The state Health Insurance Marketplaces (originally called Health Insurance Exchanges) were created under the Affordable Care Act (ACA). They are state-based competitive marketplaces where people and small businesses with fewer than 50 employees can shop for and purchase private health insurance. The Marketplaces provide:
- More choice, giving consumers a choice of health plans to fit their needs.
- More competition, making it easier for consumers to compare plans on the basis of price, quality and benefits. This gives insurance companies incentives to offer better products at lower prices than their competitors.
- More clout, giving 25 million individuals and small businesses the same purchasing power as big businesses by bringing people and businesses together, lowering costs by spreading the cost of insurance across a larger group of people, and allowing insurance companies to reduce prices.
The state Marketplaces are not private insurance companies or government-run health plans. Rather, they are a state-specific resource consumers can use to find out if they qualify for private health insurance plans and other health insurance programs like Medicaid and the Children’s Health Insurance Program (CHIP). In the Marketplace, many consumers will receive tax credits, and cost-sharing reductions. And Marketplaces will help consumers choose the best coverage for their individual needs and budgets. With one application, they can learn about all their options and enroll on the spot.
Key Consumer Resources
How It Works
Starting October 1, 2013, consumers will be able to file a Marketplace application. But everyone is encouraged to create his or her Marketplace account now, to be ready to enroll on October 1. Remember, consumer health insurance coverage begins as early as January 1, 2014.
Getting health care coverage is relatively quick, 4-step process:
1. Create an Account
3. Pick a Plan
Each State Marketplace will tell consumers automatically if they qualify for discounts or qualify to participate in other state programs, like Medicaid, based on their income. Once a consumer is approved, he or she can choose the best health plan through the online plan comparison tool, or based on information provided on-site by navigators, or through mailed information following a phone call to the Marketplace.