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

By Jen Christensen, CNN

Atlanta (CNN) — 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.

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.

Facing multiple curveballs

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.”

A restaurant that ‘oozes community’

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.

‘The math is brutal’

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.”

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