SHOP Marketplace: What it Means For Small Business. John Arensmeyer Founder & CEO Small Business Majority November 5, 2013

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1 SHOP Marketplace: What it Means For Small Business John Arensmeyer Founder & CEO Small Business Majority November 5, 2013

2 About Small Business Majority Small business advocacy organization founded and run by small business owners National 30 team members with offices in Washington, DC, California and seven (7) other states. 20,000 network members; reach 300,000 small businesses via 85 strategic partners Research and advocacy on multiple issues: healthcare, taxes, access to capital, immigration, clean energy, workforce issues and more Very focused on education of small business owners, especially regarding ACA implementation

3 Who are small businesses? 28 million small businesses; 6 million employ 60 million people IMPORTANT: 22 million self-employed 80% of small businesses have fewer than 10 employees

4 Small business: healthcare Healthcare continues to be a major issue affecting small firms. Our polling: small businesses supported reform to help lower costs; provide more choices. Our polling: two-thirds majority supports establishment of marketplaces and other key ACA components

5 Small businesses struggling with costs Soaring cost of insurance especially for small businesses 25% of small business owners are uninsured (2012 Kaiser study) 30% self-employed: not covered Small firms pay 18% more than large businesses: Lack of negotiating power and admin. efficiencies Our national study (Jonathan Gruber): Small business health costs would more than double by 2018 to $2.4 trillion without reform

6 Small businesses struggling with costs Our most recent opinion survey: Small employers who don t offer coverage say lack of affordability is the biggest reason (70%) Which one or two of the following best describes the reasons you do not provide health benefits?

7 SHOP insurance marketplace Small Business Health Options Program Large marketplace for small businesses to pool and shop for health coverage in each state Private insurance plans compete for your business Who? Small businesses with fewer than 50 full-time employees Enrollment began Oct 1, 2013 Coverage begins January 1, 2014 RAND study: Expand coverage to 85.9% of small business employees (60.4% today); an increase of 10.5 million workers

8 Why is SHOP important for small businesses? Creates economies of scale/reduces costs Provides much-needed HR services Tax credits available More choices, especially employee choice Easier to navigate than current market

9 Full array of services meeting employer needs important 80% of all small businesses have fewer than 10 employees; most do not have sophisticated HR departments. SHOP can provide: o Qualification and calculation of the small business tax credit o Coverage of out-of-state employees o Coordinating coverage of Medicare-eligible employees o Additional HR services such as COBRA administration, Section 125 service, HSA/FSA/HRA o Prevention and workplace wellness programs

10 Single point of entry For employers All necessary information for employer and employees to make decisions on coverage One application One premium payment & detailed accounting One source for enrollment changes

11 State marketplace status (as of June 2013) Source: Kaiser Family Foundation

12 Insurance exchanges: Coming in 2015 and beyond More bells and whistles Incentives for outcome-based compensation, electronic medical records and quality Employee choice in all states Streamlined billing process (premium aggregation) in all all states

13 Moving forward: we d like to see Get SHOP up and running in all states More small business education/outreach Additional insurer participation in some areas

14 Info about the marketplaces Objective website dedicated to small businesses and healthcare, run by SBM English & Spanish Provides step-by-step information on how to navigate healthcare market with ACA taking full effect Jan., 2014 Includes FAQ about how the ACA impacts small businesses Tools such as calculator to estimate tax credits for small businesses Interactive website dedicated to the ACA, run by HHS State specific information on SHOP marketplaces Calculators for FTEs, types of coverage, compare your existing coverage Create a pre-enrollment checklist Oct. 1, 2013 and beyond: buy health insurance right here

15 Resources National HHS website: SBM Coverage Guide: Our website: o What s in Healthcare Reform for Small Businesses o Healthcare Policy Page o Detailed FAQ o Tax credit calculator

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