The Effects of Health Reform on Small Businesses and Their Workers

This report finds that ACA will likely help reverse these trends due largely to the introduction of the Small Business Health Options Program (SHOP) and reforms to health insurance markets.

Using Urban’s Health Insurance Policy Simulation Model, researchers estimated that insurance offer rates for all firms with fewer than 100 employees would increase by 9.7 percent under ACA, from a projected 43.4 percent to 47.6 percent. The biggest jump would be seen in the smallest firms, with a projected increase in offer rates of 14.2 percent among businesses with fewer than 10 employees.

When combined with a projected drop in premium costs, the report indicates that ESI coverage will increase modestly for workers employed by firms with fewer than 50 employees, as well as for their dependents. [For purposes of completing the simulation, researchers assumed ACA was fully implemented in 2010.]