Insurance Exchanges

As states continue to refine the operations of their health insurance exchanges, regardless of the exchange type (state-based exchange, state partnership exchange, or federally facilitated marketplace), it's helpful to compare and contrast operational resources. This chart contains each state's resources and forms for three distinct and fundamentally important areas of exchange operation: applications, appeals, and taxes. With links directly to the states' forms and guides related to these issue areas, this chart serves as a one-stop resource library for those interested in developing new, or revising old, versions of applications, appeals, and tax resources.

Since 2010, eight states have negotiated with the federal government to implement Delivery System Reform Incentive Payment (DSRIP) or “DSRIP-like” programs. These programs are a component of Section 1115 demonstrations that incentivizes system transformation and quality improvements in hospitals and other providers serving high volumes of low-income patients. DSRIPs aim to meet strategic goals, based on the Triple Aim principles of better care, improved health, and lower costs by incentivizing reforms that transition away from episodic treatment of disease toward prevention and management of health and wellness among patient populations. This report provides an in-depth cross-state analysis of current DSRIP and DSRIP-like programs. It describes implementation experiences from the federal, state, and provider perspectives.

The Supreme Court is expected to issue a ruling by the end of June in King v. Burwell, a case challenging the legality of health insurance subsidies provided to low- and middle-income people in the 34 states where the federal government is operating the insurance Marketplace under the Affordable Care Act. This map and table show for each state: the number of people now receiving premium subsidies who would lose them if the Court finds for the challengers; the total amount of federal subsidy dollars; the average premium tax credit that subsidized enrollees have qualified for; and the average increase in premiums that subsidized enrollees would face if the subsidies are disallowed.

This report reveals significant collaboration between Arkansas's public and private sectors to expand health care coverage through the Health Care Independence Program (commonly known as the "private option") and the federally facilitated marketplace partnership. The political environment in Arkansas that led to decisions related to the ACA are detailed in the report, along with the fluid status of the state’s pioneering decisions in light of recent leadership transitions and uncertainty at the federal level.

This survey reports on the views and experiences of people purchasing health insurance coverage in the non-group market. Over the past few years, the ACA has had a significant impact on this group, as new rules took effect that standardized coverage, guaranteed coverage for those with pre-existing conditions, and established income-based federal financial assistance to those buying insurance through new health insurance Exchanges or Marketplaces. Starting on January 1, 2014, all coverage newly purchased either through a Marketplace or directly from an insurance company had to follow new rules under the ACA (i.e. “ACA-compliant”).