Submitted by the Economic Development Council.
Prepared by the EDC of San Juan County, based on survey data (www.sanjuansedc.org/survey).
Overview
This briefing summarizes responses from San Juan County business owners and individual residents regarding anticipated reductions to ACA marketplace credits and projected increases in health insurance costs. The summary highlights the most prevalent trends, supported by representative participant comments and respondent-identified impacts.
Across both business and individual respondents, expectations of rising health care costs were universal. Concerns centered on affordability, the potential loss of coverage and downstream effects on household budgets, workforce stability and local economic activity.
Top takeaways (in order of prevalence)
Rising costs are universally expected: All business owner respondents (100%) reported that they expect their insurance costs to increase. One-third anticipate increases above 70%, one-third expect increases between 51-70% and the remainder are unsure.
Among individuals, respondents widely expect much higher out-of-pocket expenses due to reduced credits or increased premiums.
High reliance on the ACA marketplace: A majority of respondents — both business owners and individuals — depend on the ACA marketplace for coverage.
• 63% of business owners purchase their own insurance through the marketplace.
• 33% of business owners reimburse employees who purchase ACA plans.
• 81% of individual respondents participate in the ACA marketplace.
Anticipated financial and health impacts: Respondents foresee significant impacts on both business operations and household stability:
• 83% of business owners anticipate severe impacts to their businesses from rising insurance costs.
• 54% of individuals expect severe financial impact on their households.
• Respondents identified potential consequences, including canceling insurance, cutting basic expenses and incurring debt.
Risks to coverage continuity: Both groups expressed concern that cost increases may lead to losses in coverage:
• 20% of business owners said they might cancel their own insurance; 12% believe employees may do the same.
• 18% of individual respondents said they may cancel insurance for themselves or their families.
Implications for local workforce and economy: Respondents identified broader economic consequences associated with increased health care costs:
• Reduced consumer spending (12% of business respondents).
• Potential workforce disruptions, including employees seeking jobs with employer-provided insurance (9% of individual respondents).
• Concerns that increased financial strain could affect health, productivity and business viability.
Representative quotes
“The increased costs of group insurance plans will either mean fewer employers offering insurance, or be passed from employers to their employees.”
“It’s not just the increased cost of coverage, it’s the increased cost of everything. Something will have to give.”
“I believe many people will decide to go without healthcare if costs rise. That will have ripple effects throughout the community.”
“As a small business owner, I’m already stretched. A big jump in premiums would force difficult decisions.”
“As an early retiree, I depend on the ACA marketplace. Reducing credits would be devastating for people like me.”
“If insurance becomes unaffordable, people will cut essentials — food, transportation, even medical care.”
Suggested next steps (respondent-indicated, synthesized)
• Monitor year-over-year premium trends to assess the scale of cost increases affecting local residents and businesses.
• Assess the potential economic impacts of reduced health care affordability on the local workforce, including retention and recruitment challenges.
• Track changes in insurance participation rates to identify emerging coverage gaps.
• Support educational outreach to help residents navigate plan changes, compare options and understand available financial assistance.
• Explore opportunities to convene stakeholders to discuss strategies for mitigating rising health care costs and supporting community resilience.
Methodology
Survey data were reviewed and analyzed manually, incorporating quantitative summaries and qualitative coding of open-ended responses. Quoted material is included verbatim to preserve respondent intent.
