- As of 2018, HealthCare.gov will no longer host the Small Business Health Options Program (SHOP) Marketplace. Usage of the healthcare insurance exchange by insurance producers and overall enrollment through SHOP never met anticipated levels.
The new regulations will take effect January 1, 2018.
“CMS will be exploring a more efficient implementation of the Federally-facilitated SHOP Marketplaces in order to promote insurance company and agent/broker participation and make it easier for small employers to offer SHOP plans to their employees, while maintaining access to the Small Business Health Care Tax Credit,” the agency said in a statement.
The proposed new approach to SHOP will not require an online enrollment at HealthCare.gov, but will instead funnel employers through an insurance company which offers SHOP plans.
The proposed changes also seek to remedy the current lack of participation by insurance producers, such as agents and brokers, who would now be able to personally enroll employers into the federally-facilitated SHOP.
The findings from a GAO report on the SHOP exchange found consistently low enrollment rates and numerous functionality issues since its roll-out in 2014.
CMS reported that in states where a federally or state run SHOP exchange existed only 27,000 employers had enrolled to use the program in 2017.
That employer involvement equated to approximately 230,000 individuals who received health insurance coverage through SHOP purchased plans.
The numbers of those currently enrolled in 2017 fell dramatically short of the four million estimated by the Congressional Budget Office (CBO).
As suggested in the GAO report, a reason for the low enrollment could be the lack of awareness of SHOP by small businesses. The report urged the “need to improve outreach by more aggressively targeting small employers and highlighting the value of the SHOPs.”
SHOP was initially created with the goal of offering an easy-access web portal that would simplify the process which small businesses employers could access lower cost/subsidized healthcare plans for their employees.
With different payers in different exchanges, SHOP has suffered from the same marketplace instability that has plagued individual ACA health insurance plans. This includes very few options or a complete absence of providers in some regions.
The proposed changes would still require employers to prove eligibility requirements by registering on HealthCare.gov.
The proposed changes to SHOP will not affect those employers who are currently registered for 2017. Those employers would still have SHOP access to choose a 2018 plan and make premium payments.
“Our goal is to reduce ACA burdens on consumers and small businesses and make it easier for them to purchase coverage,” said CMS Administrator Seema Verma. “This new direction will help employers find affordable healthcare coverage for their employees and make the SHOP exchanges function more effectively.”