Small Business Insurance Exchanges

The small-business exchanges, created under the law's Small Business Health Options Program (SHOP), offer group health plans to small companies. Employers with fewer than twenty-five employees must purchase coverage through a SHOP if they wish to take advantage of the small-business tax credit for health insurance established in the ACA. States had the option of creating these as separate exchanges or combining the individual and small-business insurance markets into one exchange. This Health Policy Brief focuses on issues that states have had to confront in designing and operating SHOP exchanges as well as challenges that these exchanges are likely to face in the future.