END OF 2018 OPEN ENROLLMENT PERIOD (41 states)

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SHOP News: RI & WA make announcements...and national total appears to be just 180K

You don't hear a whole lot about the other ACA healthcare exchange system, the Small Business Health Options Program (SHOP, although it should really be "SBHOP" which looks like a typo). In fact, to my knowledge, the HHS Dept. has never said a peep about the SHOP numbers in any of their official reports or press releases. There's a reason.

Rhode Island just made an announcement about their SHOP program. RI only has a total population of just over 1.05 million people anyway. so 3,500 people enrolled in the state's Small Business exchange policies actually isn't too bad, really (for comparison, this would be the equivalent of California enrolling around 128,000 people in theirs).

PROVIDENCE, RI– HealthSource RI, Rhode Island’s state-based health benefits exchange, marked a milestone this week by enrolling its 500th small business in the Small Business Health Options Program (SHOP). There are now 503 businesses enrolled as of today, representing over 2,000 employees and 1,500 family members for a total of more than 3,500 enrolled in coverage.

Small businesses enrolled in SHOP have access to a total of 20 different health insurance plan options from three insurance carriers–Blue Cross & Blue Shield of Rhode Island, Neighborhood Health Plan of Rhode Island and UnitedHealthcare. SHOP also offers an innovative ‘full employee choice’ option that allows employers to determine a contribution level (also called “defined contribution”). Employees can then choose from any of the 20 plans offered and opt for the level of coverage that works best for them and their families.

Sam Iserson, president of NC3 in Pawtucket, says the full choice model is one of the reasons he joined SHOP. “Using HealthSource RI gives our employees options that they never had before. It provides them the opportunity to be better educated consumers and really understand the cost and benefit of their healthcare.”

Behind strong 2015 enrollment numbers, including an 89% renewal rate and a 57% growth rate, Rhode Island continues to be a leader of state-based exchanges in enrolling small businesses.

In other SHOP news, Washington State also issued a press release today:

Less than eight months after its statewide launch, the Washington Health Benefit Exchange today announced that more than 100 Washington businesses from across the State have now enrolled through Washington Healthplanfinder Business.

Starting this November under the Affordable Care Act, Washington Healthplanfinder Business will expand its coverage to businesses of up to 50 employees to larger businesses of up to 100 employees.

“Business owners are looking for the best way to get quality, affordable health insurance for themselves, their families and their employees,” said Catherine Bailey, director of Washington Healthplanfinder Business. “Washington Healthplanfinder Business provides employers the opportunity for Washington business owners to compare plans, decide their contribution level and manage payment all in one place—and it’s the only place where small businesses can access tax credits to help cover the cost of health insurance.”

According to an accompanying Seattle Times story, WA is up to a whopping...535 people enrolled via SHOP.

A few months back, I did a rough projection based mainly on California's SHOP enrollment. The wording of the official quote made it sound like the 16,000 figure was for employees only, not dependents, so I thought that this meant more like 40,000 covered lives (assuming 2.5 people on average per household), and concluded that the national total would likely be around 330,000.

However, more recently I was informed that the 16,855 enrollees in CA's SHOP program includes dependents, which changes things considerably.

With that in mind, when you add up the only SHOP enrollment data that I actually have access to from 9 states (California, Colorado, Connecticut, DC, Massachusetts, Minnesota, New Hampshire, Rhode Island and Washington State, it only totals 49,391. Some of those state numbers are several months out of date, so it could be a bit higher by now (in Rhode Island's case, 3,500 is about 6.6% higher from February's 3,282), but even so, it's not likely to be more than 53,000 or so.

If you then take DC out of the equation (their SHOP number is heavily skewed because something like 15,000 Congressional staffers are legally required to enroll using the DC SHOP exchange), that's around 36,000 for the other 8 states...which, combined, make up 21.7% of the national population.

Extrapolating from that, it looks like the national SHOP enrollment is likely to be no more than around 165,000, plus the 16,250 in DC, for a grand total of perhaps 180,000 people or so total.

Last year the SHOP total was a mere 72,000 or so...but only about a dozen of the SHOP exchanges were even operational. This year, all 51 were supposedly working, and the program appears not to have even broken 200K.

I'm glad to see both Rhode Island and Washington State pushing their SHOP programs, but to be perfectly honest, I think it's time to admit that the ACA's SHOP program has turned out to be quite a dud. It needs to either be seriously rethought or simply scrapped.

This isn't necessarily a terrible thing. The SHOP program may simply be unnecessary, given that unemployment has been steadily dropping for quite some time now; a model at the Brookings institute is projecting May unemployment to be a mere 5.2%.

In short, SHOP may simply have been a solution in search of a problem.