Now that Congress is back in session, the effort to alter an Affordable Care Act provision that would expand the definition of the small-group insurance market has begun to gain momentum.
The current rule mandates that by Jan. 1, companies with 100 or fewer employees, rather than the previous cutoff of 50 or fewer employees, will be included in the small-group market. That means more companies will now have to offer a set package of benefits that may be more generous than what they have offered, and insurers will no longer be able to account for certain company characteristics when setting premiums, the New York Times reports. Some predict the result will be higher premiums.
Though this particular provision has been billed as Republicans' best bet to chip away at the president's signature healthcare law, legislation to let states keep their current definition of a small employer actually has bipartisan appeal, with 43 Democrats among the 229 House members who support it and 10 Democrats among its 43 Senate supporters, according to the Times.
Industry groups such as America's Health Insurance Plans and the Blue Cross Blue Shield Association (BCBSA) also support the fix, as well as the U.S. Chamber of Commerce and the National Federation of Independent Business.
Indeed, about two-thirds of midsize employers can expect substantial rate increases once the new small-employer definition takes effect, Alissa Fox, a senior vice president of the BCBSA, tells the Times.
The Obama administration's argument for the new rule, however, has been that it could kick-start the small-business exchanges, which have suffered from low enrollment and technical woes. Still, as Rep. Frank Pallone (D-N.J.) points out, it may make sense to delay the provision by a few years.
The small-group market expansion is not the only part of the ACA that industry groups want to change, however. The fight against the Cadillac Tax, which would impose financial penalties on high-cost employer-sponsored plans, has gained momentum in recent months, and Senate members this past week introduced legislation to repeal it.
To learn more:
- here's the Times article