{ "id": "R44065", "type": "CRS Report", "typeId": "R", "number": "R44065", "active": true, "source": "CRSReports.Congress.gov, EveryCRSReport.com, University of North Texas Libraries Government Documents Department", "versions": [ { "source_dir": "crsreports.congress.gov", "title": "Overview of Health Insurance Exchanges", "retrieved": "2023-04-20T04:03:30.295669", "id": "R44065_20_2023-03-17", "formats": [ { "filename": "files/2023-03-17_R44065_ab56d26a8f0c9e97d93cdd5093a50c144cbfdd70.pdf", "format": "PDF", "url": "https://crsreports.congress.gov/product/pdf/R/R44065/20", "sha1": "ab56d26a8f0c9e97d93cdd5093a50c144cbfdd70" }, { "format": "HTML", "filename": "files/2023-03-17_R44065_ab56d26a8f0c9e97d93cdd5093a50c144cbfdd70.html" } ], "date": "2023-03-17", "summary": null, "source": "CRSReports.Congress.gov", "typeId": "R", "active": true, "sourceLink": "https://crsreports.congress.gov/product/details?prodcode=R44065", "type": "CRS Report" }, { "source_dir": "crsreports.congress.gov", "title": "Overview of Health Insurance Exchanges", "retrieved": "2023-04-20T04:03:30.293752", "id": "R44065_16_2021-04-29", "formats": [ { "filename": "files/2021-04-29_R44065_b124c6dde7eb2867470bfceeb4ea86e754305b4e.pdf", "format": "PDF", "url": "https://crsreports.congress.gov/product/pdf/R/R44065/16", "sha1": "b124c6dde7eb2867470bfceeb4ea86e754305b4e" }, { "format": "HTML", "filename": "files/2021-04-29_R44065_b124c6dde7eb2867470bfceeb4ea86e754305b4e.html" } ], "date": "2021-04-29", "summary": null, "source": "CRSReports.Congress.gov", "typeId": "R", "active": true, "sourceLink": "https://crsreports.congress.gov/product/details?prodcode=R44065", "type": "CRS Report" }, { "source_dir": "crsreports.congress.gov", "title": "Overview of Health Insurance Exchanges", "retrieved": "2023-04-20T04:03:30.293134", "id": "R44065_15_2021-02-16", "formats": [ { "filename": "files/2021-02-16_R44065_6763d9879fdaebe98abc5844573aa7a414cc2f38.pdf", "format": "PDF", "url": "https://crsreports.congress.gov/product/pdf/R/R44065/15", "sha1": "6763d9879fdaebe98abc5844573aa7a414cc2f38" }, { "format": "HTML", "filename": "files/2021-02-16_R44065_6763d9879fdaebe98abc5844573aa7a414cc2f38.html" } ], "date": "2021-02-16", "summary": null, "source": "CRSReports.Congress.gov", "typeId": "R", "active": true, "sourceLink": "https://crsreports.congress.gov/product/details?prodcode=R44065", "type": "CRS Report" }, { "source": "EveryCRSReport.com", "id": 582164, "date": "2018-06-20", "retrieved": "2018-06-22T13:08:50.243532", "title": "Overview of Health Insurance Exchanges", "summary": "The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) requires health insurance exchanges to be established in every state. Exchanges are marketplaces in which consumers and small businesses can shop for and purchase private health insurance coverage. In general, states must have two types of exchanges: an individual exchange and a small business health options program (SHOP) exchange.\nExchanges may be established either by the state itself as a state-based exchange (SBE) or by the Secretary of Health and Human Services (HHS) as a federally facilitated exchange (FFE). Some states have SBE-FPs: they have SBEs but use the federal information technology platform, including the federal exchange website www.Healthcare.gov. In states with FFEs, the exchange may be operated by the federal government alone or in conjunction with the state. States may have different structures for their individual and SHOP exchanges. \nConsumers who obtain coverage through the individual exchange may be eligible for financial assistance from the federal government. Financial assistance in the individual exchanges is available in two forms: premium tax credits and cost-sharing reductions. Small businesses that use the SHOP exchange may be eligible for small business health insurance tax credits. The tax credits assist small businesses with the cost of providing health insurance coverage to employees. \nThe ACA generally requires that health insurance plans offered through an exchange are qualified health plans (QHPs). To be a certified as a QHP, a plan must be offered by a state-licensed issuer and must meet specified requirements, including covering the essential health benefits (EHB). QHPs sold in the individual and SHOP exchanges must comply with the same state and federal requirements