New CMS Administrator Verma takes first step to kill the Federal SHOP marketplace

CMS Announces Plans To Effectively End The SHOP Exchange, Timothy Jost, May 15, 2017, Health Affairs Blog

“On May 15, 2017, the Centers for Medicare and Medicaid Services announced that it was planning to essentially end the Federally Facilitated SHOP exchange, which covers 33 states, as of the end of 2017. Under rules that CMS proposed to take effect as of January 1, 2018, would continue to make eligibility decisions for FF-SHOP participation for small employers—essentially determining eligibility for the small employer tax credit–but would no longer handle enrollment for employers or employees, process premium payments, or handle other SHOP functions.

Instead, employers would enroll directly with insurers offering SHOP plans or though agents and brokers registered with the FF-SHOP. State-based SHOP marketplaces could continue to provide online enrollment or could alternatively take the federal approach and direct small employers to insurance companies or to SHOP registered agents and brokers to enroll.

The CMS press release quotes CMS Administrator Seema Verma as stating that the change is intended to reduce ACA burdens on small businesses and to make it easier for them to purchase coverage. The change, CMS states, will “help employers find affordable healthcare coverage for their employees and make their SHOP exchanges function more effectively.”

It is far from obvious, however, why…” G2X TAKE: This isn’t likely to be a big surprise to anyone close to this program as, according to the article, the metrics shown to date fall considerably short of expectations. This won’t be the last ACA program to be on the chopping block for Verma as she looks to score some quick wins. 

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