In the United States, health insurance marketplaces, also called health exchanges, are organizations set up to facilitate the purchase of health insurance in each state in accordance with Patient Protection and Affordable Care Act (known colloquially, and sometimes pejoratively, as "Obamacare"). Marketplaces provide a set of government-regulated and standardized health care plans from which individuals may purchase health insurance policies eligible for federal subsidies.
All health exchanges were to be fully certified and operational by January 1, 2014, under federal law. Enrollment in the marketplaces started on October 1, 2013, and will continue for six months.
As of January 3, 2014, more than 2 million people had selected a health plan through the health insurance marketplaces.
Health insurance marketplace Contents
Health insurance marketplace Background
Health insurance exchanges in the United States are intended to help insurers comply with consumer protection laws, compete in cost-efficient ways, and expand insurance coverage to more people. Exchanges are not themselves insurers, so they do not bear risk themselves, but they do determine the insurance companies that are allowed to participate. An ideal exchange promotes insurance transparency and accountability, facilitates increased enrollment and delivery of subsidies, and helps spread risk to ensure that the costs associated with expensive medical treatments are shared more broadly across large groups of people, rather than spread across just a few beneficiaries.
Health insurance marketplace History
Health insurance exchanges by state.
Creating state-operated exchanges
Establishing state-federal partnership exchanges
Defaulting to federal exchange
President Barack Obama promoted the concept of a health insurance exchange as a key component of his health care reform initiative. Obama stated that it should be "a market where Americans can one-stop shop for a health care plan, compare benefits and prices, and choose the plan that's best for them, in the same way that Members of Congress and their families can. None of these plans should deny coverage on the basis of a preexisting condition, and all of these plans should include an affordable basic benefit package that includes prevention, and protection against catastrophic costs. I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest." Although the House of Representatives had sought a single national exchange as well as a public option, the Patient Protection and Affordable Care Act (ACA) as passed used state-based exchanges, and the public option was ultimately dropped from the bill after it did not win filibuster-proof support in the Senate. States may choose to join together to run multi-state exchanges, or they may opt out of running their own exchange, in which case the federal government will step in to create an exchange for use by their citizens.
The Patient Protection and Affordable Care Act (PPACA) was signed into law on March 23, 2010. The law required that health insurance exchanges commence operation in every state on October 1, 2013. In the first year of operation, open enrollment on the exchanges runs from October 1, 2013, to March 31, 2014, and insurance plans purchased by December 15, 2013, began coverage on January 1, 2014. For 2015 open enrollment will begin November 15, 2014 and end on January 15, 2015.
Implementation of the individual exchanges changed the practice of insuring individuals. The expansion of this market is a major focus of President Obama's Patient Protection and Affordable Care Act.
Health insurance marketplace Patient Protection and Affordable Care Act regulations
- Insurers are prohibited from discriminating against or charging higher rates for any individual based on pre-existing medical conditions or gender.
- Insurers are prohibited from establishing annual spending caps of dollar amounts on essential health benefits.
- All private health insurance plans offered in the Marketplace must offer the following essential health benefits: ambulatory care, emergency services, hospitalization (such as surgery), maternity and newborn care, mental health and substance abuse services, prescription drugs, rehabilitative and habilitative services (services to help people with injuries, disabilities, or chronic conditions to recover), laboratory services, preventive and wellness services, and pediatric services.
- Under the individual mandate provision (sometimes called a "shared responsibility requirement" or "mandatory minimum coverage requirement"), individuals who are not covered by an acceptable health insurance policy will be charged an annual tax penalty of $95, or up to 1% of income over the filing minimum, whichever is greater; this will rise to a minimum of $695 ($2,085 for families), or 2.5% of income over the filing minimum, by 2016. The penalty is prorated, meaning that if a person or family has coverage for part of the year they won't be liable if they lack coverage for less than a three-month period during the year. Exemptions are permitted for religious reasons, for members of health care sharing ministries, or for those for whom the least expensive policy would exceed 8% of their income. Also exempted are U.S. citizens who qualify as residents of a foreign country under the IRS foreign earned income exclusion rule. In 2010, the Commissioner speculated that insurance providers would supply a form confirming essential coverage to both individuals and the IRS; individuals would attach this form to their Federal tax return. Those who aren't covered will be assessed the penalty on their Federal tax return. In the wording of the law, a taxpayer who fails to pay the penalty "shall not be subject to any criminal prosecution or penalty" and cannot have liens or levies placed on their property, but the IRS will be able to withhold future tax refunds from them.
