At one Atlanta restaurant, workers are family. A health insurance crisis tested that commitment

When doctors diagnosed Jen Chan with an aggressive form of breast cancer last year, she and her wife, Emily, faced a frightening reality: surgery, chemotherapy, radiation and uncertainty about whether the treatment would even work.

For a while, it seemed as though it had. In April, Jen danced toward the chemotherapy ward bell , smiling broadly, fists raised in triumph. Medical staff cheered and shook hot pink pompoms all around her, celebrating what they all thought was the end of her grueling treatment.

But follow-up tests found cancer cells in Jen’s lymph nodes. Doctors said she’d need another year of chemotherapy.

Then came the second blow.

During one of the chemotherapy sessions, Emily got an email from their insurance broker, Trey Wilson.

It began, “Emily, I don’t know what you’re going to do about this …”

Their insurance costs were about to go way, way up.

The couple co-own JenChan’s, a popular Chinese and pizza restaurant in Atlanta’s quirky Cabbagetown neighborhood, and Mikkelson’s Market , a funky bodega one neighborhood over in Reynoldstown. After Jen’s cancer treatment and an employee’s accident-related surgery drove up claims, their broker essentially said the bill would double, but not just for Jen and the injured employee. For everyone.

The message captured a familiar crisis for small businesses: Many owners want to offer health insurance to attract and keep good staff and protect them from financial disaster, but one serious illness or injury can send costs soaring.

“It’s insane. We can’t even cover spouses or dependents with this policy,” Jen Chan said. She said their son is not on their policy. “We can only insure our full-time employees.”

Industry surveys show that only about a third of US restaurants offer insurance coverage. Small businesses often have few affordable options.

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Getting health insurance from your job will be extra pricey for 2027

Scott Bierman, vice president of government affairs for the Georgia Restaurant Association, said that 9 in 10 of its members are small businesses and that most cannot afford to offer insurance.

“Insurance is often a bridge too far for small businesses like restaurants. Many of our folks would like to offer this option, but they just can’t stretch it,” Bierman said.

And restaurants that manage to find money in their budget can still face sudden, unsustainable increases.

“This is definitely not the first time rates have skyrocketed with my restaurant clients,” said Wilson, the Chans’ independent insurance broker, who works mostly with small businesses. “You do have these horror situations when, unfortunately, prices will double, which totally sucks. But what are you going to do?”

For the past four decades, health insurance costs have remained the No. 1 concern for small businesses, according to the March Small Business Insurance Survey by the National Federation of Independent Business . Of the small employers surveyed who offer insurance, 98% believe that high costs will make it unsustainable within the next five to 10 years.

Hospitality workers are already some of the least insured professionals. A 2021 Bureau of Labor Statistics report found about 32% have health insurance, compared with 77% of all private-sector workers.

The Chans’ experience shows how difficult the situation can be. They consider the offer of insurance for full-time staff an essential benefit, but costs had already tripled four years years ago.

The Chans added an optional 4% healthcare contribution surcharge to diners’ checks in 2024 but received death threats after an out-of-town customer complained on social media, Emily said. The story made headlines, and the community rallied around them.

“We really are lucky to have such friends and customers,” Emily said.

They kept the 4% fee, but it still doesn’t cover the full cost. “Far from it,” Emily said.

The insurance bill for the restaurant varies by month, depending on the claims employees file. There are nine employees on the policy now, and more will be added soon. Last year, on average, the Chans paid about $491 a month per employee. Then the cost jumped to an average of about $1,135 per person per month for the year.

In June alone, because of their recent claims, the tab spiked to more than $2,400 per person in one month. It was $21,868.71 — nearly four times what they pay for the restaurant’s rent.

“Things had really curveballed for us,” Emily Chan said.

Even when they use their benefits, they say, they often have to fight for coverage. Jen’s doctor prescribed an immunotherapy drug the insurer would not approve. She had to go with a different treatment.

