While 86 percent express worry about a broad range of regulations and rules, 75 percent said they expect that the Affordable Care Act will increase costs for their businesses while 71 percent think that implementation will make it harder to hire more employees.
Five percent say the law will make healthcare more affordable.
Tom Donohue, Chamber president and chief executive, said Thursday that Washington needs to reach a broad deal to rein in deficits and consider entitlement reforms to help out on that path.
When it comes to solutions to solve what ails the nation's pocketbook, 88 percent of those surveyed say they are supportive of looking at entitlement spending.
All told, 82 percent of small business say the economy is on the wrong track, and more than half expect the business climate to worsen over the next two years.
A majority (88 percent) of small businesses want certainty from policymakers rather than assistance from Washington.
On New Year's Day, Congress passed the "fiscal cliff" bill, which extends lower income tax rates for those making less than $400,000 a year.
Now lawmakers face a trio of challenges within the next couple of months — raising the $16.4 trillion debt ceiling, replacing spending cuts in a scheduled sequester and completing a funding bill for the remainder of fiscal 2013.
Overall, 62 percent view the nation's deficit and debt problem as a threat to the success of their businesses.
A large majority, (92 percent) say that a comprehensive approach to energy exploration and the increased revenue from such ventures could provide some relief to the nation's fiscal challenges.
The survey was conducted between Dec. 17 and Jan. 2 among 1,482 small-business executives who run companies with fewer than 500 employees and have annual revenue less than $25 million.