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U.S. House Advances Healthcare Affordability and Access Bills

July 6, 2023 Last Edit: March 19, 2026

Healthcare legislation aims to improve small business healthcare affordability and access

U.S. House Advances Healthcare Affordability and Access Bills

Healthcare costs and access continue to be a top concern for small business owners. In a recent NFIB survey on the challenges small businesses face with health insurance costs, 98% of small employers are concerned that their ability to provide health insurance will become unsustainable in the next 5-10 years. NFIB issued a Key Vote alert on H.R. 3799, the CHOICE Arrangement Act, and sent a letter to members of the United States House of Representatives supporting the legislation. “For nearly 40 years, small business owners have cited the rising cost of health insurance as their top business concern,” said Josselin Castillo, NFIB Manager of Federal Government Relations. “Small business owners often struggle to manage the cost of offering employer-sponsored health insurance, which threatens their ability to offer competitive benefits packages to attract and retain a talented workforce, especially with a tight labor market. NFIB welcomes the advancement of this important legislation and urges a floor vote in the U.S. Senate.” Key legislation such as the CHOICE Arrangement Act and the Employer Reporting Improvement Act holds the potential to enhance access to affordable and flexible healthcare, reduce administrative burdens, and empower small employers. Forty-nine percent of small employers have taken a lower profit or suffered a loss to pay for health insurance premium increases over the last five years. Specifically, the CHOICE Arrangement Act would:

Expand Access to Association Health Plans (AHPs) by leveling the playing field between large and small businesses.
It would create certainty for employers seeking to offer employees tax-preferred funds so that they may purchase insurance in the individual market.
Finally, this legislation seeks to foster an environment that supports and encourages small businesses to explore self-insurance as a viable option for providing their employees with affordable, flexible, and predictable healthcare coverage.

“Small business owners desperately want to take care of their employees, but the broken health insurance system makes it harder to compete in attracting top talent,” explained Castillo. “Main Street faces higher costs than large corporations because small businesses don’t have the same market power and face higher regulatory requirements and mandates.” The Hill recently published an op-ed from Castillo on the importance of Congress acting on health insurance options. NFIB also joined a coalition letter with other associations asking Congress to improve healthcare options and affordability for Main Street. Take Action: The CHOICE Arrangement Act would enhance access to affordable and flexible healthcare, reduce administrative burdens, and empower small employers. Act now and urge your Senators to support increased choice and flexibility in health insurance.

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U.S. House Advances Healthcare Affordability and Access Bills

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