This week marks the eighth anniversary of the Affordable Care Act (ACA). I’m the director of the Main Street Alliance, a national network of small business owners working to give business owners a voice on important public policy issues.

Main Street Alliance started 10 years ago when small business owners convened to fight for a better health-care system — a system that didn’t allow insurance companies to set all the rules, and provides people good health care at a reasonable cost.



Though the ACA has been far from perfect for small business owners since it was signed eight years ago, it did offer stable, single-digit increases in premiums from year to year.

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After years of being on their own when it came to “shopping” for and affording quality health care, the ACA meant Main Street business owners and their employees could finally reap some of the benefits of being part of a larger insurance pool like their corporate competitors, including being less vulnerable to wildly increasing costs each year.





But for more than a year, President Trump Donald John TrumpBubba Wallace to be driver of Michael Jordan, Denny Hamlin NASCAR team Graham: GOP will confirm Trump's Supreme Court nominee before the election Southwest Airlines, unions call for six-month extension of government aid MORE and his Republican allies have been actively sabotaging our health-care system. After repeatedly failing to repeal and replace the ACA in the face of overwhelming public opposition, they’ve instead resorted to dismantling our health care piece by piece.



Primarily, they passed a sham of a tax bill last year aimed at giving major corporations and the 1 percent trillions in unneeded tax cuts, stripping our nation’s coffers of much-needed revenue.

After blowing that hole in the budget, Republican leaders like Speaker Paul Ryan Paul Davis RyanKenosha will be a good bellwether in 2020 At indoor rally, Pence says election runs through Wisconsin Juan Williams: Breaking down the debates MORE (R-Wis.) wasted no time starting their talking points about needing to cut the public services they’ve been clamoring to slash for decades — namely Medicaid, Medicare and other essential services — to offset the cost of the GOP’s tax giveaway to Wall Street.



Their sabotage strategy didn’t stop there. The Trump administration also forced insurance companies to increase premiums by continually threatening to cut off cost-sharing payments, curtailing the period where Americans can enroll in the insurance marketplace and slashing outreach and marketing programs by 90 percent.

If that wasn’t enough, they have reintroduced both short-term and association health plans that offer junk policies across state lines — junk plans that once again give insurance companies a way to make all the rules and worm out of paying claims.



Perhaps most damaging of all, they intentionally destabilized the health-care market by repealing the individual mandate in the tax bill. Their sabotage strategy is working — they’re siphoning off healthy people from state insurance pools, creating tumult in the market and are sending premiums through the roof.



After pretending to champion Main Street in their tax bill, small businesses are the ones already paying the price for the GOP’s greed-driven agenda. In 2017, the average increase before subsidies for those buying insurance on an exchange or private market plan was a shocking 25 percent.

This year, the price jump in group plans is expected to be the largest since 2011. Another new report from Covered California predicts that without action, cumulative increases from 2019-2021 could hit 35 to 90 percent.



The rapidly increasing cost of health care is hitting small businesses and their employees particularly hard. Tony Sandkamp owns Sandkamp Woodworks in Jersey City, New Jersey.

During the last year, he says premiums on the small group health insurance plan that covers him and his employees have risen by over 50 percent. His insurance alone costs about $900 a month.

Over in Princeton, New Jersey, Dorothea von Moltke employs 20 people at her business, Labyrinth Books. She reports that this year their group plan premiums went up by 20 percent.



Republicans have touted their tax bill as a driver of economic growth and a win for American businesses. But those who stand to benefit most from the bill are those with the most to begin with, while small business owners and the rest of the middle class are being punished with higher health-care premiums and looming cuts to other essential services that far offset the nominal cuts average income earners are seeing from the tax bill.



On this anniversary of the ACA, that’s what we’re hearing from small business owners across the country — real concern about continued attacks on our health care, absent any praise of the tax bill.

Amanda Ballantyne is the national director of Main Street Alliance, a national network of small business owners.