STAT+: America’s small businesses are giving up on health insurance

Manage alerts for this article Email this article Share this article By Bob HermanJuly 7, 2026 Herman has covered employer-based health insurance for over a decade. He spoke with more than 50 people for STAT’s Out of Pocket, Out of Reach series, including small business owners, workers, employee-benefits leaders, health policy experts, attorneys, consultants, brokers, and insurance executives. Bob Herman[email protected]Bob covers the money in health care, focusing on health insurance and hospitals. His stories delve into Medicare Advantage, opaque prescription drug benefits, and how much executives actually make. He is also the author of the Health Care Inc. newsletter. You can reach Bob on Signal at bobjherman.09. It has never been more difficult for employers to offer health insurance for their workers. That’s especially true for America’s small businesses, the backbones of entire communities. More and more, they’re giving up entirely. America’s employer-based health insurance system — the dominant form of coverage for people younger than 65 — is crumbling. The percentage of working-age adults who get their health coverage from a job has declined from 67% in 1998 to about 60%. It’s also more expensive than ever. STAT interviewed dozens of people across the country as part of a series that probes how and why this is happening. Panic, despair, and anger are most apparent among smaller shops and firms.Advertisement Small business owners and workers feel as though most, if not all, of their options are unaffordable, especially if they have plans with high out-of-pocket costs. Rising premiums — driven by high prices for hospitals, doctors, and prescription drugs and more intensive care — are eating into bottom lines and paychecks. Desperate companies are getting rid of traditional health benefits at an unprecedented pace. This shift is fraying the uniquely American expectation that jobs come with protection for injuries and illnesses — an expectation that is the product of World War II wage controls, industry opposition to government health care, and the biggest break in the tax code. STAT+ Exclusive Story Already have an account? Log in This article is exclusive to STAT+ subscribers Unlock this article — plus in-depth analysis, newsletters, premium events, and news alerts. Already have an account? Log in Monthly $39 Totals $468 per year $39/month Get Started Totals $468 per year Starter $30 for 3 months, then $399/year $30 for 3 months Get Started Then $399/year Annual $399 Save 15% $399/year Get Started Save 15% 11+ Users Custom Savings start at 25%! Request A Quote Request A Quote Savings start at 25%! 2-10 Users $300 Annually per user $300/year Get Started $300 Annually per user View All Plans To read the rest of this story subscribe to STAT+. Subscribe Log In health care costs, Health insurance, patients, Policy, STAT+ Submit a correction requestReprints Bob Herman Business of Health Care Reporter Bob covers the money in health care, focusing on health insurance and hospitals. His stories delve into Medicare Advantage, opaque prescription drug benefits, and how much executives actually make. He is also the author of the Health Care Inc. newsletter. You can reach Bob on Signal at bobjherman.09. Recommended Out of Pocket, Out of Reach July 7, 2026 STAT Plus: For a Georgia entrepreneur, health coverage has never been affordable Out of Pocket, Out of Reach July 7, 2026 5 takeaways from STAT’s series on the soaring cost of health insurance Advertisement A STAT Examination May 26, 2026 STAT Plus: How Kyle Diamantas defied expectations as he rose to lead the FDA Exclusive May 13, 2026 STAT Plus: Bill Cassidy risked his legacy. It may not be enough to save his career A STAT Examination May 7, 2026 STAT Plus: What was lost at the FDA Subscriber Picks