Policy Examples

• The Utah Health Exchange, Avenue H, was created prior to the enactment of the ACA and was the only state-run Small Business Health Options Program (SHOP) exchange for small employers to participate in a defined contribution arrangement and compare, select, and enroll in commercial health insurance online. source
• In 2016, 16 states and the District of Columbia operated a state-run SHOP alongside an individual insurance marketplace, including Utah and Mississippi, which opted out of running an individual marketplace but built their own SHOP. source
• On May 15, 2017, CMS announced that it was planning to end the Federally Facilitated SHOP exchange, which covers 33 states, as of the end of 2017. According to CMS, the intention behind closing SHOP was to reduce the ACA burden on small businesses to make it easier for them to purchase coverage. source

Outcome Evidence

•  In 2015, an Urban Institute article cited minimal interest in SHOP among small employers, and few had enrolled. A shared perception exists among critical stakeholders that SHOP does not add value to the coverage already available to small employers. source