United States Department of Health and Human Services (HHS) federal poverty level in 2013
|48 Contiguous States
- In participating states, Medicaid eligibility is expanded; all individuals with income up to 133% of the poverty line qualify for coverage, including adults without dependent children. The law also provides for a 5% "income disregard", making the effective income eligibility limit 138% of the poverty line. States may choose to increase the income eligibility limit beyond this minimum requirement. As written, the ACA withheld all Medicaid funding from states declining to participate in the expansion. However, the Supreme Court ruled in National Federation of Independent Business v. Sebelius (2012) that this withdrawal of funding was unconstitutionally coercive and that individual states had the right to opt out of the Medicaid expansion without losing pre-existing Medicaid funding from the federal government. For states that do expand Medicaid, the law provides that the federal government will pay for 100% of the expansion for the first three years, then gradually reduce its subsidy to 90% by 2020. As of April 25, 2013, fifteen states—Alaska, Alabama, Georgia, Idaho, Indiana, Iowa, Louisiana, Mississippi, Nebraska, North Carolina, Oklahoma, South Carolina, Texas, Wisconsin, and Virginia—were not participating in the Medicaid expansion, with ten more—Kansas, Maine, Michigan, Montana, Missouri, Ohio, Pennsylvania, South Dakota, Utah, and Wyoming—leaning towards not participating. (See further: State rejections of Medicaid expansion).
- The Patient Protection and Affordable Care Act eliminates lifetime and annual limits from plans in the individual health benefits exchanges. This effectively eliminates the ceiling on financial risk for individuals in the individual exchanges.
The subsidies for insurance premiums are given to individuals who buy a plan from an exchange and have a household income between 133% and 400% of the poverty line. Section 1401(36B) of PPACA explains that each subsidy will be provided as an advanceable, refundable tax credit and gives a formula for its calculation:
Except as provided in clause (ii), the applicable percentage with respect to any taxpayer for any taxable year is equal to 2.8 percent, increased by the number of percentage points (not greater than 7) which bears the same ratio to 7 percentage points as the taxpayer's household income for the taxable year in excess of 100 percent of the poverty line for a family of the size involved, bears to an amount equal to 200 percent of the poverty line for a family of the size involved. *(ii) SPECIAL RULE FOR TAXPAYERS UNDER 133 PERCENT OF POVERTY LINE- If a taxpayer's household income for the taxable year is in excess of 100 percent, but not more than 133 percent, of the poverty line for a family of the size involved, the taxpayer's applicable percentage shall be 2 percent.
- -- Patient Protection and Affordable Care Act: Title I: Subtitle E: Part I: Subpart A: Premium Calculation
A refundable tax credit is a way to provide government benefits to individuals who may have no tax liability (such as the earned income tax credit). The formula was changed in the amendments (HR 4872) passed March 23, 2010, in section 1001. To qualify for the subsidy, the beneficiaries cannot be eligible for other acceptable coverage. The U.S. Department of Health and Human Services (HHS) and Internal Revenue Service (IRS) on May 23, 2012, issued joint final rules regarding implementation of the new state-based health insurance exchanges to cover how the exchanges will determine eligibility for uninsured individuals and employees of small businesses seeking to buy insurance on the exchanges, as well as how the exchanges will handle eligibility determinations for low-income individuals applying for newly expanded Medicaid benefits. Premium caps have been delayed for a year on group plans, to give employers time to arrange new accounting systems, but the caps are still planned to take effect on schedule for insurance plans on the exchanges; the HHS and the Congressional Research Service calculated what the income-based premium caps for a "silver" healthcare plan for a family of four would be in 2014:
Health Insurance Premiums and Cost Sharing under PPACA for Average Family of 4
|Income % of federal poverty level
||Premium Cap as a Share of Income
||Income $ (family of 4)a
||Max Annual Out-of-Pocket Premium
||Additional Cost-Sharing Subsidy
||3% of income
||4% of income
||6.3% of income
||8.05% of income
||9.5% of income
||9.5% of income
||9.5% of income
a.^ Note: In 2014, the FPL is projected to equal about $11,800 for a single person and about $24,000 for a family of four. See Subsidy Calculator for specific dollar amount. b.^ DHHS and CBO estimate the average annual premium cost in 2014 would be $11,328 for a family of 4 without the reform.
