Single-payer schemes and proposals to incrementally give government more control and power over health care spending and decisions would harm access and erode quality. Policy initiatives that promote competition, and encourage investment in new drugs, treatments and innovative solutions for delivering health care are the type of reforms that will make the system more responsive to America’s health care consumers.

Coalition Letter to DEA: Revised Rule Needed to Ensure Patient Access to Care via Telehealth

April 1st, 2024 by

The Honorable Anne Milgram
United States Drug Enforcement Administration
8701 Morrissette Drive
Springfield, VA 22152

Dear Administrator Milgram:

Thank you for your leadership and engagement in public listening sessions last fall related to telemedicine flexibilities and for your actions to ensure continued patient access to care delivered through telemedicine in advance of final telemedicine regulations this year.

Now that the first quarter of 2024 has passed, we write to request that DEA expedite the release of a revised proposed rule to permit and regulate the prescribing of controlled substances through telehealth. This rule is crucial for access to mental health, substance use disorder, and other telehealth care. As you know, the current flexibilities for telehealth expire at the end of this year; we request the updated rules be proposed immediately for the following reasons:

• Given the complexity of these issues and the significant stakeholder interest (as demonstrated through more than 38,000 public comments received by DEA on proposed rules), DEA must plan to ensure stakeholders have adequate time to provide feedback on any policy proposal.

• If DEA were to create a special registration process for telehealth prescribers, as proposed by both DEA and many stakeholders, significant operational lead time would be needed for DEA, practitioners, pharmacies, and other related service providers to implement the new special registration process and comply with other potential operational requirements and guardrails.

• Given widespread provider shortages, particularly in the mental health and substance use disorder treatment spaces, a rulemaking late in the year that makes significant policy changes would affect the ability of patients and clinicians to make appointments and ensure consistent access to care. While we hope the final rulemaking preserves patient access, any policy change that requires patients to seek in-person care would be extremely disruptive due to long scheduling lead times and in-office wait times.

• In addition to operational and implementation challenges for clinicians, there will be significant operational and staff training needs for pharmacies and other parts of the healthcare delivery system to ensure patients uninterrupted access to needed medical treatments offered through telehealth.

• Finally, DEA’s national leadership is needed to set a clear path forward for the nation and to encourage more consistent definitions and aligned requirements from state regulatory bodies. Alignment of requirements is needed to simplify compliance for healthcare providers and encourage telehealth
providers to offer care in our nations most underserved areas – without geographic barriers such as state lines limiting access to care.

Thank you for your consideration of this request. We looking forward to working with you to ensure continued
access to needed telehealth services for all Americans while protecting against diversion and inappropriate use.


A Mind Affair LLC
Access TeleCare, LLC
Ace Mentality
ACHIEVE Psychiatric Wellness Center
Advanced Practice Psychiatry, LLC
AGMP Telehealth
Alliance for Connected Care
Alliance Mental Health
Alliance of Community Health Plans (ACHP)
Allina Health
ALS Association
American Academy of Hospice and Palliative Medicine
American Academy of Neurology
American Academy of PAs
American Association of Nurse Practitioners
American Association of Psychiatric Pharmacists
American Health Care Association/National Center for Assisted Living
American Psychological Association Services
American Telemedicine Association
American TelePhysicians
American Urological Association
Anderson Mental Health Services LLC
Anxiety and Depression Association of America
Array Behavioral Care
Aspire Mental Health
Association for Behavioral Health and Wellness
At Your Service Psychiatry, PLLC
ATA Action
Baylor Scott and White Health
Ben Archer Health Center
Bicycle Health
Big Cities Health Coaltion
Broad Mountain Holistic Mental Health Services
Casel Mental Health and MetRX
Center for Freedom and Prosperity
Chesapeake Psychological Associates

