WASHINGTON, D.C. (September 18, 2026) — The following opinion article was written by Ramiro A. Cavazos, President and Chief Executive Officer of the United States Hispanic Chamber of Commerce (USHCC).
Every fall, America’s small businesses face a painful decision: absorb another jump in health insurance premiums, pass the cost on to employees, or stop offering coverage altogether.
This year appears no different. Health insurance premiums are expected to rise sharply again, extending a trend that has steadily made it harder for small employers to provide one of the benefits workers value most.
For a neighborhood restaurant, family owned construction company, local manufacturer, or Hispanic-owned startup, health insurance isn’t just another expense. After payroll, it’s often one of the largest costs of doing business. Unlike Fortune 500 companies, small employers have little leverage to negotiate lower rates in an increasingly consolidated insurance market. They simply pay what they’re charged.
That’s a problem not just for business owners, but for the American economy.
We celebrate entrepreneurs as the backbone of our economy. We encourage people to start businesses, create jobs and invest in their communities. Yet every year, rising health care costs make those goals harder to achieve. Health insurance has quietly become one of the biggest barriers to growth for small employers.
Consider the numbers. Small businesses account for 99% of all U.S. businesses and employ roughly 45% of the nation’s private-sector workforce. For firms with fewer than 200 employees, the average annual premium for family health coverage rose from $16,977 in 2020 to $26,054 in 2025 — an increase of more than 50% in just five years.
Every dollar consumed by higher premiums is a dollar that can’t be used to hire another employee, raise wages, invest in new equipment, expand to a second location, or weather an economic slowdown. Rising health care costs don’t simply strain small businesses — they limit their ability to grow.
Eventually, many employers reach a breaking point.
In 2010, 83% of businesses with fewer than 200 employees offered health insurance. By 2025, that figure had fallen to just 59%. That’s not because small-business owners suddenly stopped valuing their employees. It’s because, for too many of them, the economics no longer work.
The consequences extend far beyond the employer.
Nearly all Americans say health insurance is an important consideration when choosing a job, and almost two-thirds say they would turn down a position that doesn’t offer coverage. When small businesses can no longer provide competitive benefits, they struggle to recruit talented workers and retain experienced employees. Workers, meanwhile, are left paying more out of pocket, purchasing expensive coverage on the individual market, or going without insurance altogether.
These challenges are especially acute for Hispanic-owned businesses.
Latino entrepreneurs have become one of the great success stories of the American economy. Hispanic-owned businesses contribute more than $800 billion to the economy each year, employ more than 3 million Americans, and accounted for 36% of all new businesses created in 2023. They are launching companies, revitalizing neighborhoods and creating opportunities in communities across the country.
Yet many Hispanic-owned businesses are also newer companies with less access to affordable capital than larger, more established competitors. They often operate on thinner margins, leaving them less able to absorb another year of steep premium increases. Rising health care costs don’t just threaten their profitability. They can delay hiring, postpone expansion and make it harder to offer the benefits employees need and expect.
America cannot claim to support entrepreneurship while making it increasingly expensive to employ people.
Lowering health care costs isn’t simply a health care priority. It’s an economic imperative.
Policymakers should pursue reforms that increase competition throughout the health care system, address growing insurer consolidation, and rein in anticompetitive practices that drive up costs for employers and workers alike.
That includes advancing meaningful pharmacy benefit manager reform to bring greater transparency and accountability to the prescription drug supply chain and ensure savings are passed on to patients and employers, not absorbed by middlemen.
Small businesses don’t expect special treatment. They simply want a health care marketplace that is as competitive as every other market in which they operate. If we want America’s entrepreneurs to keep creating jobs, strengthening communities, and driving economic growth, we cannot allow the cost of providing health insurance to become an ever-greater obstacle to success.
