Year Two of the ACA Coverage Expansions: On-the-Ground Experiences from Five States

As of Spring 2015, states had completed the second open enrollment period for the new health insurance marketplaces established by the ACA and most of the 30 states that have adopted the Medicaid expansion to low-income adults were well into their second year of implementation. This brief provides an on-the-ground view of ACA implementation after completion of the second open enrollment period based on 40 in-person interviews conducted in five states – Colorado, Kentucky, Utah, Virginia, and Washington. The report presents key findings related to enrollment systems; enrollment and renewal; outreach, marketing, and enrollment assistance; and access to and utilization of care. It concludes with key priorities identified by stakeholders looking ahead.