\"post-header__meta-label\">Published:<\/span>\n\t\t\t<date>Sep 10, 2025<\/date>\n\t\t<\/div>\n\t\t<\/div>\n\t\n\t<div class=\"post-header__social-sharing\">\n\t\t<button class=\"post-header__social-sharing__button print\">\n\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t<path d=\"M4.348 2.5v3.391H2.783A.787.787 0 0 0 2 6.674v4.696c0 .429.353.782.783.782h1.565V14.5h7.304v-2.348h1.565c.43 0 .783-.353.783-.782V6.674a.787.787 0 0 0-.783-.783h-1.565V2.5H4.348Zm.522.522h6.26v2.87H4.87v-2.87ZM2.783 6.413h1.782a.26.26 0 0 0 .085 0h6.697a.26.26 0 0 0 .086 0h1.784c.148 0 .261.114.261.26v4.697c0 .147-.113.26-.26.26h-1.566V9.283H4.348v2.347H2.783a.257.257 0 0 1-.261-.26V6.674c0-.147.113-.261.26-.261Zm9.39.783a.522.522 0 1 0 0 1.043.522.522 0 0 0 0-1.043ZM4.87 9.804h6.26v2.043a.264.264 0 0 0 0 .086v2.045H4.87v-2.043a.261.261 0 0 0 0-.085V9.804Zm1.043.783a.262.262 0 0 0-.265.26.26.26 0 0 0 .265.262h4.174a.26.26 0 1 0 0-.522H5.913Zm0 1.043a.26.26 0 1 0 0 .522h3.13a.26.26 0 1 0 0-.522h-3.13Zm0 1.044a.26.26 0 1 0 0 .522h4.174a.262.262 0 0 0 .264-.261.26.26 0 0 0-.264-.261H5.913Z\" fill=\"#004B88\" stroke=\"#004B88\" stroke-width=\".5\"\/>\n\t\t\t<\/svg>\n\n\t\t\tPrint\t\t<\/button>\n\t\t<a href=\"mailto:?subject=About%20Half%20of%20Adults%20with%20ACA%20Marketplace%20Coverage%20are%20Small%20Business%20Owners%2C%20Employees%2C%20or%20Self-Employed&#038;body=https%3A%2F%2Fwww.kff.org%2Faffordable-care-act%2Fabout-half-of-adults-with-aca-marketplace-coverage-are-small-business-owners-employees-or-self-employed%2F\" class=\"post-header__social-sharing__button\">\n\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t<path d=\"M2.333 4.25h-.25v9.14h12.5V4.25H2.333Zm1.083 1.693-.353-.2V5.23h10.54v.513l-.353.2L8.333 8.73 3.416 5.943Zm-.353 6.467V6.884l.107.06 5.04 2.857.123.07.123-.07 5.04-2.857.107-.06v5.526H3.063Z\" fill=\"#004B88\" stroke=\"#004B88\" stroke-width=\".5\"\/>\n\t\t\t<\/svg>\n\n\t\t\tEmail\t\t<\/a>\n\t\t<button class=\"post-header__social-sharing__button copy\">\n\t\t\t<svg width=\"16\" height=\"17\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t<path d=\"M11.533 2.9c-.615 0-1.23.235-1.697.702L8.502 4.936a2.4 2.4 0 0 0-.575 2.46l.958-.958a1.32 1.32 0 0 1 .371-.748l1.334-1.333a1.331 1.331 0 0 1 1.886 0c.52.52.52 1.365 0 1.885l-1.334 1.333c-.21.21-.474.331-.748.372l-.958.958a2.393 2.393 0 0 0 2.46-.576l1.334-1.333a2.402 2.402 0 0 0 0-3.394 2.393 2.393 0 0 0-1.697-.702Zm-1.61 3.46a.533.533 0 0 0-.367.162l-3.2 3.2a.533.533 0 1 0 .754.754l3.2-3.2a.534.534 0 0 0-.387-.915ZM6.586 7.973a2.388 2.388 0 0 0-1.816.697l-1.334 1.333a2.403 2.403 0 0 0 0 3.394 2.393 2.393 0 0 0 1.697.702c.614 0 1.229-.234 1.697-.702l1.333-1.334a2.4 2.4 0 0 0 .576-2.46l-.959.958a1.32 1.32 0 0 1-.37.749l-1.334 1.333a1.334 1.334 0 0 1-1.886-1.885l1.334-1.334c.21-.21.474-.331.748-.372l.958-.957c-.21-.07-.426-.11-.644-.122Z\" fill=\"#004B88\"\/>\n\t\t\t<\/svg>\n\n\t\t\t<span>Copy Link<\/span>\n\t\t<\/button>\n\t\t\t<\/div>\n\t<\/div>\n\t\t\t\n\n<p class=\"wp-block-paragraph\">The enhanced premium tax credits, created under the American Rescue Plan Act (ARPA) and later extended through the Inflation Reduction Act (IRA), have <a href=\"https:\/\/www.kff.org\/affordable-care-act\/inflation-reduction-act-health-insurance-subsidies-what-is-their-impact-and-what-would-happen-if-they-expire\/\">reduced<\/a> premiums for millions of Marketplace enrollees. They have also contributed substantially to Marketplace enrollment more than doubling to <a href=\"https:\/\/www.kff.org\/affordable-care-act\/state-indicator\/marketplace-enrollment\/?currentTimeframe=0&amp;sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D\">24.3 million<\/a> people in 2025.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Currently, over nine in 10 <a href=\"https:\/\/www.kff.org\/affordable-care-act\/state-indicator\/marketplace-plan-selections-by-financial-assistance-status-2\/?currentTimeframe=0&amp;sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D\">enrollees<\/a> (92%) receive some amount of premium tax credit. If these enhanced tax credits expire at the end of 2025, out-of-pocket premiums would <a href=\"https:\/\/www.kff.org\/affordable-care-act\/inflation-reduction-act-health-insurance-subsidies-what-is-their-impact-and-what-would-happen-if-they-expire\/#:~:text=The%20enhanced%20subsidies%20in,average%20%24705%20per%20enrollee.