Rules that allow some small employers to avoid regulation under health reform are unlikely to have a major impact on the future cost of health insurance unless those rules are relaxed to allow more businesses to opt out.

Analysis by the RAND Corporation of two rules that allow small businesses to avoid participating in health reform concludes they will have only a minor impact because few businesses are likely to take advantage of the options. Findings were published in the February issue of the journal Health Affairs.

"We found that keeping the rules as they are written, particularly the limitations on maintaining a grandfathered plan, will be essential to keeping premiums affordable in small business insurance exchanges," says Christine Eibner, the study's lead author and a senior economist at RAND, a nonprofit research organization.

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