NFIB, a prominent small business advocacy group, has published a health care policy paper highlighting the rising costs of employer-provided health insurance. According to NFIB State Director Gregg Thompson, “Small business owners have been struggling with rising health insurance premiums for years.” He expressed concern over proposed legislation that could further burden small businesses without significantly aiding most workers.
The legislative session is considering several bills that Thompson argues favor special interests at the expense of broader constituencies. These include HB 152 on transcranial magnetic stimulation access, HB 297 on imaging mandates, HB 489 on ambulance ride payments, HB 567 on lab test mandates, and HB 906 on medical device payments. “These mandates don’t apply to self-insured companies, which are usually big corporations,” Thompson noted. “That means only small businesses will be stuck footing the bill.”
Thompson emphasized findings from the NFIB report titled “Addressing the Health Insurance Affordability Crisis for Small Businesses,” urging North Carolina lawmakers to reject new insurance mandates. He stated, “The cost of health insurance has been one of the biggest concerns for small businesses for nearly 40 years.” He warned that while well-intentioned, these mandates could increase insurance costs and reduce coverage for workers.
The report reveals that only 30 percent of small businesses currently offer health benefits, a decline from nearly 50 percent in 2000. Thompson highlighted that “our small business members want to provide health benefits to their workers,” but increasing costs might hinder this goal.
Additional findings show that small businesses pay almost double for health insurance compared to larger companies. For instance, those earning less than $600,000 annually spend about 12% of payroll on health benefits versus around 7% by companies earning over $2.4 million. Enrollment in the small-group insurance market has also decreased by 44%, dropping from 15 million people in 2014 to just 8.5 million in 2023. Furthermore, 98% of small businesses express concern about maintaining health insurance offerings over the next five years.
“We’re committed to working with lawmakers this session on solutions that help Main Street businesses and their employees,” Thompson concluded.