Maximum Out-of-Pocket Premium Payments
Health insurance marketplace Guaranteed issue
In the individual market, sometimes thought of as the "residual market" of insurance,underwriting to ensure that each individual paid for his or her actuarial value or to deny coverage altogether. The House Committee on Energy and Commerce found that, between 2007 and 2009, the four largest for-profit insurance companies refused insurance to 651,000 people for previous medical conditions, a number that increased significantly each year, with a 49% increase in that time period. The same memorandum said that 212,800 claims had been refused payment due to pre-existing conditions and that insurance firms had business plans to limit money paid based on these pre-existing conditions. These persons who might not have received insurance under previous industry practices are guaranteed insurance coverage under the ACA. Hence, the insurance exchanges will shift a greater amount of financial risk to the insurers, but will help to share the cost of that risk among a larger pool of insured individuals. The ACA's prohibition on denying coverage for pre-existing conditions began on January 1, 2014. Previously, the ACA provided funds for state-run high-risk pools for those with previously existing conditions.
insurers have generally used a process called
Health insurance marketplace Limit to price variation
- Pricing Factors Allowed in the exchange under the ACA:
- Age: 3:1
- Smoking status: 1.5:1
Pricing variation will be allowed by area (within a state) and family composition ("tier") as well.
Health insurance marketplace Comparable tiers of plans
Within the exchanges, insurance plans are offered in four tiers designated from lowest premium to highest premium: bronze, silver, gold, and platinum. The plans cover ranges from 60% to 90% of bills in increments of 10% for each plan. For those under 30 (and those with a hardship exemption), a fifth "catastrophic" tier is also available, with very high deductibles.
Insurance companies select the doctors and hospitals that are "in-network".
Proponents of health care reform believe that allowing comparable plans to compete for consumer business in one convenient location will drive prices down. Having a centralized location increases consumer knowledge of the market and allows for greater conformation to perfect competition. Each of these plans will also cap liabilities for consumers with out-of-pocket expenses at $6,350 for individuals and $12,700 for families.
Health insurance marketplace Economics of health insurance exchanges: the individual mandate
The health insurance advocacy group America's Health Insurance Plans was willing to accept these constraints on pricing, capping, and enrollment because of the individual mandate: The individual mandate requires that all individuals purchase health insurance. This requirement of the ACA allows insurers to spread the financial risk of newly insured people with pre-existing conditions among a larger pool of individuals.
Additionally, a study done by Pauly and Herring estimates that individuals with pre-existing conditions in the 99th percentile of financial risk represented 3.95 times the average risk (mean). Figures from the House Committee on Energy and Commerce would indicate that approximately 1 million high-risk individuals will pursue insurance in the health benefits exchanges. Congress has estimated that 22 million people will be newly insured in the health benefits exchanges. Thus the high-risk individuals do not number in high enough quantities to increase the net risk per person from previous practice. It is thus theoretically profitable to accept the individual mandate in exchange for the requirements presented in the ACA.
Health insurance marketplace Acronym
HIX (Health Insurance Exchange) is emerging as the de facto acronym across state and federal government stakeholders, and the private sector technology and service providers that are helping states build their exchanges. The acronym HIX differentiates this topic from health information exchange, or HIE.
