(DCNF)—Soaring health care costs are placing major financial strain on American small business owners.
The ability to afford health care has emerged as a key concern across the nation ahead of November’s midterm elections. Several analysts told the Daily Caller News Foundation that some Main Street businesses are struggling due to skyrocketing health costs, including having to scrap bonuses, facing difficulty hiring new employees and conducting layoffs.
Many small businesses have had to reduce employee hours amid rising health care affordability concerns, according to Tyler Dever, principal of federal government relations for the National Federation of Independent Business (NFIB).
“Small businesses are being squeezed by the rising cost of health care, forcing small business owners into an impossible dilemma,” Dever told the DCNF. “They can either absorb higher premiums and cut back elsewhere — such as reducing hours, laying off workers, or eliminating bonuses — or drop health coverage altogether, which would put them at a disadvantage when competing for talent.”
Dever also claimed President Donald Trump’s administration could help bring down health care costs by “expanding access to more affordable [health care] alternatives outside the traditional small group market.”
“One immediate step the Administration could take today is restoring and extending Short-Term Limited Duration Insurance, which was previously available for up to three years but shortened by the Biden administration in an effort to drive more people to the Obamacare marketplace,” Dever said.
“Other efforts, such as codifying the 2019 [Internal Revenue Service] rule that created Individual Coverage Health Reimbursement Arrangements, removing barriers for small businesses to join Association Health Plans, and expanding the eligibility rules on HSAs would have to be accomplished by Congress,” he added. “We are hopeful the president will throw his support behind expanding health options in a reconciliation bill this Congress.”
Established under the Congressional Budget Act of 1974, reconciliation provides a fast-track process for considering specific legislation related to taxes, government spending and the debt limit, according to the Center on Budget and Policy Priorities.
Dever also asserted that “for small businesses trying to offer meaningful benefits, having access to a broader range of coverage options would provide much-needed flexibility and more workable solutions.”
Nearly half of U.S. small employers (49%) have reported taking a lower profit or suffering a loss to afford health insurance premium increases over the past 5 years, according to an NFIB survey released in March 2023. The survey also found that 98% of small businesses currently offering health insurance worry the cost of providing it to their employees will become unsustainable over the next five to 10 years.
After payroll, health insurance notably represents the largest expense for small businesses, CNBC reported. The median health insurance premium for U.S. small employers has climbed 23% since 2022, outpacing inflation by 13% over that time period, Gusto reported in November 2025.
For American small businesses that do not offer health insurance, 65% cited cost as the top reason, according to a JPMorgan Chase report published in June 2024.
Many small business owners have recently had difficulty making key investments in their companies and hiring new workers due to climbing health costs, according to Alexis D’Amato Falvey, senior director of federal government affairs at Small Business Majority.
“Small Business Majority’s research has found that the high cost of health care is forcing many small businesses to make difficult decisions,” Falvey explained. “In fact, nearly half of business owners said high health care costs are making it difficult for them to invest in their business, while 31% said high health care costs make it difficult for them to attract and hire new employees.”
“Among business owners that do have coverage, over 71% say that their health care premiums have increased this year,” he added. “While many discussions have taken place in Congress revolving around making health care more affordable, results remain slim, and an overwhelming majority, 78%, of entrepreneurs believe that policymakers have not been effective at all in addressing rising health care costs for small businesses. Thirteen percent said they’re anticipating closing their business to get health insurance through an employer.”
The Trump administration “should continue to direct Congress to pass legislation that would increase hospital price transparency, foster greater competition in health care,” Falvey continued. He also claimed that many small business owners cannot afford to offer their employees “robust” medical benefits due to rising costs.
“Health care has become the biggest cost for small businesses after payroll, and the reality is that even though many small businesses want to offer robust health benefits, most cannot afford to do so,” he said.
Falvey also called health care a “barrier to entry for many aspiring small business owners.”
“In fact, we’ve heard from numerous entrepreneurs over the years who said that they were afraid to start a business because they would lose their health care coverage, or they were only able to start a business because they could continue coverage through their spouse or partner,” he noted. “Access to health care should not be a barrier to small business ownership or employment but it will be for as long as health care costs continue to rise.”
“As long as health care remains unaffordable, small businesses will continue to compete on an uneven playing field because they’ll be priced out in the race for top talent,” he added.
John Goodman, a senior fellow at the Independent Institute, told the DCNF that he thinks it would help bring down the cost of medical services “by allowing insurers in the [Obamacare] exchanges to post reference prices which can be used at any provider instead of a narrow network of providers.”
“This approach has been shown to dramatically cut costs and improve access to care,” Goodman noted.
In 2023, about 49% of U.S. employees at small firms worked at establishments that offered health insurance coverage, according to The Commonwealth Fund.
A Gallup survey published on March 31 found that the majority of Americans, 61%, said they worry “a great deal” about being able to afford health care. Moreover, Democrats have historically had an edge over Republicans on the issue of health care, KFF reported on April 2.
In early April, Trump slapped tariffs on patented pharmaceuticals and their ingredients in an effort to “bolster American national security and public health,” according to a White House fact sheet. The president had unveiled a new health care plan in January which aims to promote competition, slash wasteful spending and put consumers “back in control.”
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Two Storms, One Harvest
Every food crisis in living memory has been a one-shock event. The 2008 price spike was a commodity bubble. The 2020 shortages were a logistics failure. The 2022 grain scare was a war on one exporter’s ports. Each time, the system bent, adjusted, and recovered, and each time the experts assured us afterward that global markets are simply too big and too diversified to fail.
