Some states block group PPACA plan choice

The list includes only the states that have HHS-run exchanges this year. The list does not include Idaho, which hopes to run its own exchange in 2015. The list also leaves out some states that have talked about shutting down state-based exchange programs next year and letting HHS run their exchange programs.

CCIIO officials note in the new employee choice decision form that the list of states that will and will not offer the choice option could change in 2016.

HHS will offer premium billing and payment services in all states with HHS-run SHOP exchange programs in 2015, whether or not the employer has access to the employer choice option, officials say. Developers of the early health insurance exchange programs, which were often known as “health insurance purchasing cooperatives,” often used access to employee choice as a major selling point. The Federal Employees Health Benefits Program has offered employee choice since 1960.

John M. Word III and Rusty Brown, the partners in charge of Word & Brown, won an award from the Health Insurance Association of America in 2002 for their efforts to create a commercial employer choice program, the CaliforniaChoice health insurance purchasing cooperative.

Drafters of the legislation that became PPACA used access to employee choice as a major reason to get a bill through Congress. But HHS announced in 2013 that it was postponing access to the employee choice option in states with HHS-run exchanges.

This year, officials at the Centers for Medicare & Medicaid Services (CMS) — the division of HHS that houses CCIIO — created a form for states that were thinking about having HHS-run SHOP exchanges offer an employee choice option in 2015.

“Please adequately explain that it is in your expert judgment, based on a documented assessment of the full landscape of the small group market in your state that the 2015 Transition to Employee Choice would be in the best interest of small employers and their employees and dependents, given the likelihood that implementing employee choice would cause issuers to price their products and plans higher than they would otherwise price them,” CMS officials say in the form instructions. ”Please base your recommendation on discussions with those issuers expected to participate in the SHOP, including naming those issuers,” officials said.