“I can’t tell you how many times I’ve wound up pacing on the phone with either the insurance company or our insurance advocate,” Emily said. “We’re going through, for us, the most devastating diagnosis that we’ve had in our life, and our doctor tells us, ‘This is the best thing that we can do for you,’ and you’re starting to put hope in that basket, and then the insurance company says, ‘Tough.’ And so, in your head, you’re like, ‘So, we’re not getting the best treatment?’ It’s really hard.”

Emily asked their broker to try to find a cheaper policy. But he said no other company would bid on their business because of their claims history.

“This exact situation is why, as much as restaurants would like to offer insurance, it is incredibly difficult,” Wilson said.

A major problem is the lack of good policy options.

“Typically, the only ‘affordable’ option [small businesses] have is to get a self-funded or a partially self-funded policy,” said Larry Levitt , executive vice president for health policy at KFF, a health policy group.

The Affordable Care Act does not bar self-funded or partially self-funded plans from setting rates based on a group’s past medical claims, Levitt said. In those plans, employers assume the risk of paying claims. Large companies can spread that risk across many people; at a small business, one serious illness or accident can quickly raise costs.

“Typically, if a small business provides insurance, they will give employees a lump sum to pay for insurance wherever they can find it, or the businesses will buy what’s known as a self-insured policy, which means that the policies are much more responsive to the actual healthcare costs of the workers,” Levitt explained.

The Chans’ policy is partially self-funded, meaning they directly pay toward medical claims up to a set limit, where a larger insurer steps in.

“The policies can seem really attractive and cheap if your employees are healthy, but if one person gets sick, it’s not such a good deal,” Levitt said.

“Only in America can people be financially ruined by an illness, even if they have health insurance.”

By summer, the Chans faced steep medical bills and unaffordable insurance costs. But dropping coverage would put an end to Jen’s lifesaving treatment as well as their staff’s coverage, and “that’s clearly not an option,” Emily said.

So Emily looked for a way around the problem. She started a GoFundMe to help pay for both. The Chans had an advantage not all small business owners have: devoted customers and community.

More than 1,700 people donated. It raised more than $128,000 . Market and restaurant regular Heather Anderson and her wife were contributors.

Anderson says she loves JenChan’s “never boring” fusion of Chinese and Southern food, especially the focaccia-style burrata lasagna pizza and the “This is My Salad Nachos,” but her admiration goes far beyond the menu.

“Everything the Chans do oozes community,” Anderson said.

Emily Chan has said she wanted the restaurant to feel like everyone’s “favorite grandma’s house,” with its exposed brick walls covered in family photos, customers’ Polaroids and positive affirmations. Staff often greet regulars – and their dogs – by name with a warm question about their day.

Loyalty to the restaurant and the market have grown through neighborhood-friendly touches like mahjong Mondays and a rainbow Pride Month Gay Card that provides discounts at the restaurant and other local businesses. Mikkelson’s Market became a go-to spot for Anderson and her neighbors to share news over chicken biscuits and strong coffee on the patio on most weekends.

“They’ve created a community for all of us, so of course our community would support them,” Anderson said.

Courtney Kovanis and her wife also contributed to the GoFundMe. Kovanis said she was thrilled their Reynoldstown neighborhood gave the Chans an award in September for being so community-oriented.

“With the GoFundMe, it really struck me that they weren’t just trying to raise money to pay for Jen’s cancer treatment, which is incredibly expensive, but they were doing this to provide insurance for their staff, too,” Kovanis said. “That really speaks to who they are as individuals.

“The service industry is so tough, and they are providing for their staff. Contributing is the least I could do,” she added.

But the Chans’ crowdfunding underscores another broader problem: Even when coverage exists, illness can be financially devastating, starting a spiral of debt.

“It’s not a personal failure of a restaurant owner or worker if their insurance coverage is not fully there,” said Allison Padilla-Goodman, chief executive officer of the Giving Kitchen , an Atlanta-based nonprofit that provides financial help for restaurant workers in crisis, including some of JenChan’s employees over the years.

