By Daniel Cloos, owner, Cloos’ Coney Island Hot Dogs

There are likely only a few weeks left in this year’s North Carolina legislative session, and health care has been one of the hottest topics in Raleigh. Issues like expanding Medicaid and legalizing medical marijuana have gotten the most attention, but other major proposals have flown under the radar. 

One of them is HB 246, a bill that threatens to add more government regulations to our health care system and drive up prescription drug costs for small businesses and patients. This bill has already passed in the House of Representatives, meaning it is up to the Senate to ensure small businesses are protected and HB 246 does not move further.   

North Carolina’s small businesses are the backbone of our economy. In 2021, the state’s 964,280 small businesses employed more than 1.7 million people – nearly half of all North Carolina employees. Small businesses face intense competition. To stay afloat, they need to keep their costs down. Importantly, this includes providing health care and pharmacy benefits that give employees and their families the coverage they need, while not breaking the bank. Overlooked policy changes like HB 246 would increase health care costs and hurt small businesses’ ability to remain competitive. 

As a small business owner, I know that the cost of providing health care continues to increase. Some national projections show that the average costs American employers pay for their employees’ health care will rise by 6.5 percent in 2023. This is a big concern in growth and hiring decisions. Lawmakers often claim to be working hard for small businesses, which is why it is surprising that the House of Representatives overwhelmingly voted in favor of HB 246 a few weeks ago.

HB 246 would increase costs for employers by inserting the government into how businesses contract with other private businesses to provide their employees with the best, most affordable prescription drug benefits possible. This bill would limit employers’ ability to choose lower-cost pharmacy options in their benefits packages and undermine convenient, cost-effective pharmacy services like home delivery of medicines. NC Chamber, the state’s largest business advocacy organization, is one of a number of employer groups that are against HB 246, explaining that "many of the provisions in this bill have the serious potential to drive up health insurance and health care costs for businesses and their employees." 

Small businesses aren’t the only ones who would lose out because of HB 246. Employees would face increased out-of-pocket costs on prescriptions, including a new $10.24 fee on most prescriptions filled in North Carolina; more expensive premiums; and higher deductibles. HB 246 would also hurt patients’ health in addition to hurting their wallets. By scaling back quality and safety standards for pharmacies that handle medication for chronic conditions and diseases like cancer, the proposal would expose patients to unnecessary risks. 

North Carolina Senate and House leadership often show they understand the challenges small businesses face. I urge the Senate to think twice before passing new regulations, like HB 246, that drive up costs and make it more difficult for employers to provide good jobs with good benefits to hardworking employees.