FOR IMMEDIATE RELEASE

CONCORD, NH (March 10, 2025) – The National Federation of Independent Business (NFIB), New Hampshire’s leading small business advocacy association, 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.

“Health insurance costs have been the number one concern for small business owners for nearly forty years,” said John Reynolds, NFIB New Hampshire State Director. “The ability to offer employe health coverage is critical for recruiting and retaining workers, but this benefit is getting further and further out of reach for many small employers. The first step that New Hampshire lawmakers can take is to stop making the problem worse by adding new mandates and regulations that drive up the cost of coverage.”

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.

NFIB New Hampshire Healthcare Priorities:

• Flexible Coverage. Let small business owners work with their employees and health carriers to determine what works best for them without saddling the individual and small group markets with additional mandates and regulations.
• Balance Access and Cost. NFIB NH supported SB 256 (Sen. Tim McGough), a proposal to ensure patients get timely access to critical medication while reducing wasteful practices and protecting against higher costs for one of the most expensive classes of prescriptions (clinician-administered drugs).
• Support New Paths. Lawmakers should explore new ways to help small employers offer Individual Coverage Health Reimbursement Arrangements (ICHRA) and make it easier to form Multiple Employer Welfare Arrangements (MEWAs) and Association Health Plans (AHP).

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

###

For more than 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.