Small Business Fights Single Payer Healthcare Proposals in Congress and States

Date: March 03, 2022

NFIB Members fight for affordable health insurance benefits for their employees

On Feb. 17, in response to a U.S. House committee hearing entitled Exploring Pathways to Affordable, Universal Health Coverage, NFIB urged lawmakers to lower health costs to benefit small businesses and all Americans under the existing model of private health insurance, not a transition to a single payer system.

Small business owners continue to face the challenge of providing affordable health insurance coverage for their employees. Since the Affordable Care Act’s (ACA) passage, for employers with less than 50 employees, the average employee-only premium has increased 42% and the number of small businesses offering coverage has dropped to 31%.

NFIB encourages Congress to consider innovative approaches to lower healthcare costs under the existing model of private health insurance. Along with protecting the health of their employees, small business owners use health insurance benefits as a tool to recruit and retain great talent. For far too many small business owners, providing health insurance is simply not affordable.

“Congress should work to provide innovative payment solutions for small businesses, such as enhancing the ability of businesses to offer Health Reimbursement Arrangements that offer predictable costs and give employees the opportunity to choose the health insurance plan of their choice,” Vice President of Federal Government Relations Kevin Kuhlman said. “Moreover, Congress should build upon the important work of increasing price transparency in medical services and insurance, while combatting provider consolidation and other cost drivers in the health insurance system.”

The proposed single payer system solutions would mean one agency, or single payer, collects all healthcare fees and pays for all health costs. The single payer effort would establish a one-size-fits-all government-run healthcare system, eliminating private health insurance coverage as we currently know it. NFIB members overwhelmingly reject that approach with 75% indicating opposition to a single-payer solution in a recent member ballot.

The fight to stop single-payer healthcare legislation is on the front burner for NFIB members in New York and California as well.

California small business owners recently saw a victory in this fight against legislation in the state. Introduced last year, Assembly Bill 1400 called for making California the first state in the nation to institute a comprehensive single-payer healthcare system that would have precluded all others (private insurance, Medicare, Medi-Cal, Tri-Care). The California State Assembly Appropriations Committee estimated AB1400 would cost the State between $314 Billion and $391 Billion. The leader of the bill could not find the votes to pass AB 1400 and pulled it from consideration prior to the vote.

New York is currently in the middle of a push by some lawmakers to pass the NY Health Act, which would establish a government-run, single payer healthcare system in the state. The top concern for small businesses is that a single payer system would heavily increase taxes and cut jobs, which would be detrimental to a state’s economy as it will be a less appealing place to own or operate a business. In New York, NFIB continues to advocate on behalf of small businesses by voicing our strong opposition to the NY Health Act and encourages New York small business owners to take action by reaching out to their state senators and assembly members.

“Anti-small business policies like California’s proposed single-payer healthcare system would add massive and unsustainable tax hikes at a time when small businesses are already struggling to survive and recover,” said NFIB’s VP of State Government Relations Tim Goodrich.

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