This key group opposes Trump's Big Beautiful Bill

President Donald Trump's One Big Beautiful Bill Act, H.R. 1, is a dream of tax cuts for corporations and the wealthy. However, the same bill that passed the Senate on Tuesday is also a loaded gun of healthcare spending cuts aimed at the American people, 11.8 million of whom could lose their coverage by 2034, according to the nonpartisan Congressional Budget Office.

Some of these Americans are mom-and-pop entrepreneurs.

Dr. Alexia McClerkin owns The Wellness Doc in Houston, Texas. She can't afford to buy herself health insurance and relies on Medicaid for her three sons' coverage. Dr. McClerkin has a bird's-eye view of how her patients cope with paying their healthcare bills.

Doug Scheffel is president of ETM Manufacturing in Littleton, Massachusetts. Two of his employees rely on state health exchanges. Other employees of Scheffel are care providers for family members receiving Medicaid.

In a recent survey of 574 small business owners, seven of 10 opposed the spending cuts in H.R. 1 that seeks to extend the 2017 Tax Cuts and Jobs Act. According to this Small Business for America's Future (SBAF) survey, 27% support the healthcare cuts in H.R. 1, the One Big Beautiful Bill Act, and 5% are not sure.

This SBAF survey found that 58% of small businesses have owners, employees, or family members who rely on Medicaid, healthcare that covers the disabled, elderly, and low-income Americans, or Children's Health Insurance Program (CHIP coverage), low-cost or free care for kids in families whose annual income disqualifies them from Medicaid, an alternative to unaffordable private healthcare insurance.

According to the SBAF survey, 56% of respondents themselves, their employees, or family members use Affordable Care Act (ACA) Marketplace coverage with premium tax credits set to expire that are not extended in the H.R. 1 legislation.

Over half, or 52%, of responding small business owners stated that climbing healthcare insurance harms their bottom lines.

"Small businesses cannot afford to be shut out of access to affordable healthcare. Medicaid, CHIP, SNAP, and enhanced ACA premium tax credits are lifelines for small business, their families, and their workers," said Sen. Ed Markey (D-Mass.) in a written statement.

"If Republicans gut these programs or allow them to expire, healthcare costs for small businesses and their families will skyrocket, employees will lose coverage, and entrepreneurs will be stifled. We must expand access to health coverage for all, especially small businesses."

A policy alternative for universal health coverage is Medicare for All. However, passing such legislation through Congress for the president to sign faces stiff opposition from the healthcare industry. It has been successful in blocking Medicare for All.

"Small business owners have been crying out for relief from crushing healthcare costs for years, and Congress' response is to make it worse," said SBAF co-chair Walt Rowen, owner of Susquehanna Glass Company in Columbia, Pennsylvania, in a statement.

"These cuts don't solve problems—they shift costs from government programs onto the businesses least able to absorb them, all while extending tax breaks for corporations that already pay lower effective rates than the corner store."