Read text on white background with the initials HJM and the text Health Justice Monitor, and a red circle with a white line as seen on a hospital heart rate monitor.From the Health Justice Monitor, current news in context from Drew Altman of Kaiser Family Foundation with commentary by Don McCanne, retired family practitioner and health policy expert.


Commercial health insurance, on a decades-long decline in affordability, dipped to a new low. Family insurance is unaffordable at small firms, children with commercial insurance are inadequately covered, and three-quarters of consumers can’t promptly pay medical bills.

December 7, 2023

One thing that really jumped out from our 25th annual KFF employer health benefit survey: Small employers no longer have affordable coverage for workers with families.

Workers employed by small firms – those with fewer than two hundred employees – would need to pay $8,334 on average towards the premiums each year for family coverage. But enrolling a family at these firms can often be much more – a quarter of covered workers at small firms must pay $12,000 annually or more to enroll in family coverage.

But that doesn’t include what workers pay for deductibles or other out-of-pocket costs which are also typically higher at small firms.

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