Insurance Exchanges

Conducted October 9–27, 2013, the Commonwealth Fund Affordable Care Act Tracking Survey interviewed a nationally representative sample of adults who are potentially eligible for the health reform law’s new insurance coverage options, whether private plans or expanded Medicaid. Among the survey’s key findings: 60 percent of potentially eligible adults are aware of the new marketplaces as a place where they might shop for coverage; 17 percent reported visiting the marketplaces in October to shop for a health plan; about one of five visitors were ages 19 to 29; and one of five visitors enrolled in a plan.

While states differ in their approaches to the education and outreach campaigns for their Marketplaces, they have a common mission of educating consumers about their coverage options. Many of the campaigns utilize creative and innovative strategies that move beyond typical government outreach efforts and target populations that are hard-to-reach and/or have high rates of uninsurance. While not exhaustive, this analysis reflects examples of state marketing efforts based on publicly available information as of September 2013. 

Beginning in 2014, millions of Americans will become eligible for a new premium tax credit that will help them pay for health coverage. This collection of frequently asked questions explains who will be eligible for this tax credit, how the size of an individual or family’s credit will be calculated, how midyear changes in income and household size will affect tax credit eligibility, and how the reconciliation between the tax credit amount a person receives and the amount for which he or she was eligible will be handled.

Survey data show that the largest barrier to health coverage is difficulty finding a plan that families can afford. Beginning in 2014, the Affordable Care Act (ACA) introduces major reforms, including the start of a new advance payment Premium Tax Credit designed to lower the cost of coverage for qualified families purchasing in the new Health Insurance Marketplaces (exchanges). These advanceable and refundable features of the new tax credits introduce new elements that most consumers haven’t previously encountered. These facts raise the possibility that consumer confusion might be a barrier to using this new program to enroll in affordable coverage.

This summary provides an overview of several key statutory functions addressed in the final rule regarding eligibilty and minimum essential coverage.