What nobody in Washington seems eager to discuss is that 2026 is shaping up to be something the modern food system has never actually faced. Two independent shocks, one climatic and one geopolitical, are converging on the same harvest cycle at the same time. Not sequentially. Simultaneously.
Start with the weather. The Pacific Ocean is currently building toward what forecasters now openly call a record event. NOAA’s Climate Prediction Center puts the odds of at least a strong El Niño near 88 percent, with roughly two in three odds it reaches “very strong” status, the tier reserved for perhaps three or four events in the entire satellite era. Every major global model now projects a median peak in Super El Niño territory, and most of them project it exceeding the 2015-16 event, which until now held the modern record. Sea surface anomalies were already brushing the super threshold in mid-July, months before these events normally peak. The atmosphere has already shifted into El Niño mode, and the event is forecast to crest in late fall and early winter.
This is not about “climate change.” It’s about the standard cycles of weather, and the cycle we’re currently in is one that has likely devastated societies in the past. We’re better prepared as a society today, but not all Americans are equally prepared.
Serious households have started doing the quiet math on their own. Grocery bills tell part of the story, and the forecast maps tell the rest, which is why long-term food storage has moved from fringe hobby to mainstream line item in the family budget, with established suppliers like Heaven’s Harvest seeing demand from people who five years ago would have rolled their eyes at the idea. That instinct is not paranoia. It is pattern recognition, and the pattern is worth walking through carefully.
Editor’s Note: Heaven’s Harvest IS a sponsor, but the warnings of this article are real and would be written even if we didn’t have a survival food sponsor. With that said, those who take advantage of what they offer can use promo code “Patriot” for 15% off.
The Fertilizer Clock Is Already Running
While the Pacific warms, the second shock has been unfolding in the Strait of Hormuz. The conflict with Iran turned the world’s most important energy chokepoint into a contested waterway, and the consequences reach far beyond the gas pump. Roughly a third of global fertilizer trade moves through Hormuz, and the disruption sent urea prices up 86 percent year over year by March, with a 53 percent jump in a single month.
The World Bank projects energy prices rising about 24 percent in 2026 and fertilizer about 31 percent. By its own accounting, fertilizer prices ran 35 percent higher in the first five months of this year than the same period last year.
Here is the mechanism the nightly news will not explain. Fertilizer is not a grocery item. It is a time-delayed input. The nitrogen a farmer in Iowa or Punjab could not afford to apply this spring does not show up as a problem this spring. It shows up as a thinner harvest six to twelve months later.
The World Bank’s own food security brief concedes that the effects of reduced applications earlier this season “are likely to become visible only later in harvest outcomes.” Translate that from institutional language into plain English and it means this. The damage is already done, it is already in the ground, and we are simply waiting for it to arrive on the shelf.
Now check the calendar. Six to twelve months from the spring planting season lands us squarely in late 2026 and early 2027. Which is precisely when the strongest El Niño in the instrumental record is forecast to peak, bringing its signature droughts to Southeast Asia, Australia, southern Africa, northern Brazil, and South Asia, the very regions that grow the world’s rice, sugar, and oilseeds.
The World Bank warns openly that a strong El Niño “could disrupt multiple crop belts simultaneously” on top of the conflict-driven input costs. Their baseline projection assumes the Middle East disruptions ease by autumn. What in the last two years of Middle East history suggests that assumption is safe?
The System Has No Slack Left
The comfortable answer is that global markets always adjust. But adjustment requires slack, and the slack is gone. Global cereal production is expected to decline from last year’s records even before El Niño does its work. The UN World Food Programme, hardly a den of right-wing preppers, is calling this the most significant disruption to its supply chains since Covid and the invasion of Ukraine, and its supply chain director put the stakes bluntly.
Today’s supply chain challenges are tomorrow’s hunger crisis.
There is also a political dimension that markets cannot price. When food gets scarce, governments do not behave like economists. They behave like politicians. Export bans, hoarding mandates, and panic buying at the national level turned the modest rice shortfall of 2008 into a global crisis, and analysts are already warning that import-dependent nations are the first dominoes.
The 2015-16 Super El Niño, a far weaker event than what is now forecast, threw tens of millions into food stress across Africa and Asia. This one is projected to be stronger, and it arrives with fertilizer already rationed by price and shipping lanes already contested by missiles.
What Joseph Knew
Scripture does not treat preparation for lean years as faithlessness. It treats it as wisdom delivered in advance to those willing to act on it.
Behold, there come seven years of great plenty throughout all the land of Egypt: And there shall arise after them seven years of famine; and all the plenty shall be forgotten in the land of Egypt.
Joseph did not respond to that warning with a hashtag or a committee. He stored grain during the years of abundance, and when the famine came, Egypt stood while its neighbors begged. The lesson is not that famine is certain. It is that the time to prepare is precisely when preparation still looks optional.
Nobody who filled a pantry in a year of plenty has ever regretted it, and nobody standing in an empty aisle has ever been glad he waited for certainty.
None of this calls for panic, and panic is the enemy of sound judgment anyway. It calls for the same unglamorous prudence our grandparents considered ordinary. Keep some cash margin, know your local growers, and put real food in deep storage while it is cheap and available, because the entire arc of this story is that cheap and available is a closing window.
Families looking for a straightforward place to start can visit Heaven’s Harvest and use promo code Patriot for 15 percent off long-term storable food. The forecasts may yet soften, the strait may yet reopen, and we should pray they do. But hope is a fine thing to hold and a foolish thing to eat.
