CMS plans to take small business enrollment off HealthCare.gov

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Enrollment in the small business version of the Affordable Care Act (ACA)’s insurance exchanges, known as Federally Facilitated Small Business Health Options Program (FF-SHOP), will be moved off HealthCare.gov for 2018, CMS has announced.

The SHOP exchanges offered plans to small businesses with 50 or fewer employees, which under the ACA aren’t required to provide health coverage, while offering tax credits to a business for the first two years after it has signed up. It didn’t prove very popular, as CMS reported in 2015 only 85,000 people in 33 states had been enrolled in SHOP plans, compared to the millions covered in the ACA’s individual marketplace.

CMS now puts the enrollment figure for SHOP, not included state-run small business exchanges, at under 40,000, saying the plans are “now defunct and do not provide needed insurance coverage for small businesses.”

“Our goal is to reduce ACA burdens on consumers and small businesses and make it easier for them to purchase coverage,” CMS Administrator Seema Verma said in a press release. “The ACA has failed to provide affordable insurance to small business and to the American people. This new direction will help employers find affordable healthcare coverage for their employees and make the SHOP exchanges function more effectively.”  

The direction CMS intends to take through future rulemaking would change how employers and employees would enroll in SHOP plans. Employers would still go to HealthCare.gov to determine their eligibility, but instead of using the site to enroll, businesses would enroll directly with an insurer or through an approved broker, and payments would be made directly to the insurance carrier.

“Small businesses with SHOP coverage that took effect in 2017 would be able to continue using HealthCare.gov for enrollment and premium payment until their current plan year ends,” the agency explained. “Some employers that purchase SHOP coverage are also able to access the Small Business Health Care Tax Credit. This option will still be available to small employers who purchase coverage under the new enrollment approach.”

State-run SHOPs wouldn’t be affected by this change, thought they could opt for the same kind of direct enrollment approached as the federally facilitated marketplace.