Dive Brief:

• Last week, President Obama signed the Protecting Affordable Coverage for Employers (PACE) Act that brings the ACA's small group definition back to 50 employees or less instead of the scheduled 100 in 2016. But many employers may still be in limbo, Employee Benefits News reported.
• Many states have passed laws redefining “small group” to the original 100 FTEs starting in 2016. Now, these states will need to pass new laws bringing the thresholds back down to 50 – but many states’ legislatures may not be in session again until next year. Companies in these states, then, may technically still be counted as “small-group” until the states lower the threshold.
• Small-group employers are subject to the 10 essential health benefits, meaning that smaller businesses with fewer healthy employees could end up paying more than those with healthier populations.

Dive Insight:

In some states, insurance commissioners could temporarily suspend the raising of the threshold if their state legislatures look ready to make the change permanent, but “that is not entirely clear and will vary by state,” EBN reported.

Additionally, there is “no guarantee” that states will keep the small-group ceiling at 50 FTEs, EBN reported, even if that’s all the ACA will now require.

Some states haven’t made any legislation on the issue of small-group employers, meaning that employers in those states with 51-100 FTEs will “automatically benefit” from the PACE Act’s undoing of the standard, EBN reports. Self-insured employers were never impacted by this, however.

“The public perception on the Affordable Care Act has been that political polarization is insurmountable. However, bipartisan amendments have been made to the law over the past five-and-a-half years,” Katherine Hayes, health policy director at the Bipartisan Policy Center, told EBN. “Between now and 2017, we think it is unlikely there will be further significant changes to the ACA. Instead, we expect the focus to now shift to the agencies to provide regulatory guidance, especially around waivers.”