The de facto acronym of HIX will be replaced in the soon (March 2013) to be released 3rd Edition of the HIMSS Dictionary of Healthcare Information Technology Terms, Acronyms and Organizations with HIEx. See more information on the HIMSS Dictionary at 2nd Edition of the HIMSS Dictionary of Healthcare Information Technology Terms, Acronyms and Organizations.
Health insurance marketplace Criticism and controversy
Health insurance marketplace Technical "glitches"
|This section has multiple issues. Please help improve it or discuss these issues on the talk page.
||This section is outdated. (February 2014)
||This section needs additional citations for verification. (February 2014)
- The system does not have a way for the user to see and re-print his/her previously filled or incomplete application.
- The website uses age instead of date of birth when showing rates. This often results in inaccurate estimates.
- Some users are unable to reset their lost or forgotten usernames/passwords for the usernames created during the first week of operation.
- The system often does not give meaningful error messages and sometimes there are no error messages when an error does occur.
- There were reports that some applications completed during the first week of operation are missing important data, so they are unable to be processed. Users are confused whether they need to remove the old application and fill a new application, or not.
- The system sends users to the Kaiser Family Foundation's subsidy calculator to estimate the Marketplace health insurance costs and savings after the subsidies.
First week of operation
||An editor has expressed a concern that this section lends undue weight to certain ideas relative to the article as a whole. Please help to discuss and resolve the dispute before removing this message. (February 2014)
"Please try again later" was the message that greeted many people who tried to view information on marketplace websites across the United States during the first week of operation. Websites were reported to have either crashed or offer very sluggish response times. There was disagreement on whether the high volume of views (8.6 million people) was at the bottom of the problem or whether there were deeper technical issues involved.
Todd Park, U.S. chief technology officer, said that the glitches were caused by unexpected high volume at the federal health exchange (Healthcare.gov) when the site drew 250 thousand visitors instead of the 50-60 thousand expected. He claimed that the site would have worked with less visitors. More than 8.1 million people visited the site from October 1–4, 2013.
On the date of enactment of the Patient Protection and Affordable Care Act of 2010, only a few health insurance exchanges across the country were up and running. Among them were the 
It was unknown how many people in total successfully enrolled in the first week. The federal marketplace website was scheduled for maintenance on the weekend. Some reporters nicknamed the program "Slowbamacare".
CGI Group came under media scrutiny as a developer behind several marketplace websites after numerous issues surfaced with the federal health insurance marketplace, Healthcare.gov.
On October 1, 2013, the state-run marketplaces also opened to the public, and some of them reported first statistics. During the first week of enrollment:
Health insurance marketplace Postponement of tax penalty
On October 23, 2013, the Washington Post reported that Americans with no health insurance would have an additional six weeks before they are penalized.
Health insurance marketplace Primary concerns
Medicaid expansion by state.
Not expanding Medicaid
Still debating Medicaid expansion
- Many lower-income individuals excluded: NPR reported that large numbers of low income people were excluded in states that did not offer Medicaid expansion to 133% of the poverty line.
- Moral and ethical concerns: Many varieties of libertarian ethical and political philosophy hold that it is wrong to require individuals to subsidize coverage of risks qualitatively different from and/or qualitatively greater than those that they impose; in other words, these schools of thought object to the governmentally mandated shift from risk-based pricing to community rating.
- Expansion of and increase in moral hazard: Economists are concerned that the prohibition of preexisting-condition exclusion increases uninsured individuals' incentive to engage in risky behavior by removing the future unavailability of insurance as an ex ante incentive discouraging behavior that increases risks of developing those conditions. This moral hazard is independent of and in addition to the incentive toward risky behavior already existing among already-insured individuals.
- Premium cost too high for some people: There was some speculation that for single people between the ages of 18-35 costs of insurance would rise.
- Data security: Minnesota's healthcare exchange was reported to have accidentally e-mailed personal information of more than 2,400 insurance agents to an insurance broker, according to the Minnesota Star Tribune.
