“While it is easy to cast blame on Washington, DC, for the 20% jump in individual health plan rates for 2026 in the Exchange, our own state actions are directly inflating insurance costs to our own residents,” testified NFIB Washington State Director Patrick Connor to the state’s Health Care Cost Transparency Board, November 20.

“Yesterday’s small group market rate announcement is astounding. The insurers’ nearly 10% average rate increase request for small-business plans was painful enough. To learn the OIC granted them 30% more, on average, than they requested is mindboggling.”

Connor also presented supplemental testimony to Transparency Board Chair Mich’l Needham.

It was a busy week for NFIB on the health-care front. On November 19 in Washington, D.C., NFIB submitted testimony for the record to the U.S. Senate Committee on Finance ahead of its hearing titled, “The Rising Cost of Health Care: Considering Meaningful Solutions for all Americans.” It outlined the impact high health premium costs are having on small business owners and offering solutions to address the growing affordability crisis.

“Small business owners know the status quo is not sustainable, and the current system is breaking them, and the health of their employees,” said Tyler Dever, NFIB Principal of Federal Government Relations. “Small businesses understand Congress cannot continue to throw money at problems and expect a different result. To solve these long-term problems requires going after the root causes—the mandates, laws, restrictions—that are fueling the exploding costs, decreased competition, and restricting small business, consumer and patient options.”

Connor also offered some solutions for improving affordability by exposing the:

• Practices and resulting cost-drivers of Pharmacy Benefit Managers (PBMs)
• Continuing growth of not-for-profit insurers’ unrestricted surpluses or “unassigned funds” that total $3.4 billion as of the third quarter of this year
• Extent to which charity care and community benefit requirements of non-profit hospitals and systems are actually reaching the patients and communities intended
• Growing number of alarming reports about misuse and other excesses in the 340B prescription drug program.

NFIB Washington sent two news releases on Connor’s testimony, NFIB Offers Rx for Reducing Health Care and Insurance Costs and Small Business Group Slams Latest Health Insurance Rate Hike, the latter of which was picked up Trending Insurance, the industry’s online news site.

Following transmission of the news releases, Connor received a promise from the senior policy analyst for the state insurance commission and also the CEO of the state’s health-care exchange to look into NFIB’s recommendations.

NFIB’s quadrennial Small Business Problems & Priorities report ranks the 75 difficulties of running a Main Street enterprise, and the cost and availability of health care has been the No. 1 issue nationally for 39 consecutive years. In February, NFIB released a policy paper titled, “Addressing the Health Insurance Affordability Crisis for Small Businesses.”

It found, “The small group market, where most small businesses purchase coverage is in a death spiral. The number of participants has declined sharply, down 7.4% from 2022 to 2023. The market ended the year in 2023 with 8.5 million participants, compared to nearly 15 million in 2014.5 In addition, issuer participation has declined from an average of 13 in 2015 to only five in 2020 and continues to fall.

“The average cost of an individual health insurance plan has increased by 120% for firms with less than 50 employees, and average family premiums have increased by 129% in the last 20 years. As a result, small firms’ offer rates have declined from nearly 50% in 2000 to just 30% in 2023.

“Further, 98% of small businesses report they are concerned about whether they’ll be able to afford health insurance in the next five years due to the pace of rising premiums and shrinking coverage choices.”