What Letter Says: Additional delays in opening the federally operated health insurance marketplace for small businesses will leave little time for businesses to find new plans, House Small Business Committee chairman says.

The delay until the end of November of the opening of the Affordable Care Act health insurance website intended for small businesses will leave businesses little time to shop for and choose plans that take effect in 2014, the chairman of the House Small Business Committee said in an Oct. 31 letter to Health and Human Services Secretary Kathleen Sebelius.

If the federally facilitated Small Business Health Options Program (SHOP) marketplaces won't be operating until Nov. 30 and enrollment must be completed by Dec. 15 for policies to be effective Jan. 1, “that leaves precious little time—possibly a mere 16 days—for an already busy and burdened small business owner to learn about various insurance plans and make a decision so that he or she has coverage in place on Jan. 1,” Small Business Committee Chairman Sam Graves (R-Mo.) said in the letter.

At a House Ways and Means Committee hearing Oct. 29, Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner said under questioning by Rep. Lloyd Doggett (D-Texas) that the federally facilitated SHOP marketplace, as well as the Spanish-language version of HealthCare.gov, CuidadoDeSalud.gov, will be ready at the “end of November,” according to a transcript of the hearing (210 DTR G-2, 10/30/13). Previously the administration had said the federal SHOP marketplace and CuidadoDeSalud.gov would be delayed by a month until Nov. 1, Graves said in his letter.

The Obama administration announced in July that the requirement that employers with the equivalent of at least 50 full-time employees provide affordable coverage of minimum value or make “shared responsibility” payments would be delayed by a year until 2015 (128 DTR G-5, 7/3/13).

Small Business Owners ‘Perplexed.'

“Small business owners who are subject to the law's many mandates and face penalties and fines for noncompliance are perplexed, confused and sometimes unaware of what is expected of them,” Graves said in the letter to Sebelius. “The administration's irresponsible pattern of misinformation, glitches and delays on the SHOPs has created additional confusion and uncertainty among our entrepreneurs.”

The situation may be more urgent for employers that are being informed that their current policies are being canceled because of ACA requirements, Graves said. “The numerous and well-publicized website problems that are reportedly causing consumers, including small business owners, to be ‘timed out’ of website sessions, blocked from even creating an account,” so that they may learn about and compare plans and premiums, “will cause this process to be even more difficult,” he said.

Graves urged Sebelius “to publicly clarify the most current information and deadlines for small businesses so they can be certain of the requirements they must meet without incurring a fine or penalty.”

NFIB Survey Finds Higher Costs

The National Federation of Independent Business (NFIB) Oct. 31 released a survey of 921 small business owners in which 64 percent reported paying more for insurance premiums per employee in 2013 than in 2012. The survey is titled “Small Business's Introduction to the Affordable Care Act Part 1.”

“The law's authors were primarily focused on increasing insurance coverage and expanding benefits. They gave little or no consideration to concerns about cost or who would foot the bill. Ironically, had they instead made reducing costs a priority, this would have been a natural incentive for increasing coverage,” NFIB Research Foundation senior fellow and study author William J. Dennis said in a release. “Unfortunately though, this single-minded approach resulted in a law with a rising price tag, and Obamacare's authors failed to consider that someone has to pay for all the bells and whistles included in the law. That ‘someone' it turns out is often the small business community—small employers, their employees and their families.”

NFIB was the only business group to challenge the law before the Supreme Court in NFIB v. Sebelius, 132 S. Ct. 2566, 2012 BL 160004 (2012). In June 2012, the Supreme Court upheld the central tenet of the law, the individual mandate, as a constitutional tax.

Families USA Telephone Briefing

In an Oct. 31 telephone briefing with reporters organized by Families USA, an organization that supports the ACA, groups that are helping to enroll people through the marketplaces spoke about efforts they are undertaking, expressing optimism that many people will gain coverage under the law.

“Things have not necessarily gone exactly the way everyone had planned with difficulties with the website, but there are enormous efforts being made in states across the country,” Ron Pollack, executive director of Families USA, said on the call.

The 182-day initial ACA open enrollment period, from Oct. 1 through March 31, 2014, compares to 54-day enrollment periods in succeeding years under the law, Pollack said. At the beginning of a new program, “problems are going to arise,” he said. “Even though there have been significant problems with respect to the website, significant activities are taking place that I think ultimately will make enrollment successful,” he said. Pollack founded the enrollment group Enroll America.

Good News From Some State-Based Exchanges

Elisabeth Benjamin, vice president, health initiatives, Community Service Society of New York, said, “as of last week nearly 200,000 people have completed the application process through our website, which had a few initial glitches the first week but since then has been rolling great.” More than 37,000 people have been enrolled in coverage in New York's state-based marketplace, she said.

Demian Fontanella, general counsel of Connecticut's Office of the Healthcare Advocate, said the fact that the state created its own marketplace has resulted in “one of the most stable marketplaces so far in the nation.”

A recent survey of people who completed applications through Oct. 15 conducted by Access Health CT, Connecticut's marketplace, found that 82 percent were “extremely” or “very” satisfied, and 75 percent found that the website was “very” or “extremely” easy to understand, Fontanella said. “Twenty-two percent of those people that completed applications through Oct. 15 completed the survey. That was 707 people,” he said.

However, in response to a question, Fontanella said that Access Health CT experienced five failed hacking attempts and that the National Security Agency was contacted to investigate the matter. Access Health CT Executive Director Kevin Counihan reported there were five attempts to hack the portal, two of which were foreign, Fontanella said.

“They notified the NSA for additional security purposes. All of those attempts were unsuccessful, and our security protocols have been vetted at all levels, including from the federal level. So they appear to be working to safeguard this information,” Fontanella said.

Bill Introduced

In other action, Sen. Lamar Alexander (R-Tenn.) said Oct. 31 that he co-sponsored a bill, the “If You Like Your Health Plan, You Can Keep It Act” (S. 1617). The bill was introduced Oct. 30 by Sen. Ron Johnson (R-Wis.) with 37 co-sponsors. It would repeal ACA requirements and allow Americans to stay on their insurance plans. The bill would allow people to remain on health plans that have been in effect through the end of 2013.

“The president promised Americans that if they liked their insurance, they'd be able to keep it, but at least 2 million Americans and many Tennesseans have already learned it isn't true,” Alexander said in a release. “The Obama administration knew in 2010 that the rules it wrote for health plans would mean at least 47 to 60 percent of the policies in the individual market would not be legally offered under Obamacare,” he said.