Congress included in the Affordable Care Act (ACA) a significant new tax credit for small business owners who provide their workers with health insurance. Under this new tax credit, businesses that have fewer than 25 full-time workers and average wages of less than $50,000 are now eligible to receive a tax credit of up to 35 percent of the cost of the health insurance that they provide for their workers. To qualify for the tax credit, small businesses must cover at least 50 percent of each employee’s health insurance premiums. In 2014, the size of the credit will increase to cover up to 50 percent of the cost of health insurance provided to workers. Families USA and Small Business Majority recently commissioned The Lewin Group to develop estimates of the number of small businesses that are eligible for this new tax break in tax year 2011 and...

Health insurance exchanges are a provision under the Affordable Care Act (ACA) and must engage in five core functions: 1) determine eligibility for federal subsidies or public coverage, 2) enroll consumers and employees into qualified health coverage (or connect eligible individuals with Medicaid and CHIP), 3) conduct plan management, 4) provide consumer assistance, and 5) perform financial management. The Center on Health Insurance Reforms at Georgetown University Health Policy Institute and the National Academy of Social Insurance (NASI), with funding from the Robert Wood Johnson Foundation (RWJF) recently released a paper focuses on one of these core functions: the series of oversight activities that federal officials have called “plan management.” States face three choices: establish their own exchange and exercise control over plan management functions, allow the federal government to establish a federally facilitated exchange (FFE) but enter into a partnership arrangement to perform plan management, or cede all plan management functions to the FFE. With the latter two approaches, the state will essentially turn over to the federal government some of its traditional authority to regulate its private health insurance markets. However, through a partnership arrangement, state regulators can recapture that authority and oversight. The U.S. Department of Health and Human Services (HHS) has defined plan management to...

A new paper titled, “Multi-State Plans under the Affordable Care Act,” was recently released by the George Washington University School of Public Health and Health Services. Authored by Trish Riley and Jane Hyatt Thorpe of the GW Department of Health Policy and funded by The Commonwealth Fund, the paper examines key issues related to the development of multi-state plans (MSPs), a new type of insurance coverage created by a provision of the Affordable Care Act (ACA). MSPs will be administered through the federal Office of Personnel Management (OPM) and offered across state lines through the new state health insurance exchanges. The findings in this paper are based on interviews with federal and state policy makers and other stakeholders, and are intended to inform the development and implementation of MSPs. A primary goal of the ACA is to...

The Affordable Care Act's Health Benefit Exchanges (Exchanges) must be implemented in every state by January 1, 2014. The development of Exchanges will have a significant impact on how consumers access and sign up for coverage. National Academy of State Health Policy (NASHP) established the State Health Exchange Leadership Network, "a peer learning network for exchange leads." The purpose of the Network is to foster interaction and education as states move ahead with the design, construction, and execution of the Health Benefits Exchange market. This report examines key consumer-related issues and challenges that states must tackle as they plan and implement their Exchanges. Three main areas where consumers intersect with the Exchange are covered in the report...

Under the Affordable Care Act (ACA), many more Americans will be eligible for health insurance through state insurance exchanges by 2014. Many of these individuals are among the 90 million American adults who lack basic health literacy – the ability to process and understand the information needed to make appropriate health decisions. The IOM Roundtable on Health Literacy held a workshop on July 19, 2011, that explored ways in which health literate communication techniques can improve communication to potential enrollees. The workshop focused on lessons learned from existing exchanges, the effect of exchanges on consumers, the relevance of health literacy to the exchanges, and the current best practices in developing materials and communicating with consumers.

The health insurance exchange is a centerpiece of the Affordable Care Act (ACA). The Small Business Health Options Program (SHOP) is intended to create a marketplace for small, and perhaps eventually large, employers to purchase health insurance for their employees. A Health Affairs article authored by Timothy S. Jost discusses the need for small-business exchanges and illustrates how they will function. The paper also describes the difficulties these exchanges will face, as well as the opportunities they will offer to states, employers, and individuals. How states decide to address these challenges may determine whether such exchanges succeed or fail.