Analysts at the National Federation of Independent Business (NFIB) recently published a new batch of survey data showing how the Patient Protection and Affordable Care Act (PPACA) is, and isn’t, helping owners of businesses with two to 100 employees.
Drafters of the Patient Protection and Affordable Care Act (PPACA) had made helping owners of small businesses one of the main reasons for passing PPACA.
The prime Small Business Health Options Program (SHOP) enrollment period started Nov. 15 and is set to end Dec. 15. Small employers that sign up for SHOP during the public exchange coverage period can offer coverage without meeting minimum participation requirements.
In theory, the SHOP exchange system can offer small employers access to a generous temporary health insurance premium subsidy tax credit.
In reality, The PPACA small business tax credit requirements are notoriously complicated, and use of the tax credit has been low. HealthCare.gov managers, and managers of most state-based exchanges, have had trouble finding the time to get their SHOP divisions up and running in any noticeable way.
The Census Bureau says about 60 million people work for U.S. small businesses. That means that SHOP exchange plans could be covering as many as 100 million workers and dependents.
Charles Gaba of ACASignups.net has estimated the SHOP exchanges might have enrolled about 330,000 people in 2015 coverage.
Vermont has boosted its SHOP numbers by requiring small groups to get their coverage through its exchange. The District of Columbia has increased its SHOP enrollment both by requiring small groups to get insured coverage through the exchange and by covering members of Congress and many congressional aides. (The U.S. Office of Personnel Management has applied a PPACA provision requiring lawmakers and some aides to have exchange coverage by telling the affected Capitol denizens to sign up for coverage through the DC Health Link’s SHOP division.)
But the U.S. Department of Health and Human Services (HHS), the parent of HealthCare.gov and the regulator of the state-based SHOP divisions, has not even bothered to publish SHOP enrollment numbers.
The struggling state-based exchange in Nevada, which shifted to using the HealthCare.gov enrollment system this year, reported in February that it had enrolled only six people in SHOP exchange coverage.
Meanwhile, when the NFIB analysts conducted their latest business owner survey, in June and July, they found that 41 percent of the 910 owners polled were offering health insurance to employees, and that 59 percent weren’t.
Fifty-two percent of the owners that don’t offer coverage gave “too expensive” as the top reason for not offering coverage.
Forty-eight percent of the owners that don’t offer coverage had no second reason for not offering coverage. “Too expensive” was the one and only reason they don’t offer coverage.
For five other sad NFIB survey findings, read on.