Small businesses are at a disadvantage compared with larger companies in terms of purchasing insurance for employees because of lower profit margins coupled with price hikes on premiums, the National Association of Insurance Commissioners said in testimony before the Senate Committee on Health, Education, Labor and Pensions. The roadblocks "are ultimately the result of medical spending that has outstripped the ability of most Americans to pay for it," said Sandy Praeger, chair of the NAIC Health Insurance and Managed Care Committee.

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