A Gallup poll from March 2025 found that about 30 million Americans reported borrowing money to pay for medical care. Specifically, Americans borrowed an estimated $74 billion to pay for medical bills in 2024 alone. More than a quarter of US adults had medical debt in 2025, according to an Urban Institute report released this month.

Before launching the GoFundMe this summer, the Chans owed about $12,000 from Jen’s first set of treatments and had about $60,000 in medical bills pending. With treatment needed for another year, it wasn’t completely clear how much more they would owe.

“Health insurance is just thin to begin with, and the math is brutal,” Padilla-Goodman said.

When a server in the US earns less than $17 an hour on average, according to the Bureau of Labor Statistics , that typically doesn’t give them a lot of savings to pay for unexpected medical bills.

“This is a group of people who many qualify as working poor,” she said. “It’s a surprise to some, since these are the people we interact with regularly, and on special occasions when we go to a restaurant to celebrate, they can feel like family.”

Most restaurant workers also lack paid sick leave. Jen and Emily Chan have worked throughout Jen’s treatments, like others have before them.

JenChan’s floor manager, Maxx Reginello , couldn’t work for a few weeks last year after he was hit while riding his bike home after a double shift on Easter. He needed surgery and wore a neck brace for about seven weeks.

“I’m happy to be alive, and I’m lucky enough to get insurance through the restaurant,” Reginello said. But there were still expenses. The Chans set up a GoFundMe to help pay his medical bills and cover other bills when he couldn’t work.

“Our community really showed out,” he said. “We’ve got some really, really generous folks.”

Jen is still undergoing chemo and will need treatment through the end of the year. After using the GoFundMe to pay for the medical and insurance bills this summer, the Chans had enough left over to to create a kind of health savings account for employees “so if something bad happens to any of them, and they have a deductible or unexpected expenses, that will be taken care of.”

Emily said they’re telling their story because the insurance problems that nearly overwhelmed JenChan’s threaten small businesses nationwide. They say they won’t give up on providing insurance for their employees, and they’ve put a link up on their website so people can contribute to help with those costs — even knowing how quickly the benefit can become a liability.

“But if no one’s talking about this, the problem will continue. We are so fortunate that our community came to take care of us, and we will continue to take care of them. But insurance puts so many businesses like ours in a terrible situation,” Emily said.

“I think our story shows we really need to rethink how health coverage works in this country. Or we will lose many more businesses like ours.”

For now, their work continues. This summer, the Chans threw a Gala for Hope to thank supporters and raise money for the Giving Kitchen .

They had such a high turnout that the couple never even delivered any remarks. They spent most of the event cooking.

“Honestly, I think the event spoke for itself,” Emily said. ”We have an awesome community.”

去年，当医生诊断 Jen Chan 患有侵袭性乳腺癌时，她和她的妻子 Emily 面临着一个可怕的现实：手术、化疗、放疗，以及治疗是否有效的未知数。

有一段时间，似乎真的如此。四月份，珍妮朝着化疗病房的铃声翩翩起舞，脸上洋溢着灿烂的笑容，高举着拳头，仿佛在庆祝胜利。医护人员在她周围欢呼雀跃，挥舞着粉红色的绒球，庆祝着他们都以为她痛苦的治疗终于结束了。

但后续检查发现珍的淋巴结中发现了癌细胞。医生说她还需要再接受一年的化疗。

然后，第二击来了。

在一次化疗期间，艾米丽收到了一封来自他们的保险经纪人特雷·威尔逊的电子邮件。

开头是这样的：“艾米丽，我不知道你打算怎么办……”

