Regulators call for ACA small group revision

A changing definition of a “small group” of employees under the Affordable Care Act could lead to higher health insurance premiums for small companies, including nursing homes, experts said recently.

The ACA defines a small group as a company with up to 100 employees; prior to that a small group included up to 50 employees. That change could push mid-sized companies with young, healthy employees to self-insure, Monica Lindeen, the Montana commissioner of securities and insurance and the president of the National Association of Insurance Commissions, told Bloomberg BNA. As a result, employee premiums for those companies left in the small group market could increase 18%.

Lindeen urged “immediate passage” of a revision to the small group definition to the House Energy and Commerce Committee's health subcommittee on September 9. The revision, known as the Protecting Affordable Coverage for Employees Act, would allow states to set limits for the small group market that reflect the “unique characteristics and dynamics” at play in each state, and maintain stability in market, Lindeen said.

The new definition is set to take effect on January 1, 2016, although many states plan to take advantage of a Department of Health and Human Services option to delay it until Oct. 1, 2017.