NFIB Washington State Director Patrick Connor addressed the state’s Health Care Cost Transparency Board on November 20, expressing concerns about rising health insurance costs. He pointed out that while federal policies are often blamed for the projected 20% increase in individual health plan rates for 2026, state-level actions also play a significant role.
“While it is easy to cast blame on Washington, DC, for the 20% jump in individual health plan rates for 2026 in the Exchange, our own state actions are directly inflating insurance costs to our own residents,” Connor said during his testimony.
Connor highlighted recent developments in the small group market, noting: “Yesterday’s small group market rate announcement is astounding. The insurers’ nearly 10% average rate increase request for small-business plans was painful enough. To learn the OIC granted them 30% more, on average, than they requested is mindboggling.”
He also provided additional testimony to Mich’l Needham, Chair of the Transparency Board.
On November 19 in Washington, D.C., NFIB submitted written testimony to the U.S. Senate Committee on Finance ahead of its hearing on “The Rising Cost of Health Care: Considering Meaningful Solutions for all Americans.” The submission outlined how high premiums affect small businesses and proposed potential solutions.
“Small business owners know the status quo is not sustainable, and the current system is breaking them, and the health of their employees,” said Tyler Dever, NFIB Principal of Federal Government Relations. “Small businesses understand Congress cannot continue to throw money at problems and expect a different result. To solve these long-term problems requires going after the root causes—the mandates, laws, restrictions—that are fueling the exploding costs, decreased competition, and restricting small business, consumer and patient options.”
Connor suggested several measures to improve affordability by examining practices such as those of Pharmacy Benefit Managers (PBMs), monitoring surpluses held by not-for-profit insurers—which have reached $3.4 billion as of this year’s third quarter—and assessing whether charity care requirements at non-profit hospitals effectively serve intended patients. He also raised concerns about misuse within the 340B prescription drug program.
Following public statements from NFIB Washington—including two news releases summarizing Connor’s testimony—both a senior policy analyst from the state insurance commission and the CEO of Washington’s health-care exchange committed to reviewing NFIB’s recommendations.
NFIB data show that healthcare cost and availability have ranked as top challenges for small businesses nationally over nearly four decades. A February policy paper from NFIB reported that participation in the small group market has dropped by 7.4% between 2022 and 2023; there were only 8.5 million participants at year-end compared with almost 15 million in 2014. Issuer participation has also declined significantly since 2015.
According to NFIB research cited in its report: “The average cost of an individual health insurance plan has increased by 120% for firms with less than 50 employees, and average family premiums have increased by 129% in the last 20 years. As a result, small firms’ offer rates have declined from nearly 50% in 2000 to just 30% in 2023.”
Additionally: “Further, 98% of small businesses report they are concerned about whether they’ll be able to afford health insurance in the next five years due to the pace of rising premiums and shrinking coverage choices.”