他们的保险费用即将大幅上涨。

这对夫妇共同拥有位于亚特兰大颇具特色的卡贝奇镇街区的JenChan's餐厅，这是一家颇受欢迎的中餐和披萨店；他们还在隔壁街区的雷诺兹镇经营着一家名为Mikkelson's Market的时尚杂货店。在Jen接受癌症治疗以及一名员工因意外事故接受手术后，理赔金额大幅增加，他们的经纪人表示，账单金额将翻倍，但不仅仅是Jen和受伤员工的理赔，而是所有人的理赔。

这条信息反映了小企业面临的一个熟悉的危机：许多企业主希望提供健康保险来吸引和留住优秀员工，并保护他们免受经济灾难的影响，但一次严重的疾病或受伤就可能导致成本飙升。

“这太荒谬了。这份保单甚至不能涵盖配偶或受抚养人，”陈珍说道。她说他们的儿子不在保单范围内。“我们只能为全职员工投保。”

行业调查显示，美国只有大约三分之一的餐厅提供保险。小型企业往往缺乏价格合理的保险选择。

图片来源：muratdeniz/E+/Getty Images

到2027年，通过工作单位购买医疗保险将会非常昂贵。

佐治亚州餐饮协会政府事务副总裁斯科特·比尔曼表示，该协会十分之九的成员都是小型企业，而且大多数小型企业都负担不起提供保险的费用。

“对于像餐馆这样的小企业来说，保险往往是一笔不小的开支。我们很多员工都想提供这项服务，但他们实在力不从心，”比尔曼说道。

即使是那些设法在预算中挤出资金的餐厅，仍然可能面临突如其来的、不可持续的价格上涨。

“这绝对不是我的餐饮客户第一次遇到保费飙升的情况了，”威尔逊说道。他是陈氏夫妇的独立保险经纪人，主要服务于小型企业。“你确实会遇到这种可怕的情况，不幸的是，价格会翻倍，这真是太糟糕了。但又能怎么办呢？”

根据全美独立企业联合会 (NFIB) 三月份发布的《小型企业保险调查报告》，过去四十年来，医疗保险成本一直是小型企业最关注的问题。在接受调查的提供医疗保险的小型企业雇主中，98% 的人认为，高昂的保险成本将在未来五到十年内使其难以为继。

酒店餐饮业从业人员的医疗保险覆盖率已经是所有职业群体中最低的之一。美国劳工统计局2021年的一份报告显示，酒店餐饮业从业人员中只有约32%拥有医疗保险，而私营部门所有员工的医疗保险覆盖率则高达77%。

陈氏夫妇的经历表明，这种情况有多么棘手。他们认为为全职员工提供保险是一项至关重要的福利，但四年前保险费用就已经翻了三倍。

2024年，陈氏夫妇在顾客账单上增加了一项可选的4%医疗保健附加费，但艾米丽说，一位外地顾客在社交媒体上投诉后，他们却收到了死亡威胁。这件事上了新闻头条，社区也纷纷声援他们。

“我们真的很幸运能拥有这样的朋友和顾客，”艾米丽说。

他们保留了4%的手续费，但这仍然不足以弥补全部成本。“远远不够，”艾米丽说。

这家餐厅的保险费用每月都会有所不同，具体取决于员工提出的索赔。目前保单上共有九名员工，不久还会增加更多。去年，陈氏夫妇平均每月为每位员工支付约 491 美元的保费。之后，费用飙升至全年平均每人每月约 1135 美元。

仅六月份，由于他们最近的索赔，人均账单就飙升至每月超过2400美元。总计21868.71美元——几乎是他们支付餐厅租金的四倍。

“事情真的给我们带来了意想不到的变故，”艾米丽·陈说道。

他们说，即使使用医保福利，也常常需要争取报销。珍的医生给她开了免疫疗法药物，但保险公司不予批准。她不得不接受其他治疗。

“我数不清有多少次在电话里焦急地踱来踱去，要么是跟保险公司，要么是跟我们的保险代理人，”艾米丽说。“我们正在经历人生中最沉重的打击，医生告诉我们，‘这是我们能为你们做的最好的治疗’，你开始抱有希望，然后保险公司却说，‘没办法。’于是，你心里就想，‘所以，我们得不到最好的治疗吗？’这真的太难熬了。”