that apply to QHPs and other health plans offered outside of the exchanges in the individual and small-group markets, respectively. Exchanges also may offer variations of QHPs, such as child-only or catastrophic plans, and non-QHP dental-only plans. \nThis report provides an overview of the various components of the health insurance exchanges. It begins with summary information about how exchanges are structured and then discusses both individual and SHOP exchanges in terms of eligibility and enrollment, financial assistance for certain exchange consumers and small businesses, and enrollment assistance entities. The report also describes exchanges\u2019 role in certifying plans as qualified to be sold in their marketplaces and outlines the range of plans offered through exchanges. Finally, the report briefly addresses funding for the exchanges. Where applicable, the report references other CRS reports that have more information on various topics.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R44065", "sha1": "6b514672437603d82eea5a1a403c0e31cacf4bd6", "filename": "files/20180620_R44065_6b514672437603d82eea5a1a403c0e31cacf4bd6.html", "images": { "/products/Getimages/?directory=R/html/R44065_files&id=/0.png": "files/20180620_R44065_images_03e2c16a3bea5744ef2a13a79637543ff09d6e87.png" } }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R44065", "sha1": "b246fa60cc802b55b85640c16a608e2e97bc3ca1", "filename": "files/20180620_R44065_b246fa60cc802b55b85640c16a608e2e97bc3ca1.pdf", "images": {} } ], "topics": [ { "source": "IBCList", "id": 4790, "name": "Private Health Insurance" } ] }, { "source": "EveryCRSReport.com", "id": 454080, "date": "2016-07-06", "retrieved": "2016-09-09T19:15:19.904174", "title": "Overview of Health Insurance Exchanges", "summary": "The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) requires health insurance exchanges to be established in every state. Exchanges are marketplaces where individuals and small businesses can shop for and purchase private health insurance coverage. States must have two types of exchanges: an individual exchange and a small business health options program (SHOP) exchange.\nExchanges may be established either by the state itself as a state-based exchange (SBE) or by the Secretary of Health and Human Services (HHS) as a federally-facilitated exchange (FFE). In states with FFEs, the exchange may be operated solely by the federal government or in conjunction with the state.\nPersons who obtain coverage through the individual exchange may be eligible for financial assistance from the federal government. The financial assistance in the individual exchanges is available in two forms: premium tax credits and cost-sharing subsidies. Small businesses that use the SHOP exchange may be eligible for small business health insurance tax credits. The tax credits assist small businesses with the cost of providing health insurance coverage to employees. \nThe ACA generally requires that health insurance plans offered through an exchange are Qualified Health Plans (QHPs). Typically in order to be a certified as a QHP, a plan must offer the essential health benefits, comply with cost-sharing limits, and meet certain market reforms. Exchanges may also offer other types of health insurance plans such as catastrophic and dental-only plans. \nThis report provides an overview of the various components of the health insurance exchanges. The report includes summary information about how exchanges are structured, the intended consumers for health insurance exchange plans, and consumer assistance available in the exchanges, as specified in the ACA. The report also describes the availability of financial assistance for certain exchange consumers and small businesses and outlines the range of plans offered through exchanges. Moreover, the report provides a brief summary of the implementation and operation of exchanges since 2014.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R44065", "sha1": "e1de912b334116c4898bb99b91fd70b16dc368f1", "filename": "files/20160706_R44065_e1de912b334116c4898bb99b91fd70b16dc368f1.