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Small business owners despair over their employees facing a $5,000 health insurance hike due to Republican ACA policies: ‘tough pill to swallow’

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John Cleveland is ready to pay a lot more for his health insurance next year.

He hasn’t forgotten the pile of hospital bills that awaited him after he had a seizure while tending to customers in his Austin, Texas, barbershop four years ago. Once doctors hurriedly removed the dangerous tumor growing on his brain, a weeklong hospital stay, months of therapy, and nearly $250,000 worth of medical expenses followed.

The coverage he has purchased for years through the Affordable Care Act marketplace covered most of those bills.

“That saved my ass,” said Cleveland, who owns three barbershops across the city.

Even with Cleveland’s monthly premiums expected to soar next year — from $560 to about $682 — he will still sign up for a plan that requires him to shell out $70 if he sees a doctor and 50% of the cost for any emergency room visits. Still, Cleveland is most worried about some of his employees, who might risk going without insurance once they see the high prices.

Small-business owners are among those who stand to lose the most should Congress let the additional, generous federal subsidies put in place during the covid-19 pandemic lapse. The looming change threatens not only their own coverage but also that of their employees, who often depend on marketplace coverage.

Whether to extend the enhanced ACA subsidies that cost taxpayers billions of dollars yearly poses a serious political conundrum for Republicans. After years of unified opposition to Obamacare, the party now faces pressure from one of its most loyal constituencies, small-business owners, who will bear the brunt of rising premiums if the subsidies disappear.

Most of the roughly 20 employees who work on Justin Miller’s 113-year-old family fruit farm in rural Northern California purchase coverage through the Obamacare marketplace.

He’s agonizing over what it could mean if health insurance through the marketplace becomes unaffordable for his employees. He fears they might consider leaving his farm for a job that comes with health coverage.

“Being a small-business owner, especially in a field like ours, where it is tough work and we really understand how hard everybody works, we have to look everybody in the eyes every day,” Miller said. “Knowing that they’re going to have to pay $4,000 or $5,000 more a year to stay on their insurance is a tough pill to swallow.”

Miller says he already pays a minimum wage of $22.50 and provides sick leave, vacation, retirement, and employee housing benefits.

Adding health insurance for his employees, he said, would be too costly to keep his farm in business.

GOP Pollsters Issue ACA Caution

About half of the 24 million people enrolled in Obamacare coverage are, or are employed by, small-business owners — a group that is more likely to vote Republican and overwhelmingly backed President Donald Trump in last year’s election. Farmers, dentists, real estate agents, and chiropractors are among the professions most represented among enrollees.

Even Trump’s own pollsters have found deep support for the Obamacare subsidies, warning that failing to extend them could cost Republicans in next year’s midterms.

A poll conducted last month by Republican pollster John McLaughlin found that a majority of independent voters would be less likely to vote for politicians who voted to let the enhanced tax credits expire.

Given that “approximately 4 million” people would lose coverage and premiums would “skyrocket by an average of 75%,” the poll also concluded that: “A candidate for congress who let the healthcare tax cuts expire would also be vulnerable to more pointed messages.”

Red States Benefited From the Subsidies

Some red states have seen Obamacare enrollment balloon since the federal government began offering extra help paying premiums in the form of more generous subsidies.

Texas and Florida have added 2.8 million enrollees each since 2020, far outpacing growth in most other states. Together, the two states now account for more than a third of marketplace enrollment nationally.

A small chorus of Republican lawmakers — up for reelection next year, mostly in competitive races — have proposed an extension of the subsidies, urging Democrats to vote to reopen the government while simultaneously pleading with House Speaker Mike Johnson to work out a bipartisan deal that doesn’t allow them to simply lapse.

At Cleveland’s barbershops in Austin, about a third of his 18 employees rely on Obamacare coverage. He’s talked to them about their health insurance options for next year but said many hadn’t started thinking about open enrollment, which began Nov. 1.

He’s worried they’ll be baffled once they see the new prices, which currently reflect what customers will pay next year without an extension of the extra subsidies.

“There’s a couple of my barbers that are going to go without, because they’re healthy and young, but I thought I was too when everything happened to me,” said Cleveland, now 47.