艾米莉请他们的经纪人帮忙找一份更便宜的保单。但他表示，由于他们的理赔记录，没有其他公司愿意承接他们的业务。

威尔逊说：“正是因为这种情况，尽管餐馆很想提供保险，但却非常困难。”

主要问题是缺乏好的政策选择。

“通常情况下，小企业唯一‘负担得起’的选择就是购买自筹资金或部分自筹资金的保险，”健康政策组织KFF的健康政策执行副总裁拉里·莱维特说。

莱维特表示，《平价医疗法案》并未禁止自保或部分自保的医疗保险计划根据团体过去的医疗索赔情况设定费率。在这些计划中，雇主承担支付索赔的风险。大型公司可以将这种风险分摊到众多员工身上；而对于小型企业来说，一次严重的疾病或事故就可能迅速推高成本。

“通常情况下，如果一家小企业提供保险，他们会给员工一笔钱，让他们自己去哪里购买保险，或者企业会购买所谓的自保保险，这意味着这些保险对员工实际的医疗保健成本更加敏感，”莱维特解释说。

陈氏夫妇的保单是部分自保的，这意味着他们会直接支付一定限额内的医疗费用，超出限额则由更大的保险公司介入。

“如果员工都很健康，这些保险政策看起来确实很有吸引力而且很便宜，但如果有一个人生病了，那就不是一笔划算的买卖了，”莱维特说。

“只有在美国，人们才会因为生病而破产，即使他们有医疗保险。”

到了夏天，陈家面临着巨额医疗账单和难以负担的保险费用。但放弃保险不仅会终止珍的救命治疗，还会让他们的员工失去保险保障，“这显然不是一个可行的选择，”艾米丽说。

于是，艾米丽想办法解决这个问题。她发起了一个GoFundMe众筹活动，希望能帮他们支付这两笔费用。陈氏夫妇拥有并非所有小企业主都具备的优势：忠实的顾客和社区支持。

超过1700人捐款，共筹集超过12.8万美元。市场和餐厅的常客希瑟·安德森和她的妻子也是捐款人之一。

安德森说她很喜欢 JenChan 将中式和南方菜融合在一起的“绝不乏味”的菜肴，尤其是佛卡夏风味的布拉塔奶酪千层面披萨和“这是我的沙拉玉米片”，但她对这家餐厅的欣赏远不止于菜单。

安德森说：“陈氏一家所做的一切都体现了社区精神。”

艾米莉·陈曾表示，她希望这家餐厅能像每个人心中“最爱的奶奶家”一样温馨舒适，裸露的砖墙上挂满了家庭照片、顾客的拍立得照片和各种鼓励的话语。员工们经常热情地叫出常客——以及他们的狗狗——的名字，并亲切地询问他们今天过得怎么样。

餐厅和市场凭借其贴心的社区服务，例如每周一的麻将活动和彩虹骄傲月同志卡（可在餐厅和其他本地商家享受折扣），赢得了更多居民的喜爱。米克尔森市场也成了安德森和邻居们周末聚会的热门地点，大家常常在露台上一边享用鸡肉饼干和浓咖啡，一边聊天。

安德森说：“他们为我们所有人创造了一个社区，所以我们的社区当然会支持他们。”

Courtney Kovanis和她的妻子也为GoFundMe捐款。Kovanis表示，她很高兴她们所在的Reynoldstown社区在9月份授予Chans一家一个奖项，以表彰他们积极参与社区活动。

科瓦尼斯说：“通过GoFundMe筹款，我真正感受到的是，他们不仅仅是为了筹集资金支付珍妮的癌症治疗费用（这笔费用极其昂贵），他们也是为了给他们的员工提供保险。这真正体现了他们的人格魅力。”

