The National Federation of Independent Business (NFIB), Ohio’s leading small business advocacy organization, released a new health care policy paper entitled, “Addressing the Health Insurance Affordability Crisis for Small Businesses.” The findings reveal a dire prognosis for the small-group insurance market as employer-provided health coverage is becoming unsustainable for millions of small businesses and their employees.

“Ohio’s small business owners have reported health insurance costs as their number one concern for nearly four decades,” said Chris Ferruso, NFIB Ohio State Director. “Despite being well-intentioned, legislators should resist pursuing health insurance mandates as it ultimately puts pressure on health insurance premiums and forces small employers to decide whether they can afford to provide this employee benefit. Larger businesses are typically exempt from state-imposed health insurance mandates under the federal ERISA law – leaving small businesses with skyrocketing costs. We encourage Ohio policymakers to make health care more affordable for all.”

Key findings from the report:

• The small-group market is in freefall, with enrollment plummeting from 15 million individuals in 2014 to just 8.5 million in 2023, a 44% drop.
• Average premiums for small businesses have skyrocketed: Average single plan premiums have gone up 120% in the last two decades, while average family plan premiums have increased by 129% for firms with 50 or fewer employees.
• Only 30% of small businesses still offer health insurance, down from nearly 50% in 2000.
• Ninety-eight percent of small businesses say they are concerned about whether they will be able to afford to continue offering health insurance in the next five years.
• Small businesses pay twice as much for health insurance as large businesses, firms with less than $600,000 in revenue spend nearly 12% of payroll on health benefits, compared to 7% for firms with over $2.4 million in revenue.

Ohio legislative recommendations include:

• House Bill 133 – legislation would provide employers with 50 or fewer employees a tax credit of up to $400 per employee for providing Individual Coverage Healthcare Reimbursement Arrangement (ICHRA).
• Senate Bill 129 – legislation would allow employers who purchase a group health plan for their employees to receive a refundable tax credit for a portion of their premiums paid.

View “Addressing the Health Insurance Affordability Crisis for Small Businesses” here.