The Affordable Care Act gives States the power to create their own health insurance marketplaces (Exchanges) or partner with the Federally Facilitated Marketplace to ensure that the terms of the act can be applied in a uniform and affordable way. Most of the functions and features available in the State Exchanges are similar to the FFM.
State regulations may vary from the conditions set down in the act to meet local needs but may not disadvantage the insured.
Private insurance exchanges operate in all States and are required to meet both federal and State regulations but may offer the client a wider range of providers and options, especially for those whose needs extend beyond basic healthcare
There are three different types of State Exchanges defined by how they choose to operate in the marketplace:
State Marketplace: In this case, the states operate in the marketplace specifically for individuals and their families and separately for Small Business Health Options Program (SHOP). You need to go to your state’s health insurance marketplace respective websites, enter your zip code and see all the plans available.
If you contact Healthcare.gov and enter your zip code you will be directed you to the relevant state website.
State Marketplace-Federal Platform: Some states choose to run their own marketplace but with the help of the technology platform used by the Federally Facilitated Marketplace. Essentially the consumers will be offered only the coverage they would obtain from applying for coverage through heatlhcare.gov taking into account State variations.
State Partnership- Marketplace: These are states that enter into a partnership with the FFM to offer ACA plans but may provide additional services such as consumer assistance programs. The Department of Health and Human Services (HHS) performs all the functions as set out and otherwise delivered under the FFM reglations..
12 State Marketplaces
- District of Columbia
- New York
- Rhode Island
6 State-Partnership Marketplace
- New Hampshire
- West Virginia
5 State-based Marketplace – Federal platform
- New Mexico