By Rachel Schwab, Justin Giovannelli, Julia Buschmann, and Kevin Lucia

The Affordable Care Act’s (ACA’s) health insurance marketplaces provide a critical source of coverage and financial assistance. States operating their own marketplaces cover a significant number of consumers without access to employment-based health insurance or public programs. Federal actions under the Trump administration undermined the marketplaces, but the new administration and Congress have opportunities to implement and advocate for policies that strengthen state-based marketplaces (SBMs) to ensure they continue to serve as a coverage safety net.

In a new issue brief for the Commonwealth Fund, CHIR experts assessed how federal policy decisions have impacted SBMs and the consumers they serve by interviewing directors and officials from 17 SBMs. The authors found that affordability topped most directors’ lists of federal policy priorities, and federal initiatives could help reduce premiums and cost sharing. SBMs officials also shared that federal policy changes are needed to improve access to marketplace plans for consumers who don’t have health insurance through their job. In addition, officials urged the federal government to reinvest in advertising and outreach for the federally facilitated marketplace.

You can read the full issue brief here.