Small-size employers with between 51 and 100 employees currently in large-business group health plans will have to transition to small-business group plans upon their renewal on or after Jan. 1, 2016. “Small businesses were facing high costs of health insurance, less competition and fewer options. We had more and more small business dropping out of coverage pre-ACA. This is why there was an attempt to change things, the system wasn’t working,” explains Terry Gardner, vice president of the Small Business Majority. At both state and federal levels, 90% of the ACA focus has been on individual and individual exchanges, he says. “There’s been a punting, punting, punting of provisions that haven’t been ready,” he adds. “We as advocates, fixing health reform, we’re not real fans of more delays justified by past delays. I think what small biz owners are interested in are solutions, not all this debate about more delays.” According to the ACA’s initial timeline, small employers with 50-100 employees that have been buying coverage in large-employer markets will now be required to buy in the small market, says Katie Mahoney, executive director of health policy at the U.S. Chamber of Commerce. The expansion is intended to make insurance more affordable for the smallest employers by expanding the risk pool to include larger companies. It also aims to increase the number of participants in the ACA’s Small Business Health Options Program, also known as the SHOP exchanges. “It seems very strange that you’ll essentially bifurcate the small business community,” she adds. “So those 50-100 size employers, the smallest subject to the mandate, will be required to buy from the small-group market where there are rating restrictions and benefit mandates.” “We support rolling back that expansion, and there have been two recent bills introduced in both chamber aimed at helping: S.B. 1099 and H.R. 1624,” she says. There are at least 10 to 20 different associations representing small business that have signed on to endorse those bills, she adds. “I think we all share the goal of wanting to see small biz and employees have access to meaningful, affordable coverage.” There are some aspects of the law, Gardner notes, that could be strengthened; such as, for example, the small business health care tax credit. In addition, he says, integrating wellness programs into the exchanges would also be a beneficial move for small business, noting two successful wellness programs in the Connecticut exchange. “We’re looking for long-term solutions,” he says. “That’s the only way we’ll fix this … changes that move us to a better system. We see that as a better solution than just more delays.’ And while Mahoney believes finding a way fix the tax credit to be a laudable goal, “if the reason is to make coverage more affordable; instead of throwing money to help biz buy it, wouldn’t it make more sense to think more comprehensibly to find a way to … just lower the cost [instead]?