Federal Marketplace Access and the Coverage Gap
The federal marketplace access is the online shop where individuals and families without access to employer-sponsored coverage can compare plans. It’s also where they can find financial assistance programs, like premium tax credits and cost-sharing subsidies, that help lower their monthly plan costs. The Marketplace offers ACA-compliant plans, without medical underwriting or pre-existing condition exclusions. It’s also where people can apply for Medicaid and the Children’s Health Insurance Program (CHIP).
While a significant part of the population receives Marketplace assistance, others purchase coverage through their employers or private insurers. Some are in the “coverage gap” — their incomes are too high to qualify for Medicaid but too low to receive Marketplace subsidies. And in the ten states that haven’t expanded Medicaid, more than 1.5 million people remain uninsured.
Access the Federal Marketplace Through the GSA Schedule
Since launching in 2014, the ACA has helped reduce the number of uninsured. These gains have come from a variety of mechanisms, including expanding eligibility for the ACA’s public insurance mechanisms, creating and operating state marketplaces, and establishing individual mandates and related enforcement mechanisms.
In our recent paper, we use a new and more precise data set to measure how well state marketplaces have served their constituents, by analyzing changes in the share of the population covered by each type of coverage. We also examine how different marketplace designs (e.g., whether a state has its own marketplace, or uses the federal platform) affects those outcomes. As the year 2024 progresses, we expect that these findings will be useful to both state and federal officials in assessing whether their current marketplace models continue to serve the needs of their constituents.…