Choptank community Health
Cincinnati Children’s
Circle Medical
Clinical Social Work Association
Coalition for Headache and Migraine Patients (CHAMP)
Collective Energy for Nurturing Training in Reproductive and Sexual Health (CENTRS Health)
College of Healthcare Information Management Executives (CHIME)
Columbia University Irving Medical Center
CommonSpirit Health
Compass Psychiatric Wellness
Compassion & Choices
Complete Behavioral Health
Connected Health Initiative
Consumer Technology Association
Corewell Health
Department of Psychiatry, University of Maryland School of Medicine
Digital Medicine Society (DiMe)
Dogtown Media / NeurCare
DoseSpot Inc.
DreamCloud Psychiatry
Driscoll Health System
Eagle Telemedicine, LLC
Eleanor Health
Elite Medical Partners
Embrace Health
Encounter Telehealth
Epilepsy Foundation
Essential Grace Mental Health Care Services LLC
Estrella Cognitive Care
Facilitation Health PLLC
Fig Tree Behavioral Wellness, LLC
Firefly Health
FOLX Health
Funner Mental Health, LLC
Gender Wellness Center, Bassett Healthcare Network
Ghaly Healing and Wellness Center
GRIN2B Foundation
Guide to Wellness PA
Half Full Psychiatry
HardemanCounty Community Health Center

Harmony & Unity Mental Health
Harmony mental health
Hawkins Group
HealthQuarters Inc dba HealthQ
HER Psychiatric Services
Hims & Hers Health, Inc.
Hopeful Mind Mental Health, PLLC
Hopscotch Health
Human Vitality
Hydrocephalus Association
Impact Carolina Services, Inc
In-Tuitt Behavioral Health Services
Indiana University Health, Inc.
Integrated Telehealth Partners
International Foundation for Autoimmune & Autoinflammatory Arthritis (AiArthritis)
Iye CollaborativeLLC
Johns Hopkins University and Medicine
Karis Holdings, LLC
KeyCare, Inc & KeyCare Medical Group
Kinspire Inc
Kohnlinq Inc.
Lifepoint Health
LMA Mental Health Services
Logan Wellness Advanced Nursing Practice Corp.

Loma Linda University Health
LT Telehealth/
Marsha’s Tea Room
Marshfield Clinic Health System
Mass General Brigham
Massachusetts Health Data Consortium
Maternal Mental Health Leadership Alliance
Meadowlark Psychiatric Services
Medical Group Management Association
Mend VIP, Inc.
Mental Health America
Mentavi, Inc.
Miles for Migraine
Mind body behavioral health
Mind Revive Psychiatry
Mindful Intentions, LLC
Minnesota Hospital Association
Mobile Primary Care
National Association for Home Care & Hospice
National Association of Pediatric Nurse Practitioners
National Disability Rights Network (NDRN)
National League for Nursing
Nest Collaborative
New Jersey Association of Mental Health and Addiction Agencies, Inc.
NextGen Healthcare
NIM Longevity
Noma Therapy
Oshi Health
OY Nursing Corporation

Oshi Health
OY Nursing Corporation
Pandemic Patients
Paragon Behavioral Health
Partnership for Employer-Sponsored Coverage (P4ESC)
Partnership to Advance Virtual Care
PAs in Virtual Medicine and Telemedicine
Patient Access Network (PAN) Foundation
Perinatal Mental Heath & Wellness
Planned Parenthood California Central Coast
Policy Center for Maternal Mental Health
Population Health Analytics Association Incorporated
Premier Inc.
Pro-Mental Health Connection
Psychiatric Medical Care
Psychiatric Medical Practitioners, Inc.
Quartet Health
Red Cedar Counseling
Red Clover Wellness
Reproductive Health Access Project
Resolve Psychiatric Services
Revive Mental Health Solutions LLC
Riverview Practice
Sandpiper Wellness
Sanford Health
Satori Mental Health LLC
Seasons of Wellness
Serenity Health Care, PLLC
Shadow Mountain Mental Health

Shrewsbury Wellness Center
Small Business & Entrepreneurship Council
Society for Participatory Medicine
Southern Comfort Psychiatric Services, LLC
Spectrum: The Other Clinic
Stanford Health Care
Stony Brook University Medical Center
STXBP1 Foundation
Sunrise Mental Health
Swing Care
Synchronous Mental Health
Synergy Family Psychiatric Services LLC
Texas Health Resources
Texas Tech University Health Sciences Center
The Global Telemedicine Group
The Process Psychiatry and Wellness
The Trevor Project
TheraTec, Inc
Thirty Madison / KMG Medical Group
Transgender Health & Wellness Center
True U Clinic
University of Pittsburgh Medical Center (UPMC) Health System
UVA Health
VerifiNow inc
Vesta Healthcare
Welcome Home Health, Inc.

