Home > FAQs > Can small businesses use the ACA’s health insurance Marketplaces (exchanges)?

Can small businesses use the ACA’s health insurance Marketplaces (exchanges)?

Author: Louise Norris | Date Posted: September 23, 2025

SHOP enrollment lagged from the start
Insurers with significant market share that offer both individual and small group coverage are no longer required to offer SHOP plans in order to offer individual plans in the exchange
Some state-run exchanges have fairly robust SHOP markets, but in states that use HealthCare.gov, SHOP plans are only available in 6 states.
Small business health care tax credit: How it works, and how some businesses can still claim it, even if no SHOP plans are available in their area.
"Small business" means up to 50 employees in most states
Year-round enrollment for small businesses

Can small businesses use the ACA’s health insurance marketplaces (exchanges)?

The Affordable Care Act created an enrollment platform called SHOP (Small Business Health Options Program), an exchange where businesses could compare health insurance plans and enroll in coverage for their employees. Originally, the SHOP exchange was an option in every state, but in the 36 states that used HealthCare.gov as of 2018, the availability of small-business plans in the exchange changed that year.¹ And even among the states that run their own exchanges, some are no longer offering SHOP coverage due to lack of insurer participation.

Instead of having small businesses use the exchange to enroll in coverage, HealthCare.gov now directs them to seek out a broker or contact an insurance company directly.² And although the site still maintains a tool where employers can check to see if there are SHOP plans available in their area (for purchase directly from an insurer or with the help of a broker), the tool no longer shows any available plans in most areas. But as described below, there are still SHOP-certified plans available in at least some areas of six states that use HealthCare.gov.

SHOP enrollment lagged from the start

The Small Business Health Options Program (SHOP) never really took off.¹ As of 2017, HHS reported that there were fewer than 39,000 people enrolled in SHOP coverage across the 36 states that had fully federally-run SHOP platforms at that point.³ Hawaii was the first state to obtain approval for a 1332 waiver, and its purpose was to eliminate the state's SHOP exchange as of 2017.⁴

Arkansas,⁵ Mississippi,⁶ and Utah⁷ used to run their own SHOP platforms (although all three states used HealthCare.gov for individual market enrollments), but had switched to the federal SHOP platform or a direct-to-carrier process by 2019. Arkansas officials noted that they would no longer have a SHOP option because insurers were no longer participating in SHOP in Arkansas.⁵

And the lack of insurer participation in SHOP has not been limited to states that use the federally-run exchange. The same thing happened in Washington state as of 2018.⁸ And Minnesota, which has a functional state-run exchange for individuals, discontinued its SHOP platform in 2018 because carriers stopped offering SHOP-certified plans.⁹

Individual market QHP issuers were allowed to stop offering SHOP plans in 2018

The decline in SHOP participation was due in part to lackluster enrollment in the early years, and also to a rule change that HHS finalized in late 2016. Under the new rule (which took effect for plan years starting in January 2018), insurers that offer individual market coverage through HealthCare.gov are no longer required to offer SHOP coverage, even if they (or an affiliate) have more than 20% of the small-group market share in the state.

Prior to 2018, those insurers were required to offer at least one silver and one gold SHOP plan to be allowed to offer individual market coverage in the exchange. But HHS eliminated that requirement for plan years starting in 2018 or later.

Which state-run exchanges still have SHOP platforms?

HealthCare.gov no longer maintains an enrollment portal for SHOP plans, but most of the state-run health insurance exchanges still have SHOP platforms for small businesses. Most use a direct-to-carrier enrollment approach, although several offer a full-service enrollment platform:¹⁰

California
Colorado (direct-to-carrier enrollments)
Connecticut
District of Columbia
Georgia (direct-to-carrier enrollments)
Idaho (direct-to-carrier enrollments)
Kentucky (direct-to-carrier enrollments)
Maine (direct-to-carrier enrollments)
Maryland (previously direct-to-carrier enrollments, but Maryland Health Connection debuted a new enrollment portal in September 2025 that allows small business employees to select from among multiple available plans)¹¹
Massachusetts
New Jersey (direct-to-carrier enrollments)
New York (direct-to-carrier enrollments)
Oregon (direct-to-carrier enrollments; prior to the 2027 plan year, Oregon uses HealthCare.gov for individual market coverage, but has a state-run SHOP platform)
Rhode Island
Vermont (direct-to-carrier enrollments)
Virginia (direct-to-carrier enrollments)

Washington, Minnesota, New Mexico, and Nevada have state-run health insurance exchanges and previously offered SHOP coverage, but they no longer have SHOP plans available.¹⁰ Pennsylvania also has a state-run exchange, but does not offer small business coverage.¹²

SHOP enrollment tends to be much lower than individual exchange enrollment. For example, although Covered California has a fairly robust SHOP program, it had about 77,000 members as of 2024¹³ — versus nearly 2 million individual market enrollees in early 2025.¹⁴

DC is an exception, with SHOP enrollment that far exceeds individual market enrollment (more than 83,000 SHOP members as of 2025, versus about 15,000 individual market enrollees).¹⁵ But that's driven in large part by the fact that all small-group plans in DC must be purchased through the exchange¹⁶ (DC is the only place in the country where there is no off-exchange market for individual or small group health plans), and by the fact that members of Congress and their staff obtain coverage through the DC SHOP exchange¹⁷

How many HealthCare.gov states have SHOP-certified plans available in 2025?

