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Key Part of Affordable Care Act Postponed One Year

The employees in Small Business Health Options Program (SHOP) exchange plans may not get as many carrier choices as expected when the exchange system starts up Jan. 1, 2014...
March 8, 2013

The employees in Small Business Health Options Program (SHOP) exchange plans may not get as many carrier choices as expected when the exchange system starts up Jan. 1, 2014. The U.S. Department of Health and Human Services (HHS) has proposed regulations (CMS-9964-P2) that could put off the day when SHOP small group exchange users get to choose from a smorgasbord of coverage offerings to Jan. 1, 2015 from Jan. 1, 2014.

Originally, HHS was going to require all SHOP exchanges to offer a smorgasbord option on Jan. 1, 2014. Now, state-run SHOP exchanges can choose to start off using the smorgasbord approach in 2014 if they want. However, the other state-run SHOP exchanges could wait until 2015 to offer a smorgasbord option, and all of the “federally facilitated exchanges” run by HHS will wait until 2015 to offer the smorgasbord option, officials said in a preamble to the proposed regulations. In ongoing discussions with HHS and Congress, PIA National has been saying that the SHOP implementation timeline is nearly impossible to meet and suggested a delay should be issued. PIA National has been on top of this issue from the outset and our efforts will continue.

The delay in implementing SHOP exchanges follows, by several weeks, another announcement from HHS that the rollout of the Affordable Care Act’s Basic Health Program — aimed at low- to moderate-income people who will not qualify for the expanded Medicaid program under the federal health law — will also be pushed back from 2014 to 2015.