Wellcore, Inc
WellTrust Medical
Willow Behavioral Health
Workit Health
Yale New Haven Health


Proposed CMS Rule to Medicare Advantage Threatens Industry Competition and Small Businesses

March 21st, 2024 by

by Karen Kerrigan –

The Centers for Medicare and Medicaid Services (CMS) is advancing a proposal that would significantly alter the marketing and broker compensation structures of Medicare Advantage (MA) plans. The change threatens the livelihood of small businesses and brokers, and risks stifling competition within the healthcare industry. Moreover, the proposal would drive the United States healthcare system towards a more socialized structure.

Understanding the consequences of the proposed rule on key stakeholders is important for CMS and lawmakers to understand – from the small firms that play a critical role in the healthcare market to the consumers who rely on them for guidance and support.

The proposal aims to target the promotion of objective plan assessments by brokers. But in doing so exposes the system to far-reaching negative consequences that would disrupt the coverage framework that seniors highly enjoy.  So why is CMS doing this, and do they understand the downstream impact on seniors and small businesses?

The Medicare Advantage Success Story

Medicare Advantage is a bipartisan success story. In fact, 95% of seniors identifying as Democrats and 93% as Republicans said they are satisfied with their Medicare Advantage coverage in 2022.

Medicare Advantage plans have consistently offered seniors and other eligible beneficiaries access to quality care, innovative services, and affordable options. This success is supported by a dynamic ecosystem of brokers, small firms, and competition that drives continuous improvement and adaptation in the sector.

A Successful Model is Threatened

The proposed CMS rule threatens to dismantle this successful model. By redefining compensation structures and marketing guidelines, the rule would disproportionately affect small firms and independent brokers – paving the way for large firms to eat up market share.

These smaller entities are an essential part of the Medicare Advantage market, ensuring consumers have access to personalized, knowledgeable advice when navigating the complex landscape of Medicare. Their marginalization would not only reduce the diversity of options available to beneficiaries, but also limit the quality of service and support that has been instrumental in achieving high satisfaction rates among Medicare Advantage plan members.

Moreover, the rule would significantly reduce competition in the healthcare industry. By making it harder for small firms and brokers to operate, the remaining market would likely consolidate around larger entities with the resources to navigate the new regulatory environment. The reduction in competition would lead to higher costs, less innovation, and a decrease in the quality of care available to beneficiaries.

Of equal concern, the proposal pushes the U.S. healthcare system further down a socialized path. By centralizing the functions that were previously distributed among a diverse network of brokers and small businesses, the rule paves the way for a healthcare system that is more controlled by the federal government and less by dynamic and responsive market forces. This shift would have profound implications for the quality, accessibility, and affordability of healthcare in the United States.

A Regulatory Shift That is Not Warranted

The proposed CMS rule represents a worrisome shift for Medicare Advantage and the broader healthcare market. Legislators and policymakers must fully understand the potential negative effects of this rule on small firms, competition, seniors, and the healthcare system as a whole.

If lawmakers want a Medicare Advantage system that works for seniors, they must stand firm and oppose the rule change. CMS must fully analyze the effects of the proposed rule and acknowledge the concerns of small business owners, brokers, and beneficiaries. By listening and collaborating with the stakeholders most affected by this proposed rule change, any alterations to Medicare Advantage would strive to strengthen rather than undermine the program.

America’s healthcare system must values choice, competition, and quality and reject government-directed moves that lead us toward a less effective and more socialized healthcare model.

Karen Kerrigan is president and CEO of the Small Business & Entrepreneurship Council


Reminder on Third-Party Payments: No One Should Be Surprised About Americans’ Views on Health Care Costs

February 7th, 2024 by

by Raymond J. Keating – 

If someone else is footing the bill, then what incentive do you, as a consumer, have to find out how much something costs?

Third-party payments are the reality of much of health care funding in the U.S., and it’s reflected regarding cost awareness, of lack thereof, among Americans according to a Gallup poll.

Gallup found that 79 percent of American adults do not know the costs of health care products and services before receiving those products and services. Meanwhile, 17 percent said that they did know.

As for requiring transparency – i.e., that healthcare organizations should be required to tell you how much a product or service will cost before you receive it – 95 percent of Americans agreed.

