Insurance Exchanges

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.

The ACA will make health insurance more accessible to millions of Americans. However, it is estimated that as many as one in four uninsured individuals eligible for Advance Premium Tax Credits (APTCs) do not have a checking account, presenting a basic signup challenge as timely payment must be made to both initiate and maintain coverage on a monthly basis. This brief, prepared by Wakely Consulting Group, offers some insights on this sizable population and explores various solutions that Marketplaces and issuers might consider in early 2014 to address the payment challenges presented by unbanked and underbanked individuals.

Implementation of the health insurance marketplaces has been an ongoing challenge across the country in the initial months of open enrollment. While state marketplaces are still evolving, and some are experiencing their own implementation challenges, they are largely working. This brief, prepared by the team at Manatt Health Solutions, looks at five state marketplaces to assess early lessons that might help to explain early enrollment trends. Based on interviews with state leadership and review of publicly available documents, the report explores the early implementation experience in Kentucky, New York, Minnesota, Rhode Island, and Washington.

Prepared by Georgetown University's Center on Health Insurance Reforms, this guide is intended to supplement the Navigator training available from HHS and help answer questions people may have about the private insurance reforms in the Affordable Care Act. This comprehensive resource addresses more than 230 enrollment questions about everything from tax credits and cost standards to enrollment periods, and more.

Conducted October 9–27, 2013, the Commonwealth Fund Affordable Care Act Tracking Survey interviewed a nationally representative sample of adults who are potentially eligible for the health reform law’s new insurance coverage options, whether private plans or expanded Medicaid. Among the survey’s key findings: 60 percent of potentially eligible adults are aware of the new marketplaces as a place where they might shop for coverage; 17 percent reported visiting the marketplaces in October to shop for a health plan; about one of five visitors were ages 19 to 29; and one of five visitors enrolled in a plan.

Young adults are the age group most likely to be without health insurance. But through the Health Insurance Marketplace, young adults can purchase quality, affordable coverage and get lower costs on monthly premiums through tax credits. This report examines data from the 34 Federally-Facilitated and State Partnership Marketplaces and finds that out of 2.9 million single young adults ages 18 to 34 who may be eligible for coverage in the Marketplace, 1.3 million (46 percent) could purchase a bronze plan for $50 per month or less after tax credits. In the 34 states, a total of 1.9 million young adults, representing nearly 7 in 10 (66 percent) of the potentially Marketplace-eligible uninsured ages 18 to 34, may be able to pay $100 or less for coverage in 2014.

In partnership with the Robert Wood Johnson Foundation, Breakaway Policy Strategies is undertaking a review of the plans being offered in all 50 state marketplaces, plus the District of Columbia, that goes well beyond an examination of premiums. This first report provides a snapshot of premiums, deductibles, copayments and coinsurances amounts for primary care physician and specialist visits for silver-level plans in 96 rating areas across 15 state marketplaces.

This final rule outlines financial integrity and oversight standards with respect to Affordable Insurance Exchanges, qualified health plan (QHP) issuers in Federally-facilitated Marketplaces (FFMs), and States with regard to the operation of risk adjustment and reinsurance programs. It also establishes additional standards for special enrollment periods, survey vendors that may conduct enrollee satisfaction surveys on behalf of QHP issuers, and issuer participation in an FFM, and makes certain amendments to definitions and standards related to the market reform rules.

This most federal guidance clarifies that individuals have until March 31, 2013 to enroll in coverage through the health insurance marketplaces to avoid being subject to the penalty for not maintaining minimal essential coverage.

This report summarizes the health plan choices and premiums that will be available in the Health Insurance Marketplace. It contains new information on qualified health plans in the 36 states in which the Department of Health and Human Services (HHS) will support or fully run the Health Insurance Marketplace in 2014. Plan data is in final stages but is still under review as of September 18 and may be revised in HHS systems before being displayed for consumers, so this information is subject to change. This analysis also includes similar information that is publicly available from 11 states and the District of Columbia that are implementing their own Marketplace.