$1,107 a Month Per Employee: Small Business Owners Ask the Senate to Fix Health Costs

On October 7, the National Federation of Independent Business (NFIB) sent a letter to Senator Ron Wyden, the ranking member of the Senate Finance Committee, answering the committee's request for information on the future of health coverage. The letter is more than a lobbying document. It puts real premium numbers from real small businesses on the record, and it points to specific tools owners can look at today.

Here is what the owners reported, what NFIB is asking Congress to do, and what you can do before open enrollment pressures hit your budget.

What Owners Told the Senate

NFIB included testimonials from small business owners across the country. The figures are striking.

Minnesota: Kelly Baltzell of Beyond Indigo Pets pays $1,107 per employee per month, up 18.9% this year. Her share costs $30,000 more per year for nine people than it did five years ago. Her request: "I need a benefit I can budget."
Hutchinson, Minnesota: Mary Schaufler of Salient Inc. pays nearly $95,000 a year in premiums for six employees. She called double-digit increases "unsustainable for small companies like mine."
Oregon: A metal fabricator reported that small-group coverage costs per employee have nearly doubled since 2020. Deductibles and out-of-pocket maximums rose from $500 and $2,500 to $2,500 and $7,000 per individual, with premiums around $1,200 a month per employee.
Iowa: Marcie Strouse pays $1,065 a month for a family on a pre-ACA plan. She estimates a comparable 2026 marketplace family plan would cost $2,700 a month, and she found no marketplace plan matching her current benefits.

These are individual accounts, not a statistical sample, but they match what many owners describe: costs rising faster than revenue while benefits get thinner.

What NFIB Wants Congress to Do

NFIB's letter argues that current rules have reduced choice and added insurer mandates. Its recommendations center on four ideas:

Expand Health Savings Accounts (HSAs)
Strengthen employer-driven options, specifically Individual Coverage Health Reimbursement Arrangements (ICHRAs) and Association Health Plans (AHPs)
Reduce regulatory burdens and mandates
Increase consumer-driven competition and price transparency

This is a request for information, not a bill. Nothing changes for your plan today, and there is no guarantee Congress acts. Treat it as a signal of where the debate is heading.

The Tools Worth Understanding Now

ICHRAs

An ICHRA lets an employer give employees a set monthly allowance to buy individual coverage instead of picking one group plan. The appeal for owners is budget certainty: you choose the dollar amount, and increases in insurer pricing do not automatically become your increase. That fits Baltzell's wish for a benefit she can budget. Rules, eligibility and tax treatment vary, so confirm the details with a benefits adviser before switching.

HSAs

Health Savings Accounts pair with qualifying high-deductible plans and let money be set aside tax-advantaged for medical costs. NFIB wants them expanded. Today, owners can already offer HSA-eligible plans, which can lower premiums in exchange for higher deductibles. The Oregon example is a warning that deductibles can climb quickly, so model what employees would really pay before choosing that route.

Association Health Plans

AHPs let small employers band together to buy coverage. NFIB wants them strengthened, but their availability and rules have changed over time, so check what is currently permitted in your state.

What to Do Before Your Next Renewal

Ask for the full renewal picture early

Request renewal quotes as soon as your carrier or broker can issue them, and ask for alternatives at different deductible levels. The testimonials show that premiums and deductibles often rise together, so compare both.

Calculate your per-employee cost

Divide your total annual premium contribution by headcount, then by 12. If your number approaches the $1,100 to $1,200 monthly range owners described, the stakes of shopping around are high. Build that figure into your profit and loss statement so it does not surprise you in budgeting season.

Check whether your policy mix is right

Health coverage is one piece of your protection. Review your overall business insurance program with your agent, since bundling and policy structure can affect what you pay.

Know who counts as an employee

Coverage rules depend on how you classify workers. If you use contractors, make sure the classification holds up; our guide on independent contractors vs. employees explains the tests.

Keep the budget separate

A dedicated account for benefit costs, set up through a business bank account, helps you spot cost creep month by month.

Why This Matters Beyond Health Care

When coverage costs consume a larger share of payroll, owners hire less or hold back raises. The owners in NFIB's letter are describing exactly that trade-off. If you employ even a handful of people, health costs may now be one of your largest and least predictable expenses.

The Bottom Line

NFIB's October 7 letter will not change your premiums this year, but it spotlights the options, HSAs, ICHRAs and association plans, that may shape small-employer coverage in the next few years. In the meantime, gather your numbers, ask for quotes early, and talk with a licensed benefits adviser about which structure fits your team.

Source: NFIB press release and letter to Sen. Ron Wyden, October 7, 2026. This article is for information only and is not insurance, tax or legal advice.

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