Consider that, based on 2022 data from the Center for Medicare and Medicaid Services, only 11 percent of national health consumption expenditures were paid for out of pocket. That means third-party payments covered the other 89 percent of these expenditures. That included 30 percent from private health insurance, and another 5 percent from other private sources. That leaves approximately 53 percent covered by government, such as via Medicare, Medicaid, CHIP, and other programs.

Price transparency in any market is vital. However, given that over half of health care services are covered by government, and another 30 percent by health insurance, for example, the power of price transparency is limited. Add in the fact that when government is the third-party payer, there’s little incentives in government to care about costs – after all, those in government are spending other people’s (i.e., the taxpayers’) money.

Eventually, when someone in government does get focused on costs, as we’ve seen, their solutions usually make matters even worse, such as resorting to price controls. Price controls, such as on prescription drugs, mean diminished investment and innovation, and therefore, fewer life-enhancing and life-saving treatments. In general, price controls mean diminished quality – not exactly what anyone should be shooting for in health care.

There has been movement in a positive direction with the expansion of health savings accounts (HSAs) coupled with high-deductible health plans (HDHP). According to KFF’s “Employer Health Benefits: 2023 Annual Survey,” among covered workers, the share with HSA-qualified HDHP have increased from 3 percent in 2007 to 24 percent in 2023. For HSAs and other out-of-pocket payments, price transparency is, in fact, essential.

Now, we just need an expansion of private HSA plans coupled with a rolling back of government involvement in health care to rein in the portion of higher costs that has nothing to do with innovation in and the quality of care.

Raymond J. Keating is chief economist for the Small Business & Entrepreneurship Council. His latest books on the economy are The Weekly Economist: 52 Quick Reads to Help You Think Like an Economist and The Weekly Economist II: 52 More Quick Reads to Help You Think Like an Economist.


KERRIGAN IN TOWNHALL: Small Business and Small Molecule Drugs Take a Big Hit in Investment

January 25th, 2024 by

In a January 24 Townhall Op-Ed, SBE Council president & CEO Karen Kerrigan writes that President Biden is undermining his Cancer Moonshot Initiative – announced with great fanfare recently, along with a commitment of $300 million in taxpayer dollars – through “the damage currently being inflicted on private-sector investment in pharmaceutical research as a result of the Inflation Reduction Act (IRA).” The IRA provides the federal government with price-control setting powers over some drugs it purchases for Medicare. As Kerrigan notes in the piece:

Small molecule drugs, typically pills or tablets, receive just nine years of exemption after FDA approval before price controls can kick in. Biologics – drugs typically administered by IV or injection in a clinical setting – receive four additional years. 

That discrepancy threatens to gut an entire class of new cancer medications – and the many innovative firms and small businesses at the forefront of developing them.

It cost a lot of money and patience to bring a drug to market. Less than 10% of new drugs entering clinical trials ever make it to market, and countless more candidates never even make it to trials. As Kerrigan notes:

Investors need to know that when a drug they back succeeds it will not only make a return on its own development costs, but also cover the cost of the inevitable failures.

Price controls not only hurt investment in new drugs, which ultimately harms health consumers and cancer patients, but the small innovative firms that dominate the bio-pharmaceutical sector:

Small molecule drugs represent around 90% of all drugs on the market and accounted for more than 75% of all FDA approvals between 2010 and 2020. Small and mid-size biotechs, meanwhile, are responsible for over 75% of drugs currently in development. For many smaller biotechs, research into small molecules makes up their entire portfolio…Nearly half of all oncology drugs originated in small biotechs throughout the 2010s. The 2020s should be building on that record. 

These firms count on capital and investors to bring their life-saving innovations to patients, and Congress needs to fix this by extending the price-control exemption period for small molecules to match the 13 years for biologics, Kerrigan writes, or better still, get rid of price controls altogether.

Read the Op-Ed in its entirety here.


New Studies: The Dangerous, High Costs of “Inflation Reduction Act” Price Controls

June 29th, 2023 by


by Raymond J. Keating –

The ills of government price controls are straightforward from an economics perspective. That is, price controls limit actual and potential returns, reduce resources available for investment, and diminish entrepreneurship, investment, innovation, supply and quality.