\">rise<\/a> by over 75% on average for the vast majority of individuals and families buying coverage through the Affordable Care Act (ACA) Marketplaces. Additionally, <a href=\"https:\/\/www.healthsystemtracker.org\/brief\/how-much-and-why-aca-marketplace-premiums-are-going-up-in-2026\/\">insurers<\/a> are proposing an increase in gross premiums (before premium tax credits are applied) of 18%, partly due to the impact on the risk pool of the expiration of enhanced premium tax credits. This double-digit increase would affect government costs for tax credits, as well as Marketplace enrollees not receiving premium assistance.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Much of the discussion about the ACA Marketplaces centers on individuals and families buying coverage on their own. However, many enrollees are connected to small businesses or are self-employed. A previous KFF <a href=\"https:\/\/www.kff.org\/affordable-care-act\/who-might-lose-eligibility-for-affordable-care-act-marketplace-subsidies-if-enhanced-tax-credits-are-not-extended\/\">analysis<\/a> found that 38% of adult individual market enrollees under age 65 making over 400% of the federal poverty line (FPL) are self-employed, compared to 7% of adults (ages 19-64 years) with incomes over four times poverty nationally. If the enhanced premium tax credits expire, individuals and families with household incomes over 400% FPL would no longer be eligible for any premium tax credits, leaving them with the full cost of their health insurance premium.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Using <a href=\"https:\/\/www.census.gov\/data\/datasets\/time-series\/demo\/cps\/cps-asec.html\">data<\/a> from the Current Population Survey (CPS) Annual Social and Economic Supplement, we estimate that 48% of adults under age 65 enrolled in individual market (direct purchase) coverage are either employed by a small business with fewer than 25 workers, self-employed entrepreneurs, or small business owners. In other words, about half of adult enrollees in the individual health insurance market \u2013 the vast majority of which is purchased through the ACA Marketplaces \u2013 is affiliated with a small business. For context, 16% of all adults under age 65 nationwide are employed by a small business or are self-employed.<\/p>\n\n\n\n<div class=\"datawrapper-embed block--datawrapper-embed \">\n\t\t\t\t\t<div style=\"min-height: px;\">\n\t\t\t<script\n\t\t\t\ttype=\"text\/javascript\"\n\t\t\t\tdefer\n\t\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/hwWK0\/embed.js?v=14\"\n\t\t\t>\n\t\t\t<\/script>\n\t\t<\/div>\n\t\t\t<img\n\t\t\tclass=\"datawrapper-embed__print-img\"\n\t\t\tsrc=\"https:\/\/datawrapper.dwcdn.net\/hwWK0\/full.png\"\n\t\t\talt=\"Nearly Half of Individual Market Enrollees Work for a Small Business or Are Self-Employed\"\n\t\t\/>\n<\/div>\n\n\n\n\n<p class=\"wp-block-paragraph\">For many employees of small businesses and self-employed individuals, the individual market functions as their main source of comprehensive health insurance outside of traditional employer coverage. Unlike larger firms, small businesses are less likely to offer <a href=\"https:\/\/www.kff.org\/health-costs\/2024-employer-health-benefits-survey\/#7a257be6-899e-4733-8523-7554cd3a5954\">health benefits<\/a> to their employees, leaving workers and entrepreneurs dependent on the affordability and stability of the individual market.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The enhanced premium tax credits have lowered premium costs for enrollees across the Marketplaces. If those subsidies expire as scheduled at the end of 2025, individual market enrollees\u2014including many people tied to small businesses\u2014would face higher out-of-pocket premiums.