Hoosier State Today

The National Federation of Independent Business (NFIB), a prominent small business advocacy group in Indiana, has released a health care policy paper titled "Addressing the Health Insurance Affordability Crisis for Small Businesses." The report highlights significant challenges facing the small-group insurance market, as employer-provided health coverage becomes increasingly unsustainable for many small businesses and their employees.

"Health insurance costs have been the number one concern for small business owners for nearly four decades – and there are no signs of improvement," stated Natalie Robinson, NFIB Indiana State Director. She added that rising costs and a collapsing market are forcing difficult decisions upon business owners. Robinson emphasized that Indiana lawmakers have an opportunity to support legislation that could provide immediate relief to small employers.

The report outlines several key findings:

- Enrollment in the small-group market has decreased from 15 million individuals in 2014 to 8.5 million in 2023, marking a 44% decline.

- Over the past two decades, average premiums for single plans have increased by 120%, while family plan premiums have risen by 129% for companies with fewer than 50 employees.

- Currently, only 30% of small businesses offer health insurance, compared to nearly 50% in 2000.

- A vast majority of small businesses, at 98%, express concerns about affording health insurance over the next five years.

- Small businesses pay twice as much for health insurance compared to larger firms. Companies with less than $600,000 in revenue allocate almost 12% of payroll on health benefits, whereas those with over $2.4 million spend around 7%.

The NFIB's legislative recommendations include:

- HB 1003: This bill aims to reduce healthcare costs through reforms such as prior authorization processes and prescription drug pricing transparency. Natalie Robinson has testified in favor of this legislation.

- HB 1004: This proposal seeks to reform nonprofit hospital community benefits and scrutinize service charges relative to Medicare reimbursement rates. The NFIB supports this bill due to its potential impact on high hospital costs.

- HB 1604: This measure mandates that out-of-pocket expenses paid directly by covered individuals be credited toward deductibles if claims are not submitted to the health plan.

Additional supported legislation includes SB 3 on fiduciary duty in health plan administration, SB 118 regarding the 340B Drug Program Report, SB 119 concerning certificates of public advantage, and SB 147 addressing physician referrals and reimbursement rates.

For further details, view "Addressing the Health Insurance Affordability Crisis for Small Businesses."