When such ills are applied to the pharmaceuticals, biotechnology and medical device sectors, for example, which are all endeavors rich in risk, uncertainty and considerable costs, the results mean fewer new and improved medical treatments. In turn, the costs don’t just include lost businesses, investment and jobs, but also lost lives and diminished health.

Two recent studies have estimated assorted ills from recent efforts to inflict price controls on biopharmaceuticals.

On June 1, 2023, Vital Transformation released a study estimating assorted costs of the Inflation Reduction Act (IRA). In a statement, it was noted: “Vital Transformation’s data shows that, even when using the most optimistic scenarios under Medicare’s guidance for negotiations, patients will lose access to 40% of medicines that would have otherwise been developed over the next 10 years because of the IRA’s price controls. And this estimate is on the conservative side – it assumes Medicare will set negotiated prices at the IRA’s ceiling price, but Medicare is likely to be more aggressive.”

Among key findings in the study – which “modeled and estimated the impacts of the Inflation Reduction Act’s (IRA) pricing provisions for a cohort of the top 200 Part B and D drugs by CMS spend, resulting in 92 drugs impacted by IRA in the next 10 years, which are produced, collectively, by 41 biopharmaceutical companies” – were:

“Had the IRA been in place beginning in 2014, we estimate the reductions in revenue on the impacted drugs to be up to 40%. Because of this, between 24 and 49 therapies currently available today would most likely not have come to market and therefore not available for patients and their providers.”

“Looking forward, we estimate that because of the IRA pricing provisions, the substantial reduction in revenue will significantly narrow investment opportunities. Conservatively, as many as 139 drugs over the next 10 years are at risk of not being developed at all.”

“…we estimate a loss of between 66,800 – 135,900 direct and 342,000 – 676,000 indirect jobs in the U.S. biopharma ecosystem.”

In addition, Vital Transformation released another study on June 15, 2023, that estimated the costs of proposed expansions of government-mandated drug pricing policies, specifically, “drug pricing provisions of President Biden’s 2024 Budget, now proposed by Senator Baldwin as the ‘Smart Prices Act (SPA)’, which would impose government price setting for selected Medicare drugs at only 5 years after initial FDA approval.”

Among the grim estimates were the following:

“Had the drug pricing provisions of the SPA been in place prior to the development of today’s top-selling medicines, we estimate that 82 of the 121 therapies we identified as selected for price setting would likely have not been developed.”

“Looking forward, we estimate that the expanded government price setting could result in roughly 230 fewer FDA approvals of new medicines over a ten-year period, once the impacts are fully reflected in the pipeline.” It also was pointed out, “Impacts will be felt most heavily in many areas of unmet need, including in rare disease, oncology, neurology, and infectious disease.”

“We estimate a loss of between 146,000 – 223,000 direct biopharmaceutical industry jobs and a total of 730,000 – 1,100,000 U.S. jobs across the economy if the proposed IRA expansion were to be implemented.”

The following graphic from Vital Transformation sums up the ills of price controls as found in each of these recent studies.

Finally, it must be noted that the biopharmaceutical sector overwhelmingly is populated by small to mid-size, entrepreneurial firms. Among employer firms in the pharmaceutical and medicine manufacturing industry, based on the latest U.S. Census Bureau data (2020):

61.6% of employer firms had fewer than 20 employees

80% had fewer than 100 employees

91.9% had fewer than 500 employees

For all of the political talk about so-called “Big Pharma,” this sector of our economy very much is about small, entrepreneurial enterprises. Whether firms are big or small, price controls mean less investment, less innovation, and fewer live-saving and life-enhancing treatments.

Raymond J. Keating is chief economist for the Small Business & Entrepreneurship Council. His latest books on the economy are The Weekly Economist: 52 Quick Reads to Help You Think Like an Economist and The Weekly Economist II: 52 More Quick Reads to Help You Think Like an Economist.


Kerrigan in The Washington Times: The high price of price controls hit U.S. small biotech and innovation

December 12th, 2022 by

In a December 12 Washington Times Op-ed, SBE Council president & CEO Karen Kerrigan writes that legislators who drafted the Inflation Reduction Act (IRA) “had some idea that their bill was going to hurt small biotech companies.” The legislation, signed by President Biden in mid-August 2022, imposes price controls on some drugs purchased by Medicare starting in 2026.

As Kerrigan notes in the piece, the non-partisan Congressional Budget Office, various economists at the University of Chicago (among others) predicted these intrusive price controls “will reduce investment into drug research, and as a result, cut the number of new medicines coming to market.” The legislation sort-of attempts to protect small bio-tech companies – which happen to dominate the bio-pharmaceutical industry – but the criteria in the legislation will actually exempt very few and vastly harm innovation and U.S. leadership in drug breakthroughs, as well as the health consumers who benefit from new drugs.

According to Kerrigan:

“The exemption suggests some wish by lawmakers not to drive biotechnology companies out of business. Yet it is so narrow as to seem like an afterthought, providing almost no help at all.  The problem is that few companies will be able to meet the criteria for exemption.”

Read more on the details of the IRA’s harmful effect on small U.S. biotech here.


Small Business Advocate Reminds Senate Finance Committee: Price Controls Do Not Work

March 16th, 2022 by


For Immediate Release

Washington, D.C. – Today, the Senate Finance Committee is holding a hearing on prescription drug prices and possible solutions to lower costs, including price controls. Small Business & Entrepreneurship Council (SBE Council) president Karen Kerrigan issued the following statement about possible legislative efforts to impose price controls on this critical American sector:

“Some members of Congress continue to believe that they can alter basic economic principles – and the proven history – of government price controls. No matter how they’ve been attempted and applied, the same distortions have occurred: dampened economic activity, entry and investment; shortages; and less innovation. The same outcome will occur if Congress imposes price controls on drugs. Price controls will undermine the production of new and improved drugs, medicines and vaccines. They will limit access to life-saving drugs for many, and damage U.S. innovative leadership in this critical sector. The health of U.S. consumers and lives are at stake.

“Moreover, the small firms that dominate the bio-pharmaceutical industry – the very firms that drive competition and innovation – will be immeasurably damaged by price controls. Approximately 79% of these companies have fewer than 100 employees, and they count on vast sums of outside capital investment to bring their innovative drugs to market, which takes extraordinary risk and time. Price controls will kill this investment and risk-taking, as they greatly reduce core risk-taking incentives. Our economy, and the health of millions of Americans, simply cannot afford the damage that price controls would inflict on our bio-pharmaceutical ecosystem, which is dominated by small to mid-size businesses.

“America’s small business owners and entrepreneurs want Congress to focus on their key pain points, such as inflation and high gas prices, broken supply chains, labor shortages and lowering health insurance costs. Our polling finds they want policies that support their ability to offer more health insurance options – not government interventions that restrict options and raise costs. Small business owners want Congress to focus on reducing the overall cost of healthcare rather than focusing just on drug pricing. In one of our recent surveys, 90% say that continued research and innovation is vital to the country’s prosperity, and that policies should be anticipating and encouraging the need for research and development of new treatments and medicines. Price controls will undercut and discourage this needed activity.

“As employers, consumers of innovative drugs, and as entrepreneurs and risk-takers in this industry, Congress must heed the concerns and wisdom of small business owners as certain Members continue to toy with the perilous idea of price controls. The focus should be on encouraging investment and innovation by all American industries, including the bio-pharmaceutical industry, not on harming productive private-sector activity.”


Karen Kerrigan:

Raymond Keating:  

SBE Council is nonpartisan advocacy, research and education organization dedicated to protecting small business and promoting entrepreneurship. For 28 years, SBE Council has worked on and advanced a range of private sector and public policy initiatives to strengthen the ecosystem for strong startup activity and small business growth. Visit for additional information. Twitter: @SBECouncil



Kerrigan and Cavazos in Real Clear Health: Policies Must Help Small Businesses Recover, Including Affordable Health Coverage

February 1st, 2022 by

In a February 1 Op-Ed in Real Clear Health, SBE Council president & CEO Karen Kerrigan and United States Hispanic Chamber of Commerce (USHCC) president & CEO Ramiro Cavazos lay out the policy priorities of small business owners as they work to survive and recover during this  uncertain pandemic economy.  As they note in the piece:

In this delicate economic environment, Congress should be very cautious about the potential impact of overreaching policies on businesses. A recent survey of small business owners found that 7-in-10 small business owners agree the pandemic has already made things hard enough, and they can’t afford to have government policies that disrupt day-to-day business.

On the issue of health care, Kerrigan and Cavazos remind readers that costs and access still remain a big challenge for small business owners. In fact, according to the SBE Council/USHCC survey they point to in the piece, 8-in-10 of small business owners agree that healthcare reforms “that add new costs for small businesses are high risk and would add another burden to recovering businesses.”

Instead of addressing these concerns, Kerrigan and Cavazos express concern that:

Congress has proposed several misaligned drug pricing policies to give the government more control and power over healthcare spending and decisions, ultimately harming access and eroding quality. Specifically, proposed negotiation policies would significantly undermine biopharmaceutical investment, mimicking Europe’s disastrous government price setting and restrictive regulations. The reason the U.S. leads the world in medical breakthroughs and lifesaving drug innovations is because of our free-market approach and entrepreneurial spirit. 

They argue that Congress has to be smart about the direction of policy and to make sure bills that are being advanced support Main Street businesses, which are the heart and soul of the U.S. economy. After all, they note:

Being “CLOSED” for business is no longer an option.

Read the full Op-ed here.


SBE Council-USHCC Joint Letter to Congress on the Healthcare Priorities and Needs of Small Business

January 13th, 2022 by

January 13, 2022

Dear Members of Congress:

As America’s small business owners continue to navigate a host of challenges and work to stabilize their firms and recover from the effects of the COVID-19 pandemic, we believe that Congress must focus on policy solutions that restore their vibrancy and growth. Our national and local economies depend on the health and job-creating prowess of small businesses, and the entrepreneurs who run these firms want policies that address their key pain points to help them succeed, especially in the area of healthcare.

The Small Business & Entrepreneurship Council (SBE Council) is a 501c(4) advocacy, research, and education organization dedicated to protecting small business and promoting entrepreneurship.  Our network of supporters, including entrepreneurs and small business owners, state and local business organizations, corporate partners, and associations work with us to strengthen the environment for robust entrepreneurship, investment, innovation, and small business growth. The United States Hispanic Chamber of Commerce (USHCC) actively promotes the economic growth, development, and interests of more than five million Hispanic-owned businesses that, combined, contribute over $800 billion to the American economy every year. We also serve as a platform for our nationwide network of over 260 local Hispanic chambers of commerce.

A new Morning Consult poll released in December of 2021 by the SBE Council and the USHCC examines the top concerns among the small business community and highlights the need for Congress to focus on policies that aid economic recovery.

The SBE Council and the USHCC urge members of Congress to engage with the small business community to better understand the necessary reforms they support that promote affordability and choice in health coverage, sustained innovation in the healthcare and pharmaceutical sectors, and economic recovery for our nation.

Some of the poll’s key takeaways include:

● 41% of small business owners (SBOs) say economic recovery from the COVID-19 pandemic should be one of Congress’ top priorities across the board.

◦ 72% of SBOs agree the pandemic has already made things hard enough for small businesses and they cannot afford to have government policies that disrupt their day-to-day business.

◦ Nearly eight out of ten SBOs agree that healthcare reforms that add new costs to their business is high-risk and would add another burden to recovering economically.

● More than nine out of ten SBOs say Congress’ top healthcare priority should be policies that address the rising cost and dwindling coverage of health insurance.

◦ In fact, 71% of SBOs want Congress to focus more on reducing the overall cost of healthcare rather than focusing solely on the reduction of drug pricing.

◦ Specifically, one third of SBOs are most concerned with addressing the cost of health insurance premiums, this was the top answer for healthcare priorities from respondents.

● 90% of SBOs agree that continued research and innovation is vital to our country’s prosperity.

● Nearly nine out of ten SBOs also believe that U.S. leaders should be anticipating and encouraging the need for research and development of new treatments and medicines for various illnesses and conditions.

These survey findings emphasize a call across the small business community for healthcare solutions that preserve economic growth and innovation, provide small businesses more choice, and flexibility in managing their rising operational costs.

In order to achieve these outcomes, policymakers need to closely examine and investigate the effects of proposed policies, including those that may impose punitive taxes or price-setting, as they may lead to unintended consequences across our healthcare system. Again, small business owners want policies that zero in on reducing health coverage costs, foster innovation, and choice.

