The state of the small group market – health plans purchased by small businesses with 50 or fewer employees – has in recent years received less attention than the individual health insurance marketplaces. Yet under the Affordable Care Act (ACA), both markets were targeted for dramatic reforms.

The small group market is now receiving some renewed focus, in part because an ACA provision scheduled to go into effect in 2016 could cause some disruption. The reform, which would require an expansion of the definition of small group to include groups of 51-100 workers, could cause premium increases for some employers as they become newly subject to a range of ACA requirements. As a result, policymakers on Capitol Hill and in the states are considering options for delaying or repealing this provision. Last week, three great new resources became available to help these officials and other stakeholders understand how the small group market is changing and how employers are likely to be affected.

National Institute for Health Care Management Foundation (NIHCM)

The NIHCM Foundation released a new “Expert Voices” essay by CHIR’s own Sabrina Corlette, discussing the dramatic changes affecting the small group market as a result of the ACA, some of the implementation challenges associated with the ACA reforms, and several challenges that could threaten the long-term viability of this market. The essay can be downloaded on the NIHCM website.

Alliance for Health Reform

The Alliance for Health Reform hosted a briefing titled: The Evolving Coverage Landscape for Small Businesses: Opportunities and Challenges. The briefing featured a panel of experts, including CHIR’s Sabrina Corlette, Terry Gardiner from Small Business Majority, Katie Mahoney from the Chamber of Commerce and Alissa Fox from the Blue Cross Blue Shield Association. The panelists discussed the reforms included in the ACA that affect small businesses, and the challenges that small employers continue to face providing adequate, affordable health insurance. The presentations and an excellent set of background materials are available on the Alliance website.

Commonwealth Fund

In the most recent Commonwealth Fund blog post arising from CHIR’s longstanding 50-state monitoring project, Ashley Williams and Sabrina Corlette assess state decisions to allow or disallow mid-sized employers (with 51-100 workers) to delay a move to the small group market. The full post with accompanying state map is available on the Commonwealth Fund’s blog.