Managers of President Donald Trump’s Centers for Medicare & Medicaid Services are hoping that, if the program still exists next year, insurance agents and brokers will help solve a major problem: HealthCare.gov has a puny Small Business Health Options Program division.
The U.S. Department of Health and Human Services, the parent of CMS, set up HealthCare.gov under former President Barack Obama, to provide Affordable Care Act public exchange services in states that were unable or unwilling to do the job themselves. HealthCare.gov now runs the SHOP division for 33 states. Officials at Obama’s CMS always avoided answering questions about HealthCare.gov SHOP enrollment.
Trump’s CMS officials have now revealed the 2017 SHOP enrollment number, in a new notice announcing a SHOP overhaul proposal.
HealthCare.gov started 2017 with just 7,600 employer clients in all of the 33 states it serves. Those 7,600 employers are covering just 39,000 people through their SHOP plans, or fewer than six people per plan, according to CMS figures.
Uncertainty about the future of the Affordable Care Act may have hurt 2017 SHOP sales. It’s possible that the 2016 enrollment numbers were better than the 2017 numbers. Any defenders of the Obama administration’s SHOP program will have trouble making that case, however, because Obama’s CMS never released 2016 enrollment numbers. The new SHOP numbers appear to be the first CMS has ever released, aside from some very rough, incomplete estimates buried in paperwork burden review notices.
The low 2017 HealthCare.gov SHOP enrollment numbers show that CMS has to change the way the SHOP division works, CMS officials say.
In the HealthCare.gov states, “SHOP programs are now defunct and do not provide needed insurance coverage for small businesses,” officials say.
CMS officials say they want to revive the HealthCare.gov SHOP division by giving up on efforts to have small employers enroll in coverage online. Officials hope to turn almost all responsibility for setting up SHOP plans, enrolling workers in the plans, and administering the plans over to insurers, agents and brokers.
The HealthCare.gov website would still determine whether a small employer was eligible for the Affordable Care Act Small Business Health Care Tax Credit subsidy, but private companies would do just about everything else.
Seema Verma, the CMS administrator, says in a statement that the goal of the proposal was to reduce burdens on small-business owners.
“This new direction will help employers find affordable health care coverage for their employees and make the SHOP exchange function more effectively,” Verma says.
The proposed changes would have a direct effect only on the 33 states that use HealthCare.gov to run their SHOP divisions.
The jurisdictions with locally run SHOP exchange divisions have posted mixed SHOP enrollment results.