As you well know, America’s more than 32 million small businesses are the heart and soul of our U.S. economy, and they overwhelmingly bore the brunt of the COVID-19 pandemic, especially those in marginalized communities. Now more than ever, access to affordable and quality health coverage is a vital issue for small business owners and their employees. As a recent report from the Kaiser Family Foundation conveyed, that the cost of health coverage has dramatically increased over the last decade. Family premiums for employer-sponsored health coverage have risen 47% and small businesses continue to be impacted, exasperated, and competitively affected by these rising costs.

Thank you for your service and partnership in supporting America’s small businesses. If you have any questions, please do not hesitate to reach out to Karen Kerrigan or Ramiro A. Cavazos via phone or email. We look forward to a positive outcome on this important legislative matter for America’s small businesses.


Karen Kerrigan                                                                  Ramiro A. Cavazos

President & CEO                                                               President & CEO

Small Business & Entrepreneurship Council                    United States Hispanic Chamber of Commerce

New Poll Highlights Small Business Healthcare Policy Priorities, Calls for Focus on Economic Recovery

December 20th, 2021 by

For Immediate Release
December 20, 2021

Washington, D.C. – Today, the Small Business & Entrepreneurship Council (SBE Council) and the United States Hispanic Chamber of Commerce (USHCC) released the results of a poll examining the top policy concerns among the small business community and highlighting the need for Congress to focus on policies that aid economic recovery.

Key takeaways from the poll, conducted by Morning Consult, include:

● 41% of small business owners (SBOs) say economic recovery from the COVID-19 pandemic should be one of Congress’ top priorities across the board.

– 72% of SBOs agree the pandemic has already made things hard enough for small businesses and they cannot afford to have government policies that disrupt day-to-day business.

– Nearly 8-in-10 SBOs agree healthcare reform that adds new costs for small businesses is high-risk and would add another burden to recovering businesses.

● More than 9-in-10 SBOs say Congress’ top healthcare priority should be policies that address the rising cost and dwindling coverage of health insurance.

– In fact, 71% of SBOs want Congress to focus more on reducing the overall cost of healthcare rather than focusing just on drug pricing.

– Specifically, one third of small business owners are most concerned with addressing the cost of health insurance premiums—the top answer for healthcare priorities.

● 90% of SBOs agree that continued research and innovation is vital to the country’s prosperity.

● Nearly 9-in-10 also believe U.S. leaders should be anticipating and encouraging the need for research and development of new treatments and medicines.

SBE Council President & CEO Karen Kerrigan said: “The disruptive economic impact of the pandemic continues to disproportionately impact small businesses, and Congress must be attuned to their challenges to help them compete, recover and thrive. Our new survey with the United States Hispanic Chamber of Commerce provides a roadmap for relevant policymaking that will help small business owners, particularly with rising healthcare costs and how these threaten their ability to support their employees and businesses in this challenging environment. The year-over-year increases in health coverage costs are unsustainable and Congress must listen to America’s small business owners and advance smart economic reforms and market-oriented healthcare solutions that promote affordability, innovation and choice. During the holiday recess, we urge members of Congress to reach out and listen to small business owners to ensure they are acting on policies that support their recovery rather than creating more burdens for them to navigate.”

USHCC President & CEO Ramiro A Cavazos said: “The past year and a half have been an uphill battle for our nation’s small businesses, particularly those in marginalized communities that disproportionately felt the brunt of this public health crisis but have continued to persevere. Policymakers must do everything they can to give small businesses the support they need, starting by listening to their needs that Congress must address such as economic recovery, rising healthcare costs, building a skilled workforce, and dwindling insurance coverage—without adding or creating more burdens or costs for the small business community.”


About the Small Business and Entrepreneurship Council

SBE Council is nonpartisan advocacy, research and education organization dedicated to protecting small business and promoting entrepreneurship. For 27 years, SBE Council has worked on and advanced a range of private sector and public policy initiatives to strengthen the ecosystem for strong startup activity and small business growth. Visit for additional information.

About the United States Hispanic Chamber of Commerce

The United States Hispanic Chamber of Commerce (USHCC) actively promotes the economic growth, development, and interests of more than 5 million Hispanic-owned businesses. The USHCC team embodies the patriotic spirit and core mission of fostering the growth of American’s business community. Learn more at


Karen Kerrigan,

Brianna Dimas,