The State-Based Marketplaces (SBM): A Focus on Innovation, Flexibility, and Coverage

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.