A health insurance marketplace – or health insurance exchange – is a key provision of the Affordable Care Act, established to provide a selection of competing providers, each offering different qualified plans.
A health insurance marketplace, also known as a health insurance exchange, is a place (both online and in-person) where consumers in the United States can purchase private individual/family health insurance plans and receive income-based subsidies to make coverage and care more affordable. As of early 2021, there were about 11.3 million Americans enrolled in marketplace plans throughout the country.
And although marketplace enrollment generally trends downward throughout the year (ie, after open enrollment ends), that has not been the case in 2021. The American Rescue Plan‘s additional subsidies and the COVID-related special enrollment period have resulted in much higher-than-normal enrollment outside of the open enrollment period for 2021. During the first several months of the COVID-related enrollment window, two million people signed up for coverage through the marketplaces nationwide.
Each state has just one official health insurance marketplace, operated either by the state, the federal government, or both. In most states, HealthCare.gov serves as the marketplace and runs the customer service call center. But some states run their own platforms, such as Covered California, New York State of Health, Connect for Health Colorado, MNsure, etc.
In the early years of ACA implementation, there was a trend of states abandoning their own state-run enrollment platforms and switching to HealthCare.gov. But that has reversed in recent years: New Jersey and Pennsylvania began operating their own exchanges in the fall of 2020, and three more states are planning to follow suit in the fall of 2021: Maine, Kentucky, and New Mexico.
Health insurance marketplaces were created by the Affordable Care Act. The law was enacted in 2010, and the exchanges opened for business in the fall of 2013, offering individual and family health insurance coverage for 2014.
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