unittd 5mm Smart

WASHINGTON, DC 20510

March 12, 2015

The Honorable Sylvia Matthews Burwell
Secretary

US. Department of Health and Human Services
200 Independence Avenue, SW

Washington, DC 20201

Dear Secretary Burwell:

We are writing to share our concerns regarding scheduled changes to the de?nition of the small
group market under the Aftordable Care Act (ACA).

Under the law, employers with 51 to 100 employees will be included in the de?nition of
small group market starting in 2016. Instead of providing stability, we believe expanding the
de?nition will force those historically de?ned ?large group plans" into the ?small group market,?
where they could experience higher premiums, less ?exibility, and new barriers to coverage. We
therefore encourage you to delay the effective date in the de?nition change for two years so the
market can more smoothly transition to the new rules.

We appreciate the Administration?s efforts to ensure the law is implemented in the least
disruptive, most bene?cial manner. For example, the Administration has delayed implementation
of the employer shared responsibility requirements. At the same time, the Small Business Health
Options Program (SHOP) has experienced delays in implementation. As enacted, the ACA was
to have provided this market segment two full years of experience under the employer mandate
and in SHOP exchanges before re-categorizing their plans into the small group market. Because
these two very signi?cant building blocks have not occurred as anticipated, we believe
continuing on with the rede?nition of small group next year would be particularly harmful and
disruptive.

We look forward to continuing to work with you to ensure that Americans have access to
meaningful and affordable health coverage.

Sincerely,

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Heidi Heitkamp Chris Coons
United States Senator United States Senator

 

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Joe Manchin Angus S?King, Jr. 

United States Se United States Senator

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1ted States SenatOr United States Senator

Claire MeCaskill
United States Senator