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R44065", "sha1": "8484482eeb9a82138bdb8576d704d8f1501c8297", "filename": "files/20160706_R44065_8484482eeb9a82138bdb8576d704d8f1501c8297.pdf", "images": null } ], "topics": [ { "source": "IBCList", "id": 3746, "name": "Health Care Reform" } ] }, { "source": "EveryCRSReport.com", "id": 453252, "date": "2016-06-08", "retrieved": "2016-06-21T21:06:26.310819", "title": "Overview of Health Insurance Exchanges", "summary": "The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) requires health insurance exchanges to be established in every state. Exchanges are marketplaces where individuals and small businesses can shop for and purchase private health insurance coverage. States must have two types of exchanges; an individual exchange and a small business health options program (SHOP) exchange.\nExchanges may be established either by the state itself as a state-based exchange (SBE) or by the Secretary of Health and Human Services (HHS) as a federally-facilitated exchange (FFE). In states with FFEs, the exchange may be operated solely by the federal government or in conjunction with the state.\nPersons who obtain coverage through the individual exchange may be eligible for financial assistance from the federal government. The financial assistance in the individual exchanges is available in two forms: premium tax credits and cost-sharing subsidies. Small businesses that use the SHOP exchange may be eligible for small business health insurance tax credits. The tax credits assist small businesses with the cost of providing health insurance coverage to employees. \nThe ACA generally requires that health insurance plans offered through an exchange are Qualified Health Plans (QHPs). Typically in order to be a certified as a QHP, a plan must offer the essential health benefits, comply with cost-sharing limits, and meet certain market reforms. Exchanges may also offer other types of health insurance plans such as catastrophic and dental-only plans. \nThis report provides an overview of the various components of the health insurance exchanges. The report includes summary information about how exchanges are structured, the intended consumers for health insurance exchange plans, and consumer assistance available in the exchanges, as specified in the ACA. The report also describes the availability of financial assistance for certain exchange consumers and small businesses and outlines the range of plans offered through exchanges. Moreover, the report provides a brief summary of the implementation and operation of exchanges since 2014.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R44065", "sha1": "7e1391dffb45c856b0f14443b2ad8094587a3ff0", "filename": "files/20160608_R44065_7e1391dffb45c856b0f14443b2ad8094587a3ff0.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R44065", "sha1": "7f85420e15b3f6830939dbd4bf9d28ddd97251dd", "filename": "files/20160608_R44065_7f85420e15b3f6830939dbd4bf9d28ddd97251dd.pdf", "images": null } ], "topics": [ { "source": "IBCList", "id": 3746, "name": "Health Care Reform" } ] }, { "source": "EveryCRSReport.com", "id": 443288, "date": "2015-06-30", "retrieved": "2016-04-06T18:51:35.534348", "title": "Overview of Health Insurance Exchanges", "summary": "The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) requires health insurance exchanges to be established in every state. Exchanges are marketplaces where individuals and small businesses can shop for and purchase private health insurance coverage. States must have two types of exchanges; an individual exchange and a small business health options program (SHOP) exchange.\nExchanges may be established either by the state itself as a state-based exchange (SBE) or by the Secretary of Health and Human Services (HHS) as a federally-facilitated exchange (FFE). In states with FFEs, the exchange may be operated solely by the federal government or in conjunction with the state.\nPersons who obtain coverage through the individual exchange may be eligible for financial assistance from the federal government. The financial assistance in the individual exchanges is available in two forms: premium tax credits and cost-sharing subsidies. Small businesses that use the SHOP exchange may be eligible for small business health insurance tax credits. The tax credits assist small businesses with the cost of providing health insurance coverage to employees. \nThe ACA generally requires that health insurance plans offered through an exchange are Qualified Health Plans (QHPs). Typically in order to be a certified as a QHP, a plan must offