Small businesses are the backbone of the American economy, driving innovation, creating jobs, and fostering community growth. Yet, when it comes to providing affordable, high-quality health insurance for their employees, these businesses often face significant challenges.
Rising costs, limited options, and a lack of bargaining power have left many small employers struggling to offer competitive benefits. That’s why the U.S. Chamber is supporting two important bills in Congress: The Association Health Plans Act of 2025 (S. 1847) in the Senate and its counterpart, H.R. 2528, in the House of Representatives.
The Chamber has been a steadfast advocate for employer-sponsored insurance, which provides coverage to over 150 million Americans. In recent letters to the Bill sponsors, Senator Rand Paul and Representative Tim Walberg, we emphasized the transformative potential of these bills that build on the foundation of employer-sponsored health insurance.
The bills provide for the creation of Association Health Plans (AHPs), which are a market-based solution that allows small businesses and self-employed individuals to band together for better buying power and access to both lower premiums and broader provider networks. By treating associations and their members as single, large group plans under the Employee Retirement Income Security Act (ERISA), the proposed legislation unlocks the same economies of scale and bargaining power traditionally reserved for larger employers.
Proven Solution. Real Impact.
The potential benefits of AHPs are substantial. According to the Congressional Budget Office, AHPs could insure 400,000 previously uninsured individuals, helping to expand coverage for America’s workforce.
The bills include critical safeguards to ensure the integrity and fairness of AHPs. Associations must exist for at least two years, serve broader non-insurance purposes, and are prohibited from discriminating based on health status or denying coverage for pre-existing conditions. These measures protect consumers while fostering a competitive and inclusive health insurance market.
The bills also build on a 2018 regulation that created AHPs by expanding which entities could establish AHPs and which individuals could join. This regulation, which was later rescinded, demonstrated AHP’s ability to lower insurance costs and broaden provider networks for small businesses. By reinstating these opportunities, the bills seek to reignite competition in the health insurance market and provide small businesses with the tools they need to thrive.
A Call to Action for Lawmakers
The Chamber applauds the leadership of Senator Paul and Representative Walberg in championing these critical reforms. Their efforts underscore a commitment to supporting small businesses and their employees, ensuring that they have access to the same benefits and opportunities as their larger counterparts.
By empowering small businesses to offer affordable, high-quality health insurance, S. 1847 and H.R. 2528 represent a pragmatic, pro-growth solution to one of the most pressing challenges facing communities across America.
As these bills move through Congress, we urge lawmakers to prioritize the needs of small businesses and their employees. By passing the Association Health Plans Act, Congress can take a significant step toward a healthier future for America’s workforce.
This work comes as the Chamber advocates for improved access to care by reducing administrative burdens, streamlining regulations, promoting advancements like AI, and improving access to care. Recently, as part of this work, we submitted responses to Requests for Information (RFIs) issued by the Department of Health and Human Services (HHS), the National Institutes of Health (NIH), and the Centers for Medicare & Medicaid Services (CMS).
Earlier this year, the Chamber’s Health Policy Center convened top administration officials, current and former members of Congress, and industry leaders for the inaugural Health Innovation Summit. Through these efforts, the Chamber continues to champion policies that drive economic growth and improve the quality of life for individuals and communities across the nation.
About the author
Lexi Branson
Lexi Branson serves as Vice President of Health Policy at the U.S. Chamber of Commerce, where she leads the Chamber’s Health Policy Division.