“服务行业竞争非常激烈，他们还要照顾员工。我能做的最起码的事情就是尽一份力，”她补充道。

但陈氏夫妇的众筹凸显了另一个更广泛的问题：即使有医疗保险，疾病也可能造成经济上的毁灭性打击，引发债务螺旋。

“如果餐馆老板或员工的保险没有完全覆盖，这并不是他们的个人过错，”总部位于亚特兰大的非营利组织“给予厨房”（Giving Kitchen）的首席执行官艾莉森·帕迪拉-古德曼（Allison Padilla-Goodman）说道。该组织为陷入困境的餐馆员工提供经济援助，多年来也曾帮助过 JenChan 的一些员工。

盖洛普2025年3月的一项民意调查发现，约有3000万美国人表示曾借钱支付医疗费用。具体而言，仅在2024年，美国人就借贷了约740亿美元用于支付医疗账单。根据城市研究所本月发布的一份报告，到2025年，超过四分之一的美国成年人背负着医疗债务。

今年夏天在GoFundMe上发起筹款活动之前，陈氏夫妇因珍的第一轮治疗欠下约12,000美元，还有约60,000美元的医疗账单尚未支付。由于珍还需要接受一年的治疗，他们最终还需要支付多少费用尚不完全清楚。

“医疗保险本来就覆盖面很窄，而且计算起来也很残酷，”帕迪拉-古德曼说。

根据美国劳工统计局的数据，美国服务员的平均时薪低于 17 美元，这通常不足以让他们攒下多少钱来支付意外的医疗费用。

她说：“这群人很多都符合在职贫困人口的定义。有些人对此感到惊讶，因为我们经常与这些人接触，在特殊场合，比如我们去餐厅庆祝时，他们就像家人一样。”

大多数餐饮业员工也缺乏带薪病假。珍和艾米丽·陈在珍接受治疗期间一直坚持工作，就像之前的其他员工一样。

JenChan的楼层经理Maxx Reginello去年复活节当天上完双班后骑自行车回家时被撞，之后休息了几个星期。他需要做手术，并佩戴颈托约七周。

“我很庆幸自己还活着，也很幸运能通过餐厅获得保险，”雷吉内洛说道。但即便如此，开销依然存在。陈氏夫妇在GoFundMe上发起筹款，以帮助支付他的医疗费用以及在他无法工作期间的其他开支。

他说：“我们社区真的太棒了。我们这里有很多非常非常慷慨的人。”

珍目前仍在接受化疗，需要治疗到年底。今年夏天，陈氏夫妇利用GoFundMe平台支付了医疗和保险费用，之后还剩下一些钱，为员工设立了一个类似健康储蓄账户的账户，“这样，如果他们中有人发生意外，需要支付自付额或应对意外支出时，这些费用就能得到保障。”

艾米丽说，他们之所以讲述自己的故事，是因为几乎让JenChan's公司破产的保险问题，也威胁着全美各地的小企业。他们表示不会放弃为员工提供保险，并在网站上设置了捐款链接，以便人们可以捐款帮助他们支付这些费用——即使他们知道这项福利很快就会变成一项负担。

“但如果没人谈论这件事，问题就会继续存在。我们很幸运，社区一直照顾我们，我们也会继续照顾他们。但保险让很多像我们这样的企业陷入了困境，”艾米丽说道。

“我认为我们的遭遇表明，我们真的需要重新思考这个国家的医疗保险制度。否则，我们会失去更多像我们这样的企业。”

目前，他们的工作仍在继续。今年夏天，陈氏夫妇举办了一场“希望盛会”，以感谢支持者并为“爱心厨房”筹款。

婚礼当天到场人数众多，这对新人甚至都没来得及致辞。他们把大部分时间都花在了准备饭菜上。

“说实话，我觉得这次活动本身就说明了一切，”艾米丽说。“我们拥有一个很棒的社区。”