Gladys Harrison, owner of Big Mama’s Kitchen and Catering, was already struggling to cover rising food prices for ingredients at the Omaha restaurant that’s been in her family for two generations. Then, she got notice last month that her health-care premiums will nearly quadruple next year.

“It’s all of the things happening at once,” said Harrison, 58, one of 24 million Americans who rely on the Affordable Care Act marketplace for insurance. She’s considering picking up more shifts at the restaurant to cover her monthly premium — and may have to cut other employees’ hours to make ends meet in a tough economy.

Small business owners like Harrison, along with their workers and people who are self-employed, make up nearly half of those enrolled in ACA plans, according to KFF, a nonpartisan h

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