Republicans, meanwhile, remain wary of voting to extend the additional Obamacare subsidies, said Rodney Whitlock, a vice president at the McDermott+ consultancy who was a longtime congressional staffer and advises on health care policy.

No Republican voted for the extra subsidies when they were introduced in 2021 or continued in 2022. Approving them now, he said, is viewed by many as a band-aid that would temporarily help a program GOP leaders have long lambasted as problematic and too costly.

But, Whitlock noted, many in the party are coming to terms with how the subsidies might affect their changing constituencies. Nearly 6 in 10 Obamacare enrollees live in a Republican-held congressional district.

“Republicans are slowly starting to grasp that the lower third of income earners are their voters,” he said. “For the first time, I think they’re getting there. That battleship turns slowly.”

Rep. Marjorie Taylor Greene, a Georgia Republican who has firmly backed Trump, broke with her party last month, calling on the GOP to extend the subsidies. Greene said in an interview that rising health care costs are the “No. 1 issue” she hears about from people living in her district.

“I know a lot of small-business owners, like a family of four, and they’re paying $2,000 a month,” Greene said during the television interview, adding that rising deductibles make the insurance hardly functional for anything other than catastrophes.

She warned in another TV interview that “ignoring” the issue could be “very bad for midterms” next year.

Miller, the farmer who lives in a conservative district in Northern California, expects monthly health insurance premiums for himself, his wife, and two of his children to jump from $264 to $600. His deductibles and copayments are going up, too. He expects all these new expenses will still be on his mind when he goes to vote in the midterm elections next year, he said. Describing himself as an independent, Miller said he is frustrated that few American politicians talk about the type of universal health care coverage that’s available in other countries.

“I’m definitely voting for those that will protect the working American, regardless of party,” he said.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.



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Gen Z’s brains are ‘growing around their phones’ the way a tree warps around a tombstone, ‘Anxious Generation’ author warns

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A global public health emergency driven by the swift transition from a play-based to a phone-based childhood has created a “global destruction of human flourishing” among young people, according to social psychologist Jonathan Haidt. The Thomas Cooley Professor of Ethical Leadership at NYU Stern, speaking at a recent Dartmouth–United Nations Development Program symposium on youth well-being, argued that children born after 1995—Gen Z—are fundamentally different from earlier generations because they experienced puberty amid omnipresent smartphones and social media.

Haidt, who previously explicated many of his thoughts about Gen Z in the New York Times bestseller The Anxious Generation, used a powerful metaphor to explain the neurological consequences of this change: tree roots. Saying they are great metaphors for neurons, Haidt explained that tree-root growth is structured by the environment where they are found. He referred to a picture of a tree growing around a Civil War–era tombstone, where the tombstone scratched the bark 100 years ago, and the tree adapted. The same is true for Gen Z, he argued: “Their brains have been growing around their phones very much in the way that this tree grew around this tombstone.”

Beyond mental health, Haidt said this has physical manifestations. Children are “growing hunched around their phone,” he said, with phone addiction literally “warping eyeballs,” leading to a global rise in myopia (shortsightedness). Screen time is also known to harm sleep, he added. He went on to describe the “great rewiring” of humanity, brought on by the smartphone.

A catastrophe of mental and physical health

This “great rewiring,” which Haidt places between 2010 and 2015, coincides with a synchronized global collapse in teen mental health. Haidt noted Gen Z is “suddenly much more mentally ill than the millennials,” primarily suffering from anxiety and depression.

The evidence of decline is seen in objective behavior, not just self-reporting. For instance, data tracking nonfatal self-harm among early teens (10- to 14-year-olds) shows the girls’ rate “more than quintuples” between 2010 and 2015. Around the world, wherever the internet is in kids’ pockets, Haidt argued, young people are becoming less happy and flourishing less.

The transition Haidt describes occurred in two acts. Act one involved the gradual decline of play-based childhood, which began in the 1980s. Act two was the arrival of a phone-based childhood, a sudden and universal shift that started in the early 2010s. Haidt summarized the tragic change by saying, “We have overprotected our children in the real world, and we have under-protected them online.”