- Employers dropping insurance for part-timers: According to NPR, some employers such as Trader Joe's and Home Depot have decided to terminate health insurance for their part-time workers.
- Scams: Scams were expected because of confusion over enrollment.
- Restricted networks: Some exchanges have been criticized for offering health plans that necessitate too many 
- "Cherry-picking" concern: The private health insurance industry fears that restricted eligibility and a market size that is too small could result in higher premiums, encourage "cherry-picking" of customers by insurers, and force a clearance of the exchange. That is what some believe will happen in Texas and California in their failed exchanges. One of these factors, "cherry-picking" of customers, will not be possible in the state-run exchanges mandated by the ACA, because all insurance plans will be "guaranteed issue" in 2014. Furthermore, the law will bring millions of new enrollees into the marketplace by way of the individual mandate requirement for all citizens to purchase health insurance and increase market size.
- Some marketplace web sites require enrollment as the first step to looking up any information.
Health insurance marketplace Congressional reaction
On October 29, 2013, Rep. Lee Terry (R, NE-2) introduced the Exchange Information Disclosure Act (H.R. 3362; 113th Congress). The bill would require the United States Department of Health and Human Services to submit weekly reports to Congress about the how many people are using Healthcare.gov and signing up for health insurance. These reports would be due every Monday until March 31, 2015, and would be available to the public. The bill would "require weekly updates on the number of unique website visitors, new accounts, and new enrollments in a qualified health plan, as well as the level of coverage," separating the data by state. The bill would also require reports on efforts to fix the broken portions of the website. The House was scheduled to vote on it on January 10, 2014.
Health insurance marketplace Private health insurance exchanges
A private health insurance exchange is an exchange run by a hospital networks, and budget. These exchanges are sometimes called marketplaces or intermediaries, and work directly with insurance carriers, effectively acting extensions of the carrier.
The idea of a health care exchange is not new. One example of an early health care exchange is First Tennessee National Corp (now First Horizon).
Health insurance marketplace See also
Health insurance marketplace References
- ^ "What is the Health Insurance Marketplace?". Healthcare.gov.
- ^ Lewis, Nicole (July 12, 2011). HHS Proposes Health Insurance Exchange Rules. InformationWeek.
- ^ Acosta, Jim; Cohen, Tom (December 31, 2013). "More than 2 million enrolled under Obamacare". CNN.
- ^ "State Decisions For Creating Health Insurance Exchanges, as of May 28, 2013 - Table". Kaiser Family Foundation. May 28, 2013.
- ^ "State Decisions For Creating Health Insurance Exchanges, as of May 28, 2013 - Map". Kaiser Family Foundation. May 28, 2013.
- ^ Hass, Christopher (June 3, 2009). "President Obama Reiterates Support for Public Option and Health Insurance Exchange". Obama for America. Archived from the original on August 20, 2012. Retrieved February 7, 2014.
- ^ a b Grier, Peter (March 10, 2010). "Health care reform bill 101: What's a health 'exchange'?". Christian Science Monitor.
- ^ "Welcome to the Marketplace". Healthcare.gov.
- ^ "What is the Health Insurance Marketplace?". Healthcare.gov.
- ^ Luhby, Tami (April 23, 2013). "Millions eligible for Obamacare subsidies, but most don't know it". CNN.
- ^ "Establishing Health Insurance Marketplaces: An Overview of State Efforts". Kaiser Family Foundation. May 2, 2013.
- ^ "How can I get ready to enroll in the Marketplace?". Healthcare.gov. Archived from the original on June 26, 2013.
- ^ Morgan, David; Begley, Sharon (September 30, 2013). "Obamacare push accelerates as government shutdown nears". Reuters. Retrieved October 1, 2013. "Sebelius said on Monday that 'the key date really is the 15th of December,' the deadline for buying coverage that starts on January 1."
- ^ "Glossary: Open Enrollment Period". Healthcare.gov. Retrieved October 4, 2013.
- ^ Young, Jeffrey (September 25, 2013). "Obamacare Benefits Enrollment Will Start Slowly, White House Predicts". The Huffington Post. Retrieved October 2, 2013.
