Paul Downs knows first-hand about dealing with health care as a small manufacturing business owner near Philadelphia. He offers up seven timely pieces of advice about the new health care environment in a recent NYT article. The state in which he operates, Pennsylvania, is a state that does not have its own health care exchange, so he has been forced to deal with the national (and infamous) HealthCare.gov website. The other parameters that have influenced his experience include: He has used an insurance agent in this process. Health care in his area is an oligopoly that includes Independence Blue Cross, Aetna, and United Healthcare The requirement (this year) to offer a single plan to all employees means that to allow flexibility to employees you have to locate a plan with options within it. Here is a summary of what he has learned: The Affordable Care Act (ACA, nicknamed Obamacare) has changed the insurance market in significant ways by offering a better way to shop for coverage, with uniform standards for comparison. Nevertheless, certain information is less than transparent. Still needed?: Comprehensive information about prices for specific services and well-structured flowcharts for decision making. "If it ain't broke, don't fix it." If your current plan is working and meets the standards of the ACA, then just re-adopt it and change it next year if you need to. If you aren't currently covering your employees, let them get their own insurance on the exchange and advise them to get an account or they will not get good data on pricing for their age and needs using the "quick quotes" available anonymously. The SHOP exchange on the federal government site is currently not functioning adequately. The only reason to attempt to use it is to enable employees to apply for tax credits if they qualify. Online requests are not being processed, and paperwork requests are not being attended to on a timely basis If insurance is currently offered to employees, but few employees buy it, it is better to stop offering insurance, so that lower-income employees can get insurance through the exchanges and might qualify for the subsidies. Offering insurance to part-time employees also no longer makes sense because the exchanges offer more cost-benefit, but employers must be careful to have clear, uniform guidelines--for example, making those who work less than 30 hours per week ineligible. Probably everyone who has had to buy health insurance for themselves or others has more advice to offer, and Paul Downs anticipates having more to say as the health care plan continues to be implemented. Sources: " Seven Conclusions About Small-Business Health Insurance ," by Paul Downs, New York Times Small Business, November 25, 2013. Follow up: Have you shopped for health insurance? Will you need to buy it or are you still covered under your parent's plan? What do you think of the process? What will it cost and what will you get? What do you think are the advantages and disadvantages of a " single payer " plan?