Affordable Care Act and Marketplaces | Center on Health Insurance Reforms
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Affordable Care Act and Marketplaces

The 2010 Affordable Care Act (ACA) ushered in significant changes to health insurance markets, including new health insurance Marketplaces where people can get low-cost, comprehensive health plans, alongside new consumer protections such as guaranteed issue, rating requirements, and a ban on preexisting condition exclusions. These reforms, in addition to federal financial assistance to help pay for coverage, are the foundation upon which millions of Americans now obtain their health insurance. Our team of nationally recognized experts has closely followed the impact of the ACA since its enactment, and continues to investigate policy proposals that improve people’s access to affordable, high quality health coverage. 

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What We Do

Our experts at CHIR conduct research to assess the impact of federal and state policies to improve health care access and affordability and ensure that health insurance works for the people who need it most. We provide unbiased, relevant, and timely information, analysis, and technical assistance to policymakers, regulators, and stakeholders seeking a marketplace where consumers have access to affordable and high quality healthcare coverage.

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What Health Insurance Risk Pooling Is, and Why It’s Key to Maintaining Affordability

This explainer describes how health insurance risk pooling works and explains how recent federal policy changes — including Medicaid cuts under H.R. 1, the expiration of enhanced ACA premium tax credits, reduced marketplace enrollment, and regulations lowering the value of coverage — will shrink insurance risk pools, raise premiums, and shift costs onto sicker Americans.

Affordable Care Act and Marketplaces, Health Insurance Coverage

What Consumers Need to Know About Health Coverage That Doesn’t Comply with the Affordable Care Act

As Trump administration policies and Congressional inaction on enhanced premium tax credits make ACA marketplace coverage harder to access and afford, this publication explains what consumers need to know about the risks of alternative coverage arrangements — including short-term plans, health care sharing ministries, fixed indemnity insurance, and Farm Bureau plans — that lack the ACA's core consumer protections.

Affordable Care Act and Marketplaces, Health Insurance Coverage

Health Care Costs for Small Employers: Analysis of Market Challenges and Policy Solutions

In this report, researchers partnered with health actuaries at Wakely Consulting Group (Wakely) to assess the current state of the market for small employer health insurance, the factors driving its decline, and the scope of potential policies to improve coverage affordability for small businesses and their workers.

Affordable Care Act and Marketplaces, Costs and Competition, Employer-sponsored Insurance, Health Insurance Coverage