Insurance Exchanges

The ACA provided for new publicly funded consumer assistance entities to help people on an ongoing basis as they apply for health coverage and subsidies and resolve questions and problems with their insurance once covered. These assistance professionals have unique insights into how ACA implementation is progressing, what is changing and what challenges remain. This report discusses the results of the 2015 Kaiser Family Foundation survey of Health Insurance Marketplace Assister Programs and Brokers, and compares the Assister Programs’ capacity and experiences during their first two years of operations under the ACA.

The Marketplace Survey Improvement Guide helps Marketplaces improve consumers’ experiences when they shop for and enroll in a health plan. The Guide provides seven evidence-based strategies that will help Marketplaces improve the consumer experience by giving consumers accurate and relevant information in a timely manner and helping consumers understand and use that information. The Guide also offers recommendations on where to focus improvement efforts.

A central feature of the Affordable Care Act (ACA) is the establishment of health insurance marketplaces. The marketplaces offer consumers organized platforms to shop for health insurance coverage, apply for financial assistance, and purchase coverage without any medical underwriting or premium adjustment based on pre-existing conditions. A key objective of the marketplaces is to foster competitive environments in which consumers can choose from a number of affordable and high quality health plans. This issue brief provides a progress report on the evolution of the competitive dynamics of the marketplaces.

In the wake of the U.S. Supreme Court’s recent decision in King v. Burwell affirming the availability of federal subsidies to states opting to use the Federally-Facilitated Marketplace model, there is growing interest in state and federal marketplace options and performance. While states implementing both the FFM and SBM models had to overcome hurdles in building and managing multifaceted IT platforms, both are making significant progress in meeting the ACA’s coverage and access goals. However, the advancements and opportunities of SBMs are not as well-known as the challenges state and federal marketplaces have faced. This paper seeks to explore and highlight early developments in states that have implemented the SBM model.

The ACA has prompted health plans to increase their use of "narrow networks" of providers as a cost containment strategy. These plans have proven popular on the ACA marketplace because they carry lower premiums. Yet consumers have little information to guide them on the tradeoff between lower premiums and network size when shopping among the various plans offered on the ACA marketplace. Regulators and policymakers also have little information on these networks. New federal requirements for updated, accurate provider directories create an opportunity to significantly improve consumers' ability to make more informed health plan choices. This data brief describes the breadth of the physician networks in plans sold on the state and federal marketplaces.