You should just be able to take ownership of the file and then renable inheritance (and/or assign whatever permissions you like/need) for it.
Nope. The owner was set to nothing, and since there was no owner and I didn't have permissions, I couldn't take ownership.
I did keep going as this was pretty critical and figured it out with the help of Malwarebytes techs.
I disabled antiransomware, and it restored the permissions. Then I was able to enable it, and with the exclusions in place it didn't detect it. With that work around in place, it makes it a lot less questionable what they did, but it did almost give me a heart attack. I was up until 2 AM my time trying before I gave up.
Also for anyone interested, the logs are there- they just don't show up in the protection log. You have to look in C:\ProgramData\Malwarebytes\MBAMService\ArwDetections to see if it's there. If it's not, it's in the mbamservice.log located in C:\ProgramData\Malwarebytes\MBAMService\LOGS