Small Business Health Insurance Trends and Costs 2025

America’s healthcare system is mostly based on employer-provided health insurance. Because roughly 46% of Americans work at small businesses, the ability of small companies to affordably offer health benefits to their employees is a critical national priority.  Based on our analysis of real-time payroll and benefits data from Gusto, we find that since 2022 the cost of offering health insurance has risen sharply for small businesses, far outpacing inflation. Additionally, health insurance premiums are expected to rise sharply in 2026, and many employers are bracing for the largest increases in costs in more than 15 years. This episode walks through our latest research report from Gusto Insights: https://gusto.com/resources/gusto-insights/smbs-continue-to-offer-health-insurance