Under that law, Massachusetts became the first state in the country to put small businesses and individuals together in the same risk pool as a way to make coverage more affordable for self-employed residents.
Because of that merged market, small businesses will now be subject to the new rate-setting period mandated for individuals.
That means those businesses, which have borne the brunt of premium hikes over the past decade, could face a fresh round of higher rates.
Last year, Patrick signed legislation limiting the annual per-capita increase in health care costs to the state’s economic growth, projected to be 3.6 percent this year. But a number of developments — including the federal rules for small business insurance, a string of hospital mergers, and health insurer projections of rising health care use and higher prices for medical care — have called into question whether the state cap is realistic.
The federal rules are proving especially vexing to Massachusetts leaders, who had hoped the state was turning a corner in its efforts to slow the rate of premium increases.
“As more of these regulations are published, it appears as if the feds are taking a different track and creating disruption in Massachusetts,” said Richard C. Lord, president of the Associated Industries of Massachusetts, a trade group representing 5,000 employers, and a member of the new state Health Policy Commission charged with cost containment.
Under pressure from Massachusetts government and business leaders, federal officials agreed to waive another requirement included in the Feb. 27 set of rules — that all small businesses and individuals switch to a single health insurance renewal period on Jan. 1. Now, insurance renewal periods are staggered throughout the year. State officials feared a fall sign-up period would create hardships for retailers preparing for the crucial holiday shopping season.
However, federal officials aren’t backing down on the need to set rates on July 1 each year for coverage that takes effect in the following calendar year.
Joseph Murphy, Massachusetts insurance commissioner, who has been part of the state’s talks with federal policy makers, said state officials will continue to press for more flexibility from their counterparts in the nation’s capital.
“We’re on the phone with them every day,” he said.