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Expanding healthcare options will lower costs and increase coverage for small businesses
By NFIB,
WASHINGTON, D.C. (Oct. 16, 2026) – The National Federation of Independent Business, the nation’s leading small business advocacy organization, sent a letter [6] to Dr. Mehmet Oz, Administrator of the Centers for Medicare and Medicaid Services (CMS), urging the administration and Congress to expand affordable and flexible healthcare options for small businesses and their employees.
Since the passage of Obamacare, the number of small businesses able to offer health coverage to their employees has dropped significantly. Today, only about 33% of small businesses can offer health coverage, while close to 96% of large corporations can provide coverage to their employees.
“For more than 40 years, small business owners have consistently identified the rising cost of healthcare as one of the most significant challenges facing their businesses,” said Tyler Dever, Principal of Federal Government Relations. “Employers want to offer health coverage to their employees but are finding it increasingly unaffordable. Without significant changes, the number of small businesses able to offer health coverage to their employees will continue to crater, leaving them at a significant disadvantage to their larger competitors. NFIB urges the administration and Congress to take meaningful steps to provide relief by increasing access to affordable and flexible healthcare options.”
Following recent roundtables with the CMS and the Small Business Administration (SBA) in Indiana and Georgia, small businesses are asking the administration and Congress to support the following legislative solutions:
- The CHOICE Act (H.R. 5463 / S.2875) which would make Individual Coverage Health Reimbursement Arrangements (ICHRAs) permanent and increase access to an affordable coverage option for small businesses and their employees.
- The Great American Healthcare Plan (H.R. 10015) which would significantly expand access to HSAs and increase their flexibility, making them a more powerful tool for workers and employers.
- The COMPETE Act (S. 3418) which would codify the 2018 short-term, limited-duration insurance (STLDI) rule allowing STLDI plans to be sold with up to 12-month contracts and renewed for another 24 months. NFIB also urges the administration to finalize the STLDI rule currently under review, giving small businesses another affordable healthcare option.
View NFIB’s letter to CMS here. [6]