The Looming Crisis: Why 2026 Could Be Tougher for Health Coverage
Insurance premiums are set to increase, and coverage is likely to contract
We're in a period of heightened market volatility. Insurers cite rising costs from increased utilization—more emergency visits, higher mental health treatment claims, and more overall healthcare utilization. They also note that as healthier individuals drop coverage, risk pools become sicker and more costly to maintain.
Meanwhile, the individual marketplace faces reduced affordability as pandemic-era flexibilities—like relaxed eligibility verification—tighten. This could lead to enrollment attrition just as support structures retract.
What This Means for Small Businesses
If you're a small business owner, you’re likely feeling the squeeze. Rising premiums and diminishing coverage make offering quality health benefits increasingly difficult. Yet, employee health coverage remains a critical part of attracting and retaining talent—and keeping your team healthy and productive.
A Better Way Forward: Direct Primary Care (DPC) — Smart, Simple, Sustainable
At Sasser Direct Primary Care, we’ve spent over a decade developing a model that sidesteps the pitfalls of traditional insurance-based medicine. Our Direct Primary Care (DPC) approach offers reliable, personalized healthcare—without the surprise costs.
Why DPC Makes Sense for Small Businesses:
- Transparent, Predictable Pricing: For a modest monthly subscription- most primary care services are included. No more hidden copays or surprise bills.
- No Insurance Hassles: With no billing to insurance, we eliminate prior authorizations and denials. Need lab work or imaging? We provide contracted-rate services at dramatically reduced prices.
- On-Site or Virtual Access: Employees can get the care they need—whether in-person or via telehealth—which keeps them healthier and less tied up with administrative delays.
- Affordable Prescriptions: Medications are dispensed directly from our clinic at discounted rates—helping employees save and increasing adherence.
- Supplement with Healthshare for Big Events: Pair DPC with a cost-effective Healthshare plan—like the Zion Healthshare Essentials—to cover major expenses like surgery or hospital stays, with significantly lower monthly rates than commercial insurance.
A Real-World Example: DPC Supporting Small Teams
Imagine a local startup or shop with eight employees. Rather than paying escalating insurance premiums, that business enrolls each team member in a DPC plan for, say, $80/month. For under $600 a month, your team has:
- Same-day or extended visits
- Unlimited tele-health access
- Low-cost labs and imaging
- Discounted medications
Pair that with a Healthshare plan and you’ve covered routine care and major emergencies affordably and predictably—no more surprises, no more coverage gaps.
The Bottom Line
The data is clear: 2026 promises to bring increased costs and diminished insurance coverage, especially in the individual market. But small businesses don’t have to bear that burden alone.
Direct Primary Care offers a lean, efficient, and employee-friendly alternative: higher quality care, greater access, lower costs, and protection against market volatility. It’s not just smart—it’s compassionate.
Ready to transform your team’s healthcare?
Visit the Plans & Benefits page on our website or contact our team to explore how DPC can be tailored for your small business (1 to 50 employees). At Sasser DPC, we’re committed to delivering care that’s simple to understand—so you can run your business, and we can care for the people who make it run.
