Small-Group Insurance Market Remains Stable Under ACA

Small-Group Insurance Market Remains Stable Under ACA About half of small-firm employees worked for an establishment that offered health insurance from 2013 to 2020, and the small-group market has remained relatively stable since the implementation of the Affordable Care Act, according to a recent Urban Institute study. Employee coverage rates at small firms — which have fewer than 50 employees — dropped 2 percentage points, from 57.1% in 2013 to 55.1% in 2020. Meanwhile, employees’ contributions to single and family coverage in the small-group market rose during the study period by 2.3 and 6.0 percentage points, respectively. Though many people anticipated that small firms would transition to self-insurance to avoid ACA’s regulations, small firms were much less likely than larger firms to offer a self-insured plan between 2013 and 2020. NOTES: The study omits firms with 50 to 99 employees because this category is not tabulated in publicly available data. The study defines small firms as those having fewer than 50 employees, medium-sized firms as having 100 to 999 employees, and large firms as having 1,000 or more employees. SOURCE: “Trends in Small-Group Market Insurance Coverage, 2013–20,” Urban Institute, January 2022.  From Health Plan Weekly Learn more about subscribing to AIS Health's publications.