Credit: Ihar-Ulashchyk/Adobe Stock
Researchers who help members of Congress understand federal programs still can't find out how many employers use the Affordable Care Act public health insurance exchange program to cover their workers.
Vanessa Forsberg, an analyst at the Congressional Research Service, revealed the ACA public exchange data gap earlier this week when she published an updated guide to the ACA exchange program.
Recommended For You
The 63-page guide provides detailed information about how HealthCare.gov works and how state-based exchanges like Covered California work.
The ACA public exchange system has helped 24 million people get individual or family coverage, but, originally, the system was also supposed to provide a way for small employers to use federal tax credits to buy small-group health insurance through the "small business health options program," or SHOP exchange system.
Some jurisdictions — including California, Colorado, Massachusetts, Vermont and the District of Columbia — do have active SHOP exchange programs, but half have no health plans available through a SHOP exchange, or no SHP coverage access at all, according to Forsberg.
Related: What will it take to lure small employers back to the fully insured group health insurance?
Forsberg also tried to answer a nagging question: How many employers have SHOP coverage and how many participants participate in SHOP plans?
The Centers for Medicare and Medicaid Services, the arm of the U.S. Department of Health and Human Services, has published detailed individual exchange enrollment data.
CMS has rarely released SHOP usage data, possibly because usage in many states was low.
Republicans now control both the House and the Senate, and a Republican is president and in charge of CMS. But Forsberg still was unable to get any SHOP usage figures compiled for coverage years after 2017.
CMS reported that 27,000 employers were using SHOP plans to cover 233,000 people in 2017, according to Forsberg.
That was up from 10,700 employers using the plans to cover 85,000 people in 2015.
The U.S. Government Accountability Office reported in 2019 that Rhode Island, Vermont and the District of Columbia were the only jurisdictions where the SHOP exchange accounted for more than 3% of enrollment in the small-group market, according to Forsberg.
© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
