Insurance Exchanges

By the end of the first open enrollment period for coverage offered through the ACA’s marketplaces, increasing numbers of people said they found it easy to find a plan they could afford, according to The Commonwealth Fund’s Affordable Care Act Tracking Survey, April–June 2014. Adults with low or moderate incomes were more likely to say it was easy to find an affordable plan than were adults with higher incomes. Adults with low or moderate incomes who purchased a plan through the marketplaces this year have similar premium costs and deductibles as adults in the same income ranges with employer-provided coverage. A majority of adults with marketplace coverage gave high ratings to their insurance and were confident in their ability to afford the care they need when sick.

Under the ACA, the health insurance marketplaces can encourage improvements in health care quality by: allowing consumers to compare plans based on quality and value, setting common quality improvement requirements for qualified health plans, and collecting quality and cost data to inform improvements. This issue brief reviews actions taken by state-based marketplaces to improve health care quality in three areas: 1) using selective contracting to drive quality and delivery system reforms; 2) informing consumers about plan quality; and 3) collecting data to inform quality improvement.
 

Going into the second open enrollment period for the health insurance marketplaces, the enrollment community must focus on both getting more uninsured consumers enrolled and also ensuring that those who are already enrolled retain coverage. It is crucial that the enrollment community organize around simple, unified messages for consumers, including those enrolling for the first time and those who are renewing coverage. This memo presents Enroll America’s suggestions for a simple consumer messaging framework in the months leading up to and during the second open enrollment period.
 

This report examines the experience of Assister Programs across the states to conduct outreach and enrollment assistance during the first open enrollment period for the Marketplaces. Based on responses to this survey, this report offers the first nationwide assessment of the number and type of Assister Programs and the number of people they helped. This report also examines the nature of help consumers needed, both pre- and post-enrollment, and the extent to which Assister Programs could meet consumer needs.  In addition, it discusses key factors that impacted the effectiveness of Assister Programs at the outset and the outlook for consumer assistance in the future.
 

Under the ACA, the health insurance marketplaces have a variety of mechanisms through which they can drive improvements in health care quality. This issue brief reviews actions taken by State-based Marketplaces (SBMs) to improve health care quality in three areas: 1) using selective contracting to drive quality and delivery system reforms; 2) informing consumers about plan quality; and 3) collecting data to inform quality improvement. Thirteen SBMs took action to promote quality improvement and delivery system reforms through their marketplaces in 2014. Although technical and operational challenges remain, marketplaces have the potential to drive system-wide changes in health care delivery.