There are SHOP-certified plans available for purchase—directly from an insurer or with the help of a broker—in six states that use HealthCare.gov in 2025.¹⁰

According to Public Use Files published by CMS (see the Business Rules PUF; filter for SHOP), there are quite a few dental-only SHOP plans. But if we limit it to medical SHOP plans, they're only available in the following states as of 2025 (and coverage areas are often limited to only certain parts of the state; note that insurer names come from the HIOS ID in the public use files):

Alabama (from Blue Cross Blue Shield of Alabama)
Montana (from Montana/Mountain Health Cooperative)
New Hampshire (from Anthem/Matthew Thornton)
Ohio (from AultCare)
Wisconsin (from Security Health Plan of Wisconsin)
Wyoming (from Mountain Health Cooperative; note that Mountain Health CO-OP is leaving the Wyoming market at the end of 2025)¹⁸

In addition, there are still SHOP-certified plans in most of the states that run their own exchanges (detailed above). This includes California, Colorado, Connecticut, DC, Georgia, Idaho, Kentucky, Maine, Maryland, Massachusetts, New Jersey, New Mexico, Oregon (state-run small business exchange, and will be a fully state-run individual exchange by the fall of 2026),¹⁹ New York, Rhode Island, and Vermont.

How does the small business health care tax credit work?

If your business qualifies for the small-business health care tax credit, you may be able to pay less in taxes by offering health benefits to your employees — although the tax credit is only available for up to two years,²⁰ so small businesses cannot count on it for long-term support.

Employers can claim the tax credit on Form 8941 (instructions here). Initially, the small business health care tax credit was only available to employers that purchased their coverage via the SHOP exchange. But as SHOP options dwindled, the IRS issued transitional relief that allowed small businesses to obtain the tax credit even if their plan was purchased outside the SHOP exchange.

However, that provision (most recently in IRS Notice 2018-27) only applies to businesses that initially purchased a plan through the SHOP exchange, and then transitioned to a non-SHOP plan (in 2017 or later) within the two-year window during which they're eligible to claim the tax credit, because SHOP plans ceased to be available during that two-year window.

This is highlighted in Example 3 in IRS Notice 2018-27: The IRS clarifies that the tax credit would not have been available in 2017 for a small business that began operations in 2017 but was in an area where no SHOP plans were available.

The instructions for Form 8941 (see page 5) confirm that this provision was still applicable for the 2024 tax year as long as the employer claimed the tax credit for all or part of 2023. So if an eligible employer began its two-year tax credit window in 2023 under a SHOP plan, and was unable to purchase a SHOP plan for 2024 due to lack of availability, they could enroll in a non-SHOP plan in the second year and still obtain the tax credit.

So if a business is in an area that still has SHOP plans available, the small business health care tax credit is still available to newly-enrolling businesses, and can be used for two years. The tax credit is also still available to a business that began its two-year tax credit window under a SHOP plan but then had to transition to a non-SHOP plan because SHOP plans were no longer available.

But businesses trying to claim the tax credit for the first time cannot do so if they're in an area where there aren't any SHOP plans available.

The IRS notes that employers in most states (those that use HealthCare.gov) can use HealthCare.gov's search tool to determine if SHOP plans are available. That tool does still work, although most areas that use the federally-run health insurance exchange do not have SHOP-certified plans available as of 2025 (if SHOP plans are available in your area, the tool on HealthCare.gov will show them to you; otherwise, the tool will simply say that there are no SHOP plans available).

As noted above, however, SHOP-certified plans are available in most of the states that run their own exchanges.

What size employers can enroll in small group health plans?

The SHOP marketplaces were originally open to businesses with up to 50 employees, but that was scheduled to change in 2016, with availability being extended to groups with up to 100 employees. However, the PACE Act, which was signed into law in October 2015, kept the definition of "small group" at 50 or fewer employees.

But there are four states that changed their laws to match the original intent of the ACA. Small group health plans in Vermont, New York, Colorado, and California are available to businesses with up to 100 employees, although Colorado is switching to the 50-employee threshold in 2026.²¹ All four of those states run their own exchange platforms; they do not use HealthCare.gov (except for California, the enrollment process is completed directly through insurers, rather than using the exchange platform).

When can small businesses enroll in health coverage?

Although small businesses in most states now enroll directly through insurers (which is what most small businesses did all along), nothing has changed about eligibility for coverage. A small employer can purchase a small group health plan at any time throughout the year — unlike individual health insurance, which is only available during open enrollment or during a special enrollment period (generally linked to a qualifying life event).

However, for groups that aren't able to meet the participation requirements and/or employer premium contribution requirements, there's an open enrollment period each fall (November 15 to December 15) when coverage is guaranteed issue regardless of employee participation and/or employer contributions.²²

Although a small employer can purchase a group plan at any point, employees can only enroll or make changes to their coverage during their employer's annual open enrollment period (dates vary by employer), a special enrollment period triggered by a qualifying life event, or when they're initially eligible (when the employer first purchases coverage, or when the employee first meets the group's coverage eligibility requirements, which may include a waiting period of up to three months of employment). This is the same process that has long applied to employer-sponsored coverage.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written hundreds of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.