Insurance Exchanges

Under the ACA, the health insurance marketplaces have a variety of mechanisms through which they can drive improvements in health care quality. This issue brief reviews actions taken by State-based Marketplaces (SBMs) to improve health care quality in three areas: 1) using selective contracting to drive quality and delivery system reforms; 2) informing consumers about plan quality; and 3) collecting data to inform quality improvement. Thirteen SBMs took action to promote quality improvement and delivery system reforms through their marketplaces in 2014. Although technical and operational challenges remain, marketplaces have the potential to drive system-wide changes in health care delivery.
 

This report examines the experience of Assister Programs across the states to conduct outreach and enrollment assistance during the first open enrollment period for the Marketplaces. Based on responses to this survey, this report offers the first nationwide assessment of the number and type of Assister Programs and the number of people they helped. This report also examines the nature of help consumers needed, both pre- and post-enrollment, and the extent to which Assister Programs could meet consumer needs.  In addition, it discusses key factors that impacted the effectiveness of Assister Programs at the outset and the outlook for consumer assistance in the future.
 

To guide stakeholders through the overwhelming volume of recent developments and upcoming issues for the Affordable Care Act (ACA), Breakaway offers this ACA Dashboard, providing a visual and concise overview of key ACA updates in one place. Breakaway will provide comprehensive updates to the ACA Dashboard each month, covering the latest developments and offering a snapshot of Breakaway's health insurance exchange data and analysis.
 

As an initial step to understanding how the Health Insurance Marketplace is working in its first year of operation, this report provides an overview of health insurance plan premiums available in the Marketplace and the important role of the advanced premium tax credit (“tax credit”) in helping families afford coverage. The report analyzes data on the change in the premium cost associated with the tax credit for plans selected through the Federally-facilitated Marketplace during the initial open enrollment period. It also examines over 19,000 Marketplace plans for 2014 within the four metal levels (bronze, silver, gold, and platinum) for each of the 501 rating areas across 50 states and the District of Columbia. The analysis shows how differences in plan and market characteristics are associated with differences in premiums across the nation.
 

This survey, conducted by PerryUndem Research/Communication for Enroll America, provides fresh insights into why some individuals enrolled in health coverage during the Affordable Care Act’s first open enrollment period and why some individuals did not. The survey, conducted April 10-28, 2014, among 671 newly enrolled individuals and 853 who remained uninsured, is the first in-depth examination of these populations and explores their attitudes, knowledge, and experiences with enrollment, costs, and health coverage.
 

This document contains final regulations relating to requirements for Affordable Insurance Exchanges (Exchanges) to report information on enrollments in qualified health plans, and it directs exchanges to report to the IRS and to taxpayers certain information necessary to reconcile the premium tax credit with advance credit payments and to administer the premium tax credit generally.
 

States have several different options to take part in the Affordable Care Act's health insurance marketplaces, where people can shop for health insurance. These range from taking full responsibility for operating the marketplaces to letting the federal government run them. To help guide state decisions, the U.S. Department of Health and Human Services recently released the 2015 health insurance marketplace models for states. In their latest blog post, the Alliance for Health Reform's Sarah Dash and Georgetown University's Amy Thomas outline key deadlines and factors that states will consider when making their choices.
 

This is the sixth in a series of issue briefs highlighting national and state-level enrollment-related information for the Health Insurance Marketplace (Marketplace). This brief includes data for State-Based Marketplaces (SBMs), Federally-Facilitated Marketplaces (FFMs), and Marketplaces that are run by states in partnership with the federal government. This brief also includes updated data on the characteristics of persons who have selected a Marketplace plan (by gender, age, and financial assistance status) and the plans that they have selected (by metal level), and it includes self-reported race/ethnicity data on persons who have selected a Marketplace plan through the FFM.
 

The Health Insurance Exchange (HIX) Compare dataset provides information on benefit design and cost sharing for health plans offered in all 50 states and the District of Columbia. Specifically, the dataset includes data on premiums, network composition, deductibles, out-of-pocket limits, and copayment and coinsurance amounts. This data, updated May 1, 2014, was collected from state and federal government-sponsored exchange websites, and will provide perspective on consumer choice and affordability under the ACA.
 

Even though the ACA’s first Open Enrollment period has ended, the work of enrolling young adults in health insurance is not done yet, and it does not need to wait until the next round of open enrollment, starting on November 15, 2014. Many situations trigger Special Enrollment Periods, allowing consumers to purchase health insurance plans on the marketplace outside of Open Enrollment. Importantly, young people are more likely to experience these life events than other age group. This report identifies the events that trigger special enrollment periods and demonstrate how young people are systematically more likely to qualify.