Arizona small business owners are making difficult decisions about health insurance coverage since Affordable Care Act premium subsidies expired at the end of 2025 and their monthly costs have spiked. About 245,000 Arizona residents received these health insurance premium tax credits last year, more than 90% of them federal marketplace enrollees. So far this year, over 70,000 fewer Arizonans have signed up for federal marketplace. The end of the premium subsidies and sharply rising costs have led to an increase in monthly costs. The U.S. House passed a bill to extend these premium subsidies last year but no action has been taken.