There is no ribbon-cutting when a Missouri employer manages to keep offering health insurance for another year. No announcement of new investment. No photograph of an expanded production line. Yet maintaining that coverage is an investment in Missouri’s workforce. At my company, Keyser Enterprises, our teammates choose to come, stay and grow. Affordable health coverage is essential to that mission.
Health insurance increases do not arrive in isolation. They land alongside housing payments, utility bills and the everyday costs of raising a family. In the Kansas City region alone, home values have risen 97 percent since 2010, while median household income has grown 55 percent. That gap leaves families less room to stomach higher health insurance costs.
Employers, meanwhile, are paying more to provide coverage. Missouri’s insurance director recently described proposed 2027 group-market premiums ranging from about $845 to more than $1,000 a month. Every additional dollar devoted to benefits is a dollar employers must find somewhere in their budgets. Absorbing those increases leaves less for raises, hiring and expansion; passing them along puts more pressure on employees already struggling to make ends meet.
I’ve seen stories about companies like Alma Mader Brewing in Kansas City, that illustrate those difficult choices. That business switched to self-funding to preserve coverage, taking on more paperwork and financial risk. Even then, it faced a 13 percent increase for 2026. That is the backdrop against which Congress should examine the No Surprises Act’s arbitration process. The law protects patients from certain unexpected out-of-network medical bills. It also established a federal process for resolving payment disagreements between providers and insurers. The results deserve scrutiny.
Researchers at Georgetown University’s Center on Health Insurance Reforms estimate that the No Surprises Act’s arbitration process generated $22.4 billion in costs nationwide from 2022 through 2025. That includes $15.6 billion in payments above in-network rates, with the remainder covering administration and arbitration fees. These findings reveal a perverse incentive structure where providers are rewarded for flooding the zone with a torrent of claims and pursuing sky-high payouts through arbitration.
The effects can extend beyond the disputed bills. If providers expect higher payments through arbitration, they have less incentive to accept competitive network rates. The Congressional Budget Office warns that this increased negotiating leverage could push health insurance premiums higher. That gives employers a stake in how these disputes are resolved, even when they have no direct role in the negotiations.
Missouri’s congressional delegation should pursue reforms that tether payments to the fair market value of the services provided- a principal everyone can get onboard with. Legislation should also discourage the weaponized use of arbitration and hold bad actors accountable for abusing system. All of these changes can be made while preserving the critical patient protections enshrined in the No Surprises Act. And while we wait for Washington to make these changes, state officials can contribute by publishing aggregate results from Missouri’s separate arbitration process, as existing law permits. Employers deserve visibility into decisions that may affect their costs.
Missouri’s economic future depends on businesses having reasons to invest here and workers having reasons to stay. Making health coverage more affordable would strengthen our ability to attract employers, retain jobs and help families build a future here. Congress should make reforming the No Surprises Act’s arbitration process part of that effort.
co-founder and CEO of Keyser Enterprises | Co-Founder of Curiosity Ventures
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