Is the Small Business Health Options Program overpromising and under-delivering? Recent developments suggest that a growing number of states are proceeding with caution over a key provision that pinned high hopes on broader choices being offered to plan participants.

The Centers for Medicare and Medicaid Services is allowing insurance commissioners in states that are part of the federally facilitated marketplace to opt out of SHOP’s employee-choice provision for 2015 if they determine that it would produce adverse selection. So far, 18 states were given permission to do so.

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