What Rising Health Premiums Mean for Montana's Small Businesses
If you run a small business in Montana, you know the ritual. Every year, the renewal letter shows up, and every year the number is bigger than the last one. You sit at the kitchen table or the back office desk, look at what covering your team is going to cost, and start doing math that never seems to work out in your favor.
This year, the math is getting harder. According to a recent analysis from the Peterson-KFF Health System Tracker, insurers in the small group market (the plans sold to businesses with roughly 50 or fewer employees) proposed a median premium increase of about 11% for 2026. The researchers looked at rate filings from 318 insurers across all 50 states. Most requested increases between 5% and 15%, and about one in ten asked for increases of 20% or more. Only three insurers in the entire country proposed lowering their rates.
Why premiums keep climbing
The analysis points to a few forces stacking on top of each other.
First, the underlying cost of care keeps rising. Insurers estimate that the combined cost of hospital stays, doctor visits, and prescription drugs is growing around 9% a year. When the care itself costs more, the coverage that pays for it costs more too.
Second, everyday economics are hitting healthcare just like they hit every other industry. General inflation and labor shortages push up what hospitals and clinics have to pay their people, and those costs flow through to premiums.
Third, expensive specialty medications are playing a bigger role. Many insurers specifically pointed to the growing use of high-cost drugs as a reason for their rate requests.
And finally, there is a quieter problem: the small group market itself is shrinking. As some businesses leave for other types of coverage, the remaining pool gets smaller and often costlier to insure, which pushes rates up for everyone still in it. It is a cycle that tends to feed itself.
What this feels like on Main Street
National percentages are one thing. What they mean in a town like Kalispell, Lewistown, or Miles City is another. For a shop with six employees, an 11% jump is not an abstraction. It is the difference between giving raises or not, hiring that extra set of hands or holding off, keeping benefits or making a painful call.
Small business owners in rural states carry an extra layer of this weight. There are often fewer plan options to choose from, fewer providers in network nearby, and longer drives to get care. So you can end up paying more for coverage while your team still struggles to actually see someone when they are sick.
Where direct primary care fits in
This is the part of the conversation we care about most at CoreMed, because it is the problem we built our practice around.
Direct primary care, or DPC, is a simple idea: instead of routing every checkup, sick visit, and question through a claims system, a patient (or an employer, on behalf of a team) pays a flat monthly membership directly to the practice. In return, members get ongoing access to a primary care provider who knows them, with time to actually listen.
To be clear, direct primary care is not insurance, and it is not a replacement for it. It does not cover hospital stays, surgeries, or emergencies. Many families and businesses pair a DPC membership with other coverage for those bigger events. What DPC does is take the everyday layer of healthcare (the checkups, the sick visits, the ongoing management of day-to-day health) and make it predictable, personal, and simple.
For a small employer staring down another premium increase, that predictability is worth a serious look. When routine care is handled through a flat monthly membership, employees have an easy front door to a provider they know, and the owner knows exactly what that piece of the budget looks like every month. No surprises in the mail each fall for that part of the picture.
A community-sized answer to a national problem
We cannot control what happens in rate filings across 50 states. What we can control is how care works here at home: a real relationship with a provider, appointments that do not feel rushed, and a front door to healthcare that stays open for our neighbors.
The national numbers say costs are going up again in 2026. Our answer is to keep the everyday part of care simple and close to home, so Montana's small businesses and families have at least one part of their healthcare that feels steady.
If you are a business owner rethinking how to take care of your team, or a family trying to make sense of your options, we are happy to talk it through. Visit coremedhealth.com or reach out to us at [email protected].
This article is for general information only. It is not medical or financial advice, and it is not a substitute for guidance from your own providers and advisors. Direct primary care is not insurance.
