Insurance Exchanges

In recent months, there has been considerable focus on cancellations of nongroup health insurance policies. It is difficult to directly obtain data on premiums that individuals were paying prior to the ACA, but this brief provides data on the premium cost to enrollees for the lowest cost bronze plans and the second lowest cost silver plans by age and income group in each state. The authors conclude that it would be difficult for the majority of individuals, particularly those qualifying for subsidies, to obtain coverage for a lower premium than those available in the Marketplaces today. Unsubsidized individuals, particularly those in older age groups, are more likely to face higher premiums.

This is OPM’s annual call for applications and recertification submissions from prospective and current Multi-State Plan (MSP) issuers for the contract term beginning January 1, 2015. The MSP Program was created to bring choice and competition to the Health Insurance Marketplace. The Program’s charge is to make available at least two quality, affordable MSP options in the Marketplace in every State and the District of Columbia. In the inaugural year, OPM certified more than 150 MSP options that are now available to consumers in 30 States and the District of Columbia. OPM also certified MSP options for the Small Business Health Options Program (SHOP) in four States and the District of Columbia. For 2015, OPM’s goal is to expand MSP coverage to at least five additional States, and to add one or more new MSP issuers or groups of issuers.

With the launch of Open Enrollment on October 1, 2013, millions of individuals and families started to enroll in Medicaid, CHIP, or private insurance with or without federal subsidies through Health Insurance Marketplaces. As the Marketplaces’ doors opened for business, technological glitches surfaced, making the role of consumer assistance organizations even more important. This report examines states’ health coverage consumer assistance efforts to date. Based on the major categories of consumer assistance entities – Navigators, In-Person Assisters, Certified Application Counselors, and Health Centers – the report takes a closer look at each state’s consumer assistance and health center entities and the funding used to support these efforts.

This is the third in a series of issue briefs highlighting national and state-level enrollment-related information for the Health Insurance Marketplace. This brief includes data for states that are implementing their own Marketplaces, and states with Marketplaces that are supported by or fully run by the Department of Health and Human Services. This brief also includes some preliminary data on the characteristics of persons who have selected a Marketplace plan by gender, age, and financial assistance status, and of the plans that they have selected by metal level.

This brief discusses the new health insurance marketplaces created under the Affordable Care Act and associated structural and process-related regulations that aim to ensure the quality and value of plans sold. To qualify to be sold in these marketplaces, new plans must be certified as a "Qualified Health Plan" (QHP), meet quality accreditation standards, and implement a quality improvement strategy. These steps require the collection of information from insurers, which will result in the disclosure of information about health insurance policies, practices, cost, and quality.