- ^ Cohn, Jonathan (August 5, 2013). "Burn Your Obamacare Card, Burn Yourself". The New Republic.
- ^ Goldstein, Amy (2010). "Priority One: Expanding Coverage". In The Staff of the Washington Post. Landmark: The Inside Story of America's New Health-Care Law and What It Means for Us All. New York: Public Affairs. pp. 73–83. ISBN 9781410428998.
- ^ "I have been denied coverage because I have a pre-existing condition. What will this law do for me?". Health Care Reform Frequently Asked Questions. New Hampshire Insurance Department. p. 2. Retrieved June 28, 2012.
- ^ Binckes, Jeremy; Wing, Nick (March 22, 2010). "The Top 18 Immediate Effects Of The Health Care Bill". The Huffington Post. Retrieved March 22, 2010.
- ^ "What does Marketplace health insurance cover?". Healthcare.gov.
- ^ "Minimum Coverage Provision". American Public Health Association.
- ^ a b "Technical Explanation of The Revenue Provisions of the Reconciliation Act of 2010, as Amended, in Combination With the Patient Protection And Affordable Care Act". Joint Committee on Taxation. March 21, 2010. "Generally, in 2010, the filing threshold is $9,350 for a single person or a married person filing separately and is $18,700 for married filing jointly."
- ^ Doyle, Brion B. (March 5, 2013). "Understanding the Impacts of the Patient Protection and Affordable Care Act". The National Law Review. Retrieved 17 April 2013.
- ^ a b Galewitz, Phil (March 26, 2010). "Consumers Guide To Health Reform". Kaiser Health News.
- ^ Downey, Jamie (March 24, 2010). "Tax implications of health care reform legislation". The Boston Globe. Retrieved March 25, 2010.
- ^ Luhby, Tami (August 13, 2013). "Uninsured next year? Here's your Obamacare penalty". CNN.
- ^ Kliff, Sarah; Klein, Ezra (March 27, 2012). "Individual mandate 101: What it is, why it matters". Wonkblog at the Washington Post. Retrieved July 2, 2012.
- ^ "Requirement to maintain minimum essential coverage". Cornell University Law School Legal Information Institute. September 18, 2013. "Described in 26 USC § 5000A(f)(4)(A)"
- ^ Sahadi, Jeanne (June 29, 2012). "How health insurance mandate will work". CNN. Retrieved July 12, 2013.
- ^ "2013 Poverty Guidelines". United States Department of Health and Human Services.
- ^ a b Rice, Sabriya (March 25, 2010). "5 key things to remember about health care reform". CNN. Retrieved May 21, 2010.
- ^ a b "Medicaid Expansion: 5. Is Medicaid eligibility expanding to 133 or 138 percent FPL, and what is MAGI?". American Public Health Association.
- ^ Luhby, Tami (July 1, 2013). "States forgo billions by opting out of Medicaid expansion". CNN.
- ^ "Is Medicaid Expansion Good for the States?". U.S. News & World Report.
- ^ Kliff, Sarah (April 25, 2013). "The outlook for Medicaid expansion looks bleak". Washingtonpost.com. Retrieved July 17, 2013.
- ^ a b MacGillis, Alec (2010). "The Insurers: More Customers, More Restrictions". In The Staff of the Washington Post. Landmark: The Inside Story of America's New Health-Care Law and What It Means for Us All. New York: Public Affairs. pp. 93–98. ISBN 9781410428998.
- ^ Peterson, Chris L.; Gabe, Thomas (April 6, 2010). "Health Insurance Premium Credits Under PPACA (P.L. 111-148)". Congressional Research Service.
- ^ Galewitz, Phil (March 22, 2010). "Health reform and you: A new guide". msnbc.com. Retrieved March 23, 2010.
- ^ Grier, Peter (March 20, 2010). "Health care reform bill 101: Who gets subsidized insurance?". The Christian Science Monitor.
