Health Insurance Marketplaces

To increase options for health insurance coverage, the ACA created new health insurance marketplaces:

Individual insurance marketplaces — online exchanges where eligible individuals and families can buy coverage. States may operate these or ask the federal government to do so.

Small business insurance marketplaces — online exchanges to help firms with 50 or fewer employees cover their workers.

RAND work in this area has been assessing consumer behavior in these marketplaces, including how various modifications to the ACA would affect individual market premiums and overall insurance coverage, and how the ACA affects the number of small business employees receiving employer offers of coverage. The RAND Health Reform Opinion Study has allowed us to examined how adults transitioned between sources of coverage during the ACA's first two enrollment periods.

RAND has also developed tools and metrics to help guide employers in selecting plans and making informed choices about health plan selection.

But enrolling in an insurance plan is only the first step for consumers. In a series of interviews with insurance companies, provider groups, and community organizations, researchers identified some of the barriers patients face in actually connecting to the health care system, including low health literacy and low insurance literacy.

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