<\/p>\n\n\n\n<div class=\"is-style-methods wp-block-tenup-callout\">\n\t\t\t<p class=\"wp-block-tenup-callout__title\">Methods<\/p>\n\t\n\t\t\t<div class=\"wp-block-tenup-callout__content\">\n\t\t\t\n\n<p class=\"wp-block-paragraph\">The data above is based on KFF analysis of 2024 CPS Annual Social and Economic Supplement. The analysis includes adults under age 65 who directly purchase their health insurance and are not currently students. People were considered to be self-employed or employed by a small business if they self-reported being self-employed or working at a business with between one and 24 employees. Employer size is measured for the primary job in the previous year, and may be different at the time of the survey.<\/p>\n\n\t\t<\/div>\n\t\n\t<\/div>\n\n\t<div class=\"post-footer\">\n\t<div class=\"post-footer__title\">More On<\/div>\n\t<div class=\"post-footer__links\">\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/topic\/affordable-care-act\/\">\n\t\t\t\tAffordable Care Act\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/topic\/health-costs\/\">\n\t\t\t\tHealth Costs\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/aca-marketplaces\/\">\n\t\t\t\tACA Marketplaces\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/coverage\/\">\n\t\t\t\tCoverage\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/employment\/\">\n\t\t\t\tEmployment\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/enrollment\/\">\n\t\t\t\tEnrollment\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/health-care-markets\/\">\n\t\t\t\tHealth Care Markets\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/individual-market\/\">\n\t\t\t\tIndividual Market\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/premiums\/\">\n\t\t\t\tPremiums\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.kff.org\/tag\/subsidies\/\">\n\t\t\t\tSubsidies\t\t\t<\/a>\n\t\t\t<\/div>\n<\/div>\n\t<\/section>\n\n\n<section class=\"wp-block-kff-shared-content-sidebar\">\n\t\t\t\n\t\t\n<div class=\"wp-block-kff-shared-related-content--green wp-block-kff-shared-related-content\">\n\t<h2 class=\"wp-block-kff-shared-related-content__heading\">Related Content<\/h2>\n\t<div>\n\t\t\t<div class=\"wp-block-kff-shared-related-content__card\">\n\t\t\t<a href=\"https:\/\/www.healthsystemtracker.org\/brief\/how-much-and-why-aca-marketplace-premiums-are-going-up-in-2026\/\" class=\"wp-block-kff-shared-related-content__link\">\n\t\t\t\t<h3 class=\"wp-block-kff-shared-related-content__card-title\">\n\t\t\t\t\tHow much and why ACA Marketplace premiums are going up in 2026\t\t\t\t<\/h3>\n\t\t\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"wp-block-kff-shared-related-content__card\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/affordable-care-act\/inflation-reduction-act-health-insurance-subsidies-what-is-their-impact-and-what-would-happen-if-they-expire\/\" class=\"wp-block-kff-shared-related-content__link\">\n\t\t\t\t<h3 class=\"wp-block-kff-shared-related-content__card-title\">\n\t\t\t\t\tInflation Reduction Act Health Insurance Subsidies: What is Their Impact and What Would Happen if They Expire?\t\t\t\t<\/h3>\n\t\t\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t<div class=\"wp-block-kff-shared-related-content__card\">\n\t\t\t<a href=\"https:\/\/www.kff.org\/affordable-care-act\/who-might-lose-eligibility-for-affordable-care-act-marketplace-subsidies-if-enhanced-tax-credits-are-not-extended\/\" class=\"wp-block-kff-shared-related-content__link\">\n\t\t\t\t<h3 class=\"wp-block-kff-shared-related-content__card-title\">\n\t\t\t\t\tWho Might Lose Eligibility for Affordable Care Act Marketplace Subsidies if Enhanced Tax Credits Are Not Extended?