Abstract
The Small Business Health Options Program (SHOP) got off to a slow start, with lower-than-expected enrollment and a public perception problem. This report examines California and Colorado’s small-business marketplaces, which opened on schedule in October 2013. For business owners, employee choice was the most important reason cited for considering SHOP, with ease of administration a distant second. Several owners see SHOP as a viable alternative to the private exchanges now taking root among large and midsize employers. Interviews also revealed that business owners consider insurance brokers to be an important source of enrollment assistance. Those in the insurance and policy communities perceived small-business owners to be poorly informed about available tax credits; business owners disagreed, saying the credits were simply not key to their decision to elect SHOP. Potential growth areas for SHOP include developing alternative benefit designs, contracting with Medicaid plans, and offering ancillary products, such as wellness programs.