- ^ wikisource:Patient Protection and Affordable Care Act/Title I/Subtitle E/Part I/Subpart A
- ^ a b Patient Protection and Affordable Care Act: Title I: Subtitle E: Part I: Subpart A: Premium Calculation
- ^ "Refundable Tax Credits". Bread for the World Institute. Archived from the original on March 5, 2012.
- ^ "Health Insurance Premium Tax Credit". Federal Register (Washington, D.C.: Government Printing Office) 77 (100): 30377–30400. May 23, 2012.
- ^ a b "Treasury Lays the Foundation to Deliver Tax Credits to Help Make Health Insurance Affordable for Middle-Class Americans" (Press release). United States Department of the Treasury. August 12, 2011.
- ^ Pear, Robert (August 12, 2013). "A Limit on Consumer Costs Is Delayed in Health Care Law". The New York Times.
- ^ Cohn, Jonathan (August 13, 2013). "The Latest Right-Wing Freakout Over Obamacare". The New Republic.
- ^ Goddard, Teagan (August 13, 2013). "Just Another Obamacare Delay". Roll Call.
- ^ Chait, Jonathan (August 15, 2013). "George Will: Now Obama Is Worse Than Nixon". New York.
- ^ a b c "Private Health Insurance Provisions in PPACA (P.L. 111-148)". Congressional Research Service. April 15, 2010.
- ^ a b "Health Insurance Premiums: Past High Costs Will Become the Present and Future Without Health Reform". Healthcare.gov. January 28, 2011. Archived from the original on January 15, 2013.
- ^ "Financing Center of Excellence | SAMHSA | Health Insurance Premiums: Past High Costs Will Become the Present and Future Without Health Reform". Substance Abuse and Mental Health Services Administration. March 14, 2011. Retrieved June 29, 2012.
- ^ "Health Insurance Premium Credits Under PPACA". Congressional Research Service. April 28, 2010. Archived from the original on October 27, 20120.
- ^ "An Analysis of Health Insurance Premiums Under the Patient Protection and Affordable Care Act". Congressional Budget Office. November 30, 2009.
- ^ "Policies to Improve Affordability and Accountability". whiteHouse.gov.
- ^ "Subsidy Calculator: Premium Assistance for Coverage in Exchanges". Kaiser Family Foundation.
- ^ a b Pauly, Mark V.; Herring, Bradley (May 2007). "Risk Pooling and Regulation: Policy and Reality in Today's Individual Health Insurance Market". Health Affairs 26 (3): 770–779.
- ^ a b Waxman, Henry A.; Stupak, Bart (October 12, 2012). "Re: Coverage Denials for Pre-Existing Conditions in the Individual Health Insurance Market [Memorandum]". United States House Committee on Energy and Commerce. Retrieved December 15, 2012.
- ^ Hall, Jean P. (October 19, 2010). "Affordable Care Act Options for People with Preexisting Conditions". The Commonwealth Fund.
- ^ Vesely, Rebecca (February 28, 2011). "States try it again". Modern Healthcare 41 (9): 17.
- ^ "Compilation of Patient Protection and Affordable Care Act". Office of the Legislative Counsel. June 9, 2010.
- ^ "How do I choose Marketplace insurance?". Healthcare.gov. Retrieved October 28, 2013. "There are 5 categories of Marketplace insurance plans: Bronze, Silver, Gold, Platinum, and Catastrophic."
- ^ Somashekhar, Sandhya; Kliff, Sarah (September 24, 2013). "Premiums unveiled show wide range for health overhaul plans". The Seattle Times.
- ^ Japsen, Bruce (June 17, 2012). "Mandate To Buy Coverage: Health Insurance Industry's Idea, Not Obama's". Forbes. Retrieved February 7, 2014.
- ^ "Individual Responsibility - Glossary". Healthcare.gov. Archived from the original on June 19, 2013. Retrieved 3 June 2013.
- ^ "The CBO report does not show the new health-care law is failing". The Washington Post. February 7, 2014.
- ^ Dimick, Chris (June 1, 2010). "Accrediting HIEs". Journal of AHIMA.