\t\t\t\t<\/h3>\n\t\t\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\t\t\t<\/section>\n\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>This analysis estimates that 48% of adults under age 65 with individual market coverage are either employed by a small business with fewer than 25 workers, self-employed entrepreneurs, or small business owners. Because the vast majority of this coverage is purchased through the Affordable Care Act (ACA) Marketplaces, changes to the ACA, including the expiration of the enhanced premium tax credits at the end of this year, would have significant implications for what small business owners and workers spend on their health care.<\/p>\n","protected":false},"author":155412866,"featured_media":689458,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"authors":[{"type":"foundation","id":528153,"name":"","_id":"e6c9a380-b912-4a50-b88c-a98836d9cfbd"},{"type":"foundation","id":66162,"name":"","_id":"6eea53ba-988d-4e70-8785-30693913c3ba"},{"type":"foundation","id":49480,"name":"","_id":"b52e6a2b-e0a4-4916-8ed5-7114744dd3d6"},{"type":"foundation","id":49499,"name":"","_id":"a76e9f5f-d928-4c60-87f4-667d674e5e38"}],"exhibits":[],"jetpack_post_was_ever_published":false,"ep_exclude_from_search":false,"_classifai_error":"","_classifai_text_to_speech_error":"","hide_from_search":false,"show_featured_image":false,"subheading":"","tag":"","search_keywords":"10810, Affordable Care Act, premium tax credits, small business, enrollment","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"shortlink":"","footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"enabled":false},"version":2}},"categories":[3962798,1274092],"tags":[954238,128562,7915,226706,579145440,24788933,301221,86400],"series":[],"partner":[],"program":[],"content-types":[579145483],"class_list":["post-689147","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-affordable-care-act","category-health-costs","tag-aca-marketplaces","tag-coverage","tag-employment","tag-enrollment","tag-health-care-markets","tag-individual-market","tag-premiums","tag-subsidies","content-types-issue-brief"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.9 (Yoast SEO v25.9) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed | KFF<\/title>\n<meta name=\"description\" content=\"This analysis estimates that 48% of adults under age 65 with individual market coverage are either employed by a small business with fewer than 25 workers, self-employed entrepreneurs, or small business owners. Because the vast majority of this coverage is purchased through the Affordable Care Act (ACA) Marketplaces, changes to the ACA, including the expiration of the enhanced premium tax credits at the end of this year, would have significant implications for what small business owners and workers spend on their health care.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.kff.org\/affordable-care-act\/about-half-of-adults-with-aca-marketplace-coverage-are-small-business-owners-employees-or-self-employed\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed | KFF\" \/>\n<meta property=\"og:description\" content=\"This analysis estimates that 48% of adults under age 65 with individual market coverage are either employed by a small business with fewer than 25 workers, self-employed entrepreneurs, or small business owners. Because the vast majority of this coverage is purchased through the Affordable Care Act (ACA) Marketplaces, changes to the ACA, including the expiration of the enhanced premium tax credits at the end of this year, would have significant implications for what small business owners and workers spend on their health care.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.kff.org\/affordable-care-act\/about-half-of-adults-with-aca-marketplace-coverage-are-small-business-owners-employees-or-self-employed\/\" \/>\n<meta property=\"og:site_name\" content=\"KFF\" \/>\n<meta property=\"article:published_time\" content=\"2025-09-10T12:00:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-09-10T17:18:04+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.kff.org\/wp-content\/uploads\/sites\/7\/2025\/09\/ACA-Small-Business-orSelf-Employed_no-logo-1.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1600\" \/>\n\t<meta property=\"og:image:height\" 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