{"id":7247,"date":"2023-05-16T11:01:45","date_gmt":"2023-05-16T15:01:45","guid":{"rendered":"https:\/\/chirblog.org\/?p=7247"},"modified":"2023-06-15T12:46:13","modified_gmt":"2023-06-15T16:46:13","slug":"more-than-a-website-should-the-federal-government-establish-additional-minimum-standards-for-the-acas-health-insurance-marketplaces","status":"publish","type":"post","link":"https:\/\/chirblog.org\/more-than-a-website-should-the-federal-government-establish-additional-minimum-standards-for-the-acas-health-insurance-marketplaces\/","title":{"rendered":"More Than a Website: Should the Federal Government Establish Additional Minimum Standards for the ACA\u2019s Health Insurance Marketplaces?"},"content":{"rendered":"\n
By Sabrina Corlette, Rachel Swindle, and Rachel Schwab<\/em><\/p>\n\n\n\n The Affordable Care Act (ACA) established health insurance Marketplaces (or \u201cExchanges\u201d) to facilitate enrollment in comprehensive and affordable health insurance plans. <\/em>The ACA envisioned<\/a> that the Marketplaces would be primarily state-run<\/a>, with the federal government stepping in as a backstop. In practice, due in part to deep anti-ACA sentiment<\/a> among some state policymakers, when the Marketplaces launched in 2013, only 14 states and the District of Columbia<\/a> were state-run Marketplaces with their own IT eligibility and enrollment platforms.* The federal government had to run the Marketplaces in the remaining 36 states, and since the inaugural year, some state-run Marketplaces have used the federal enrollment platform HealthCare.gov. Over the course of the first decade of the ACA\u2019s Marketplaces, the number of state-based Marketplaces (SBM) has fluctuated from 15 in the first year, to a low of 12 in plan year 2017, to the current 18 in 2023. (See Exhibit). States transitioning to a full SBM in recent years sought control<\/a> in part because the Trump administration\u2019s efforts to roll back the ACA led to instability in their insurance markets and an increase in the numbers of uninsured<\/a>. The ability to adapt an SBM to state circumstances and priorities has enabled these states to build on the ACA and expand enrollment.<\/p>\n\n\n\n