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Implementing the Affordable Care Act: State Action to Establish SHOP Marketplaces

health workers doll shop


The Affordable Care Act seeks to help small employers offer coverage by reforming the small-group market and establishing Small Business Health Options Program (SHOP) marketplaces. Seventeen states and the District of Columbia chose to operate their own SHOP marketplaces in 2014, with the federal government operating the SHOP marketplace in 33 states. This brief examines state decisions to enhance the value of SHOP marketplaces for small employers and finds that most have set IMPORTED: www_commonwealthfund_org____media_images_publications_infographics_view_shop_ex_map_360x260_h_260_w_360.jpg predictable participation and eligibility requirements and will offer a competitive choice of insurers and plans. States also are seeking to facilitate small employers’ shopping experience through online tools and access to personalized assistance. While not all SHOP marketplaces are yet functioning as intended, their establishment offers an opportunity to identify successful strategies for improving the affordability and accessibility of coverage for small employers.

Publication Details



S. J. Dash, K. W. Lucia, and A. Thomas, Implementing the Affordable Care Act: State Action to Establish SHOP Marketplaces, The Commonwealth Fund, March 2014.