Contrary to some predictions, small businesses’ health coverage offerings remained relatively stable during the COVID-19 pandemic, according to a report from the Urban Institute in August 2021. Over the past 20 years, the share of small employers offering comprehensive health benefits dropped from almost half to less than one-third. When costs rise, many small businesses shift to coverage exempt from Affordable Care Act rules, unsettling the market. If left unaddressed, these trends could create a more costly pool of enrollees for insurers to cover in the small-group market.