- ^ Mangan, Dan (October 4, 2013). "99% of Obamacare applications hit a wall". CNBC.
- ^ "How can I find out if I can get lower costs on coverage?". Healthcare.gov.
- ^ Mullaney, Tim (October 6, 2013). "Obama adviser: Demand overwhelmed HealthCare.gov". USA Today.
- ^ "State Health Insurance Exchanges".
- ^ Blumberg, Linda J.; Pollitz, Karen (April 1, 2009). "Health Insurance Exchanges: Organizing Health Insurance Marketplaces to Promote Health Reform Goals". Urban Institute.
- ^ Lohr, Kathy (October 5, 2013). "Glitches Slow Health Exchange Sign-ups". NPR.
- ^ Goldstein, Amy; Sun, Lena H.; Somashekhar, Sandhya (October 1, 2013). "Rush of interest continues on insurance Web sites". The Washington Post.
- ^ a b c d e Westneat, Danny (October 8, 2013). "Obamacare is here, GOP, ready or not". The Seattle Times.
- ^ Auerbach, David (October 8, 2013). "What really went wrong with healthcare.gov?". Slate. Retrieved February 7, 2014.
- ^ Periroth, Nicole (October 2, 2013). "Problems at Health Care Web Site Not From Online Attack, Experts Say". New York Times.
- ^ Landa, Amy Snow (October 21, 2013). "Washington Healthplanfinder: more than 35,000 have enrolled in 3 weeks". The Seattle Times.
- ^ Somashekhar, Sandhya; Goldstein, Amy; Eilperin, Juliet (October 23, 2013). "Americans will have an extra six weeks to buy health coverage before facing penalty". The Washington Post.
- ^ "Status of State Action on the Medicaid Expansion Decision, as of July 1, 2013 - Table". Kaiser Family Foundation. June 20, 2013.
- ^ "Status of State Action on the Medicaid Expansion Decision, as of July 1, 2013 - Map". Kaiser Family Foundation. June 20, 2013.
- ^ Allen, Greg (October 1, 2013). "In Florida, Insurer And Nonprofits Work On Enrollment". NPR.
- ^ "Subsidy Calculator". Kaiser Family Foundation.
- ^ Bastasch, Michael (October 3, 2013). "Study: Obamacare spikes young people’s health insurance costs". The Daily Caller.
- ^ Condon, Stephanie (October 2, 2013). "Obamacare marketplaces raise data security concerns". CBS.
- ^ Ydstie, John (October 4, 2013). "Part-Time Workers Search New Exchanges For Health Insurance". NPR.
- ^ Thompson, Connie (September 30, 2013). "Scammers newest ruse: Health care reform". KLEW-TV.
- ^ Tarpley, Tiffany (October 1, 2013). "Protecting yourself from healthcare law scams". WDJT-TV.
- ^ Landa, Amy Snow (October 4, 2013). "Left off many networks, Seattle Children’s sues". The Seattle Times.
- ^ McGarr, Cappy (October 5, 2009). "A Texas-Sized Health Care Failure". The New York Times. Retrieved October 6, 2009.
- ^ John, Arit (October 11, 2013). "The Two Scenarios That Would Have Improved the Obamacare Launch". The Wire.
- ^ "H.R. 3362 - All Actions". United States Congress. Retrieved January 7, 2014.
- ^ a b c Kasperowicz, Pete (January 4, 2014). "House GOP to demand O-Care updates". The Hill. Retrieved January 7, 2014.
- ^ "Text of H.R. 3362". GovTrack. Retrieved January 7, 2014.
Health insurance marketplace External links
- See "Clips" tab then "Clips Timeline" drop-down for abstracts of edited clips from the following videos:
- Health Care Law Exchanges Apr 22, 2013, Jenny Gold, Kaiser Health News correspondent, Interview
- Report Video Issue Health Insurance Exchanges Jul 25, 2013, Politico Pro Health Care Breakfast Briefing
- Update on the Health Care Law Jul 1, 2013, Julie Rovner, National Public Radio health policy correspondent, Interview