Small Businesses Could Buy Health Insurance for Nearly 10 Million People Through New Health Insurance Exchanges

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<p>The Affordable Care Act's state health insurance exchanges for small businesses are estimated to cover nearly 10 million people, in addition to the 15.3 million who will gain coverage through the individual exchanges when the health reform law is fully implemented, according to an article in the February issue of <em>Health Affairs</em>. The article, by Fredric Blavin and colleagues at The Urban Institute, is one of a group of articles in the journal examining the <a href="/publications/journal-article/2012/feb/employers-and-exchanges-under-small-business-health-options">Small Business Health Care Options Program</a> (SHOP), the formal name for the small business exchanges. </p><p>The collection of articles, supported by The Commonwealth Fund, examines SHOP's potential to provide affordable insurance options for small businesses that now face high premiums and administrative costs when they insure their workers. Under the Affordable Care Act, the SHOP exchanges, along with the exchanges for individuals, are expected to be open for business on January 1, 2014. </p>
<p>In his overview, Timothy Jost at Washington and Lee University School of Law asserts there is a real need for the SHOP exchanges, as small businesses struggle to afford and manage health insurance for their employees. Jost concludes that in order to be successful, the SHOP exchanges will have to provide small employers with a choice of attractive alternatives to the options currently available, keep costs affordable and limit administrative burdens, and protect against adverse selection. Other articles are by: </p>
<li>Jon Kingsdale, who draws on his experience as founding director of the Massachusetts Connector exchange, as well as examples from Utah's already functioning exchange for small employers, to lay out a business case for the SHOP exchanges. </li>
<li>Terry Gardiner, vice president for policy with the Small Business Majority and former Alaska state legislator, who argues that often overwhelmed small-business owners need an exchange that will fulfill many of the functions served by the human resources departments of larger businesses. </li>
<li>Christine Eibner and colleagues at RAND, who conclude that allowing small businesses to continue to self-insure would have little to no effect on premiums in the SHOP exchanges—a concern that has been raised by critics. </li>
<li>Mark Hall of the Wake Forest University School of Law, who addresses what measures states might take if the trend toward self-insurance does in fact lead to adverse selection in the exchanges. </li>
<li>William Kramer, executive director for national health policy for the Pacific Business Group on Health, who says eventual participation in the SHOP exchanges by large employers will depend in part on how viable the exchange marketplaces become, whether the Affordable Care Act survives mostly intact, and whether the labor market becomes competitive again. </li>
<p>Be sure to join The Commonwealth Fund webinar, <a href="; target="_blank">The Small Business Health Insurance Exchanges: Opportunities and Challenges</a>, on February 22 at 1:00 p.m. And read Timothy Jost's commentary on <a href="~/link.aspx?_id=0B67ACA7A5CB453CB876F3DB59E19448&_z=z">The Commonwealth Fund Blog</a>. </p>