A collection of resources to assist employers and their advisors in understanding the impact of the health insurance exchanges under the Affordable Care Act (ACA).
In addition to many market reforms that directly affect group health plans, the Affordable Care Act (ACA) required each state to establish, by January 1, 2014, a health insurance exchange (also known as a "marketplace") to assist individuals in purchasing qualified health plans (QHPs). ACA exchange coverage was intended to help individuals satisfy the related ACA requirement to maintain minimal health coverage (known as the "individual mandate") (see Practice Note, Affordable Care Act (ACA) Overview: Individual Mandate and Affordable Care Act (ACA) Toolkit). For states that chose not to implement their own exchange, the federal government was required to establish and operate an exchange in the state.
The ACA health insurance exchanges have been the topic of regulations and other guidance from the administrative agencies, on issues including:
Establishing the exchanges and their functions.
Certifying QHPs offered on the exchanges, and the scope of benefits available under QHPs.
Consumer assistance tools and programs for accessing the exchanges.
Open enrollment for exchange-based coverage began in October 2013, although the launch of the federal government's exchange website was hindered by software crashes and resulting delays.
In early 2024, the Biden administration announced that well over 20 million individuals had enrolled in ACA exchange coverage for 2024 since the start of the most recent marketplace open enrollment period, which began on November 1, 2023 (Fact Sheet (Jan. 10, 2024); CMS Press Release (Jan. 24, 2024)).
Against this backdrop of recent litigation, this toolkit provides resources to assist employers and their advisors in understanding various aspects of the ACA exchanges.