Small businesses are the engines of the American economy, but it’s getting to the point where it is almost impossible for them to get ahead.

Soaring health costs are negatively impacting their ability to compete and still offer affordable health coverage for their employees. Since 2004, the average annual family premium in small firms increased 69 percent. Family insurance premiums for small firms increased from $9,950 in 2003 to $16,834 in 2014, according to the Kaiser Family Foundation. The problem is the economy rose at just a fraction of premium increases, creating an affordability gap many find too difficult to surmount.