State legislatures have considered bills regarding health insurance exchanges each year since the Affordable Care Act (ACA) was enacted. But the upcoming U.S. Supreme Court decision in the case of King v. Burwell, which challenges whether the ACA’s premium subsidies can be made available in states with exchanges run by the federal government, could have significant implications for states that have chosen not to operate a state-based exchange.
charts and maps
As states continue to refine the operations of their health insurance exchanges, regardless of the exchange type (state-based exchange, state partnership exchange, or federally facilitated marketplace), it's helpful to compare and contrast operational resources. This chart contains each state's resources and forms for three distinct, and fundamentally important, areas of exchange operation: applications, appeals, and taxes.
This map tracks state Medicaid expansion decisions and approaches states are taking for expanding eligibility to 138 percent of the Federal Poverty Level (FPL).
This map provides the percent of plan selections receiving premium tax credits (PTC) in each of the 34 states that use the federally facilitated marketplace, healthcare.gov. This information provides some context for the possible impact of the King v. Burwell Supreme Court decision, which may result in some or all of these individuals losing access to federal subsidies, and demonstrates that states may be affected differently based on the percentage of plan selections receiving subsidies in the state.
The Affordable Care Act (ACA) makes health insurance coverage more affordable for many Americans by providing federal premium tax credits (PTC) to eligible individuals purchasing a qualified health plan (QHP) through a health insurance marketplace with individual income below $46,680 in 2014 (or households earning under 400% of the federal poverty line).
This map highlights the extent of overlap in 2015 between issuers offering managed care plans in a state's separate Children’s Health Insurance Program (CHIP) and those offering plans in health insurance marketplaces. This map updates a 2014 map showing data from the first year marketplace coverage was available. Plans offered by the same issuer in CHIP and the marketplaces likely differ in benefits and cost sharing.
This map highlights the extent of overlap in 2014 between issuers offering managed care plans in a state's separate Children’s Health Insurance Program (CHIP) and those offering plans in health insurance marketplaces. Although plans offered by the same issuer in CHIP and the marketplace are likely to differ in benefits and cost sharing, overlap in issuers may provide an opportunity for aligning the plans to promote consistency and continuity for children who may be moving from one program to another.
The Round Two State Innovation Model (SIM) Test Awards granted by HHS to eleven states (Colorado, Connecticut, Delaware, Idaho, Iowa, Michigan, New York, Rhode Island, Ohio, Tennessee, and Washington) support state efforts to build multi-payer models of health system transformation. As noted in a previous analysis, population health improvement is an important component of the SIM awards.
Policymakers in Congress are considering the role of the Children’s Health Insurance Program (CHIP) in the context of health coverage options available under the Affordable Care Act (ACA). Federal funding for CHIP is due to end in September, 2015 without Congressional action.