WASHINGTON, D.C. (May 8, 2025) – Josselin Castillo, NFIB Principal of Federal Government Relations, joined Scott Becker of Becker’s Healthcare Podcast to discuss the health insurance affordability crisis for small businesses.

Castillo shared findings from NFIB’s recent health care policy paper and offered solutions that lawmakers should consider to make health insurance plans more accessible for Main Street business owners.

Listen to Castillo’s interview here.

“A recent report that we released took a look at what we call the small group insurance market nationwide, and we are seeing a deterioration that is happening rather rapidly. It started in 2014, and since then, the market has lost about 43% of its beneficiaries, and also 60% of carriers. That means that this market has less lives and also less options, less insurance plans.”

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“The businesses that employ 10 or fewer individuals is actually the segment of the business community that has seen the sharpest decline in what we call offer rates. So, about [two decades ago], half of all small business owners in America offered some type of health benefit. We employ 66 million individuals, so that’s a very important thing for us to do in order to attract and retain talent. That number now stands at 30%, and for the 10 and fewer, it’s really 20% and declining every day. So, that means that employees that work for a small business will have less options for coverage. For us, it also means that it puts a lot of strain on our budgets. We’re paying nearly twice as much as large businesses are for health insurance.”

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“In our paper, we call attention to some of the tweaks, rather incremental tweaks, that Congress could make in this session to make small business owners’ lives a little bit easier when it comes to accessing tools. And at the end of the day, small business owners want to provide this benefit for their employees. Many of them are adopting wellness programs, trying to keep their employees from needing access to chronic disease management and just wanting a healthier and productive workforce but they need the tools and sadly, I think what we’re seeing right now is a collapsing market and short of action, we could have ourselves a small business insurance crisis on the horizon.”

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For over 80 years, NFIB has been advocating on behalf of America’s small and independent business owners, both in Washington, D.C., and in all 50 state capitals. NFIB is nonprofit, nonpartisan, and member-driven. Since our founding in 1943, NFIB has been exclusively dedicated to small and independent businesses, and remains so today. For more information, please visit nfib.com.