The ACA sought to address problems in the health insurance market for small businesses by making coverage easier to access and more affordable. This report explores trends in small business health insurance, including the effects of new incentives created by the ACA. The authors examine the continued existence of non-compliant plans, the migration of employees to individual coverage, and alternative options for employers such as self-funding arrangements. Our findings suggest that small employers have made fewer than expected changes to their health plans in the wake of the ACA, but that 2017 could be a year for significant market shifts.