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Small business part of Affordable Care Act marketplaces to be dismantled

CMS 'still working out the details'

FILE PHOTO - The federal government forms for applying for health coverage. REUTERS/Jonathan Bachman/File Photo
FILE PHOTO - The federal government forms for applying for health coverage. REUTERS/Jonathan Bachman/File Photo

The Trump administration said Monday it will dismantle part of the Affordable Care Act that created online insurance marketplaces for small businesses and tried to foster a greater choice of health plans for their workers.

Moving to end the ACA’s small business enrollment system by 2018 represents the first public step by the Health and Human Services Department to implement an executive order President Donald Trump signed his first night in office, directing agencies to ease regulatory burdens of the health care law.

In starting with the Small Business Health Options Program, or SHOP, the administration is targeting an aspect of the ACA that has been troubled from the outset and never lived up to its proponents’ expectations.

As of early this year, federal figures show, nearly 230,000 people were covered through SHOP health plans — a fraction of the four million that congressional budget analysts had predicted as the small-business marketplaces began in 2014.

Although that means relatively few Americans will be directly affected by the decision, its symbolic impact is large.

The specifics of the impending change are a work in progress, and federal health officials said Monday that they plan to propose a new federal rule to take effect in January. The basic idea is to narrow, but not eliminate, the federal website for small-business insurance so that companies could still go online to apply for government tax credits under the law.

However, they no longer would use that website to select health plans. The site instead would show the names of available insurers and tell companies to deal directly with brokers of the health plans.

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“We’re still working out the details on that,” said a senior official at HHS’ Centers for Medicare and Medicaid Services, who spoke on the condition of anonymity about decisions that have not been finalized. “The goal here is to reduce the burden,” he said, noting that the current method is cumbersome for insurers.

The official said the announcement was made now because insurers selling ACA health plans are deciding this spring and summer whether to continue next year.

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