Small Business Health Insurance Coverage in a Post-ACA World

Employees of small businesses have much lower rates of insurance coverage and less generous benefits than their peers at bigger companies, owing largely to challenges unique to the small group market. The ACA introduced significant reforms aimed squarely at these problems, but implementation has moved slowly and the ultimate impact of these changes is unclear. This essay takes a look at developments in the small group market since the passage of the ACA and highlights several issues that could threaten the long-term viability of this market as implementation moves forward.