The erosion of focus and meaning

The crisis extends into cognitive ability. Haidt points out, “Fifty years of progress ended in 2012” in educational achievement metrics, specifically the National Assessment of Education Progress, or NAEP, also called the “nation’s report card.” This decline suggests a “broader erosion in the human capacity for mental focus and application,” leading to what Haidt calls a “complete disaster for humanity”: a loss of that capacity. “We’re getting dumber exactly as our machines are getting smarter and taking over more areas of life,” he said.

Students themselves acknowledge the cognitive shift, according to Haidt. He related an anecdote from one of his students, describing the difficulty of reading: “I open a book, I read a sentence, I get bored, I go to TikTok.” Furthermore, he said, high school seniors increasingly report “life often feels meaningless.” Haidt connected this directly to the time spent online, adding that he can’t fully disagree: “If you’re spending five hours a day on social media, you’re not doing anything. Your life actually is meaningless.”

The paths to this “pit of despair” differ by gender. For girls, social media remains the “clearest culprit,” altering development, social relationships, and moods. For boys, the danger centers on a dopamine addiction crisis, with companies competing to “hook them” via highly addictive video games and increasingly available high-definition porn.

Haidt’s comments came as part of a symposium organized by Dartmouth economics professor David Blanchflower, whose work has previously been covered in Fortune. Most recently, he and University College London’s Alex Bryson found the midlife crisis has become a thing of the past, with a quarter-life crisis very real in reams of economic data. Young workers really are full of rising despair, their research found. Blanchflower told Fortune in September he’s “freaked” out by what his research is showing: “Suddenly young workers look to be in big trouble … Now, both absolutely and relatively, the young are worse off.” The midlife hump in despair, commonly known as the midlife crisis, used to be one of social science’s most important patterns, he added, and that’s over now.

The symposium occurred just weeks after an authority no less than Jerome Powell, chair of the Federal Reserve, acknowledged Gen Z is having an especially hard time in the economy of 2025. “Kids coming out of college and younger people, minorities, are having a hard time finding jobs,” Powell said in mid-September, at a press conference following the Federal Open Market Committee meeting.

The solution: Collective action

Haidt asserted the theory suggesting the rewiring of childhood is the only one that can account for the synchronized collapse in mental health globally. Given that this is a collective action problem, the solution must also be collective action, he argues.

Haidt proposed four key norms to reverse a phone-based childhood and restore the play-based model:

  1. Delay smartphone use: Give children a flip phone or simple phone until high school or age 14 internationally.
  2. Social media age limit: “No social media before 16,” Haidt stresses. “We are completely insane if we give puberty over to social [media].”
  3. Phone-free schools: Implement “bell-to-bell” policies, which teachers have welcomed, and studies are already showing raised grades.
  4. Promote independence and play: Encourage “far more independence, free play, and responsibility in the real world.”

Haidt stressed that although there will be a “permanent echo of diminished potential” in the generation that has already passed through puberty with these devices, “it’s not too late for individuals if they make an effort and they make it collectively.”

For this story, Fortune used generative AI to help with an initial draft. An editor verified the accuracy of the information before publishing. 



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JPMorgan CEO Jamie Dimon says Gen Z needs in-demand skills to succeed in 2025 job market

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For many years, the rule of thumb was that working hard will guarantee some level of success. But according to Wall Street veteran Jamie Dimon, for the generations now entering the workforce, hard work alone won’t cut it. In a world increasingly shaped by artificial intelligence, successful individuals will have to be armed with the tools needed in specific sectors.

“When you graduate, whether it’s high school, or community college, or college, you need the skills to get the job,” Dimon said in a recent interview with CNN. “It’s not enough anymore to say, ‘I can work hard.’ In the old days, you could be in 10th grade, go get a factory job in Detroit, and eventually you could afford a family, a home, a car, and that may not be true anymore.”

Dimon’s words will resonate with many. Even in the past few years, buying a home has become increasingly unaffordable for first-time buyers. Per data from the National Association of Realtors, in 2022 its housing affordability index stood at 108, with a value of 100 representing a family with the median income having exactly enough income to qualify for a mortgage on a median-priced home.

By 2025, this had dropped to 97.4, meaning the average American family trying to buy their first home doesn’t have the income to qualify for a mortgage on a median-priced home.

Likewise, childcare costs have skyrocketed compared with a few decades ago. Data from the Federal Reserve Bank of St. Louis charting tuition, school fees, and childcare across an average of U.S. cities has increased from an index of 100 in 1983 to 897 by September 2025.

In the face of an increased cost of living, younger workers now graduating and entering the workforce are more concerned than their older counterparts about the threat of artificial intelligence. Nearly one in five Gen Z workers reported being deeply worried that artificial intelligence will put them out of work within the next two years, according to a recent survey from Deutsche Bank Research. But their older peers are notably less alarmed: While nearly a quarter of young adults ages 18 to 34 gave high scores of concern on a 0 to 10 scale, only about one in 10 baby boomers and Gen Xers (ages 55 and above) expressed comparable anxiety.

Dimon said that AI and coding are areas where “we know we need the skills,” adding that speedy industry training courses also present paths to secure employment: “And it works, those things work. We just have to get people to invest in them.”

Many of the nation’s fastest-growing job markets are in highly specialized sectors—some of which require no degree but do require technical training. According to U.S. Bureau of Labor Statistics projections for job growth in 2023–33, released last year, wind turbine service technicians came in first with a growth rate of 60% and median annual pay of just under $62,000. No degree is required.

Second was solar photovoltaic installers with a growth rate of 48% and annual pay of a little under $49,000—again, no degree required.

Plumbers and electricians in demand

Nvidia CEO Jensen Huang has also urged job market entrants to explore skills-focused roles adjacent to the immediate technology sector.

While the billions being invested into AI have pushed up valuations courtesy of promised efficiencies and streamlining, Huang points out that it will also have real-world impacts when it comes to building data centers and the wider infrastructure needed to support the shift.

“If you’re an electrician, you’re a plumber, a carpenter—we’re going to need hundreds of thousands of them to build all of these factories,” Huang told Channel 4 News in the U.K. in September. “The skilled craft segment of every economy is going to see a boom. You’re going to have to be doubling and doubling and doubling every single year.”

Huang isn’t alone. Earlier this year BlackRock CEO Larry Fink told an energy conference he has warned the White House about the shortage of workers needed to support the rollout: “I’ve even told members of the Trump team that we’re going to run out of electricians that we need to build out AI data centers. We just don’t have enough.”





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Jamie Dimon says he still reads customer complaints himself because his staff filters too much: ‘The bureaucracy does want to control you’

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Jamie Dimon doesn’t trust hierarchy to tell him the truth.

The JPMorgan Chase CEO, who runs a $4.5 trillion bank with 300,000 employees, still reads customer complaints himself, a habit that, he says, keeps him connected to reality inside one of the world’s most powerful financial institutions.

“I still read customer complaints,” Dimon said at the America Business Forum in Miami on Thursday. “If they ask you a question, you’ve got to respond to me directly and not go up that chain of command. The chain of command starts to edit it and fine-tune it. The bureaucracy does want to control you, so you’ve got to kill the bureaucracy.”

For Dimon, bureaucracy is a reflex that creeps into any large institution and shields leaders from reality. He sees it as a constant fight. 

“If you’re in a position like mine, you’ve got to break down those barriers all the time,” he said.

Instead, Dimon prizes what he calls constant curiosity. He starts every morning reading five newspapers and still takes time to visit branches with his management team. 

“Get on the bus and go to a branch,” he said. “Talk to people. You’ll learn something: something stupid we do, something that doesn’t work, or something they did better at another bank.”

That hands-on approach, he said, forces him to stay grounded inside a firm with 300,000 employees in 60 countries. 

“Once your mind closes, you’re not going to make a lot of progress,” Dimon said.

Culture, he added, is what keeps a company from collapsing under its own weight. “You better be relentless,” he told the crowd. “People don’t believe what you write in memos, they believe what you do. They see you fire bad people or a client who mistreats employees. That’s how they know you mean it.”

He’s also learned to value plainspoken communication. Early in his career, Dimon said, he underestimated its power. Now, every message from his office is written in his own voice, stripped of what he calls “corporate pablum.”

For Dimon, the danger is internal complacency. In his view, once bureaucracy takes hold, “it kills a company’s ability to think.”



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