Center on Budget and Policy Priorities July 17, 2024
Millions of small-business and self-employed workers gained coverage under the Affordable Care Act (ACA). Their uninsured rates reached record lows in 2022, due in part to policies that stabilized Medicaid coverage and enhanced premium tax credits to lower the cost of health coverage for millions of people in the ACA marketplace. States that adopted the ACA Medicaid expansion also played an important role. Extending and building on these policies will drive further progress.
Self-employed workers and small-business employees have had persistently higher uninsured rates than employees of large businesses. Relatively larger shares of small-business and self-employed workers have lower incomes, making health insurance premiums less affordable. And small businesses have long been less likely to offer health coverage to their...
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