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Two years in and SHOP exchanges still struggling

Enrollments less than expected; capture only small piece of small business market

With almost two years in operation, the Small Business Health Options Program (SHOP) exchanges created under the Affordable Care Act have yet to catch on with small business owners, according to Kaiser Health News.

Enrollments in the federal and state-run SHOP exchanges have been less than expected. Federal data released last spring show about 85,000 people across the U.S. from 11,000 small businesses have coverage through SHOP, KHN reported. Those totals did not include businesses that began coverage in 2014 and had not yet renewed coverage through Healthcare.gov for 2015.

The SHOP allows employers with fewer than 50 full-time workers to buy insurance coverage. In 34 states, the program is run through the federal government, while 16 states and the District of Columbia have state-run exchanges for small businesses.

The KHN report outlined numerous problems. Insurance brokers say the program has fewer health plan options--four states have only one insurer--and more expensive policies than people can purchase outside the exchange. Many small businesses have remained with existing plans they purchased outside the program even though they don't meet all the requirements of the ACA, an option allowed until 2017.

The SHOP exchanges have struggled from the start with technical glitches. Software problems in several states made it hard for employers and employees to sign up and the federal exchange did not have its full website running until fall 2014 making it necessary for employers to contact an agent or broker to sign up when the program first launched.

Another problem is that many small businesses, not required to offer health insurance to employees, are encouraging workers to purchase their own individual plans on Healthcare.gov, FierceHealthPayer previously reported.

While some question the value of SHOP, Kevin Counihan, the Obama administration's top insurance exchange official, told KHN the program will take time to catch on and he expects enrollment will grow as more employers and insurance brokers learn about SHOP.

To learn more:
- read the KHN article

Related Articles:
Small businesses continue to drop coverage for employees
Employers continue to shift workers onto private exchanges
Insurers are cancelling plans that don't make business sense
White House set to allow grandfathered plans to continue
Glitches continue on Healthcare.gov, small business exchange
SHOP exchanges face sluggish adoption, technical glitches