September 3, 2025
NFIB expert wrote an opinion article on legislation to make health insurance more affordable
What it means: Small business owners are reaching a breaking point with the small group health insurance market. Congress needs to take action to provide relief for small businesses through legislation that promotes flexible, cost-effective plans.
Our take: “The overarching theme is clear: without Congressional action, small businesses will continue to face disproportionate pressure from rising health insurance costs, leading to lower offer rates, higher turnover, and diminished economic dynamism,” said Tyler Dever, NFIB Principal of Federal Government Relations.
Take Action: Urge Congress to act now by providing your small business perspective on health insurance affordability.
Health care affordability remains a major issue for small businesses. According to an NFIB survey, 98% of small employers offering health insurance are concerned that the cost of providing health insurance to their employees will become unsustainable. NFIB Principal of Federal Government Relations Tyler Dever wrote an op-ed in Association Health Plans regarding the small business health insurance affordability crisis.
The small group health insurance market is uneven, and small employers are reaching a breaking point. Participation by issuers is in decline from an average of 13 carriers in 2015 to fewer than five in 2020. This means fewer options and higher prices for America’s job creators.
“The cost of health insurance has been the top small business concern for nearly 40 years; however, it has become a growing percentage of total operating costs for businesses operating on tight margins,” wrote Dever. “This has disproportionately impacted smaller firms, which pay twice as much for health insurance as their larger counterparts, leading to reduced profits and higher prices.”
Congress must take action to provide relief for small businesses through legislation like the Association Health Plans Act of 2025 which would promote more flexible, cost-effective plan designs while preserving important consumer protections.
“Providing small businesses with increased flexibility and options that enable voluntary pooling arrangements is not only good policy but essential to stabilizing a market segment that serves about half of the private U.S. workforce,” explained Dever. “As Congress considers next steps on health reform, affordability and access for small businesses must remain a central focus.”
Take Action: Tell your small business story about the process of providing health insurance and the impact of the rising costs.
NFIB is a member-driven organization advocating on behalf of small and independent businesses nationwide.
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