Small-Business Workers Often Face Higher Health Insurance Costs with Less Financial Protection

December 10, 2024

Workers at small businesses often pay more in premium contributions for health plans that provide less financial protection, compared to workers at larger companies, a new Commonwealth Fund report finds.

Key findings from the report, Trends in Employer Health Insurance Costs, 2014-2023: Coverage Is More Expensive for Workers in Small Businesses, include:

• In 2023, small-business employees paid an average of $7,529 annually for their share of family premiums — $733 more than employees at larger firms.
• In certain states, employee premium contributions for family health plans at small firms were nearly double those at large firms.
• Small-firm employees pay more in up-front premium contributions, yet their plans often have high deductibles.

The report, which features data for all 50 states and the District of Columbia, outlines several policy options for alleviating the financial burden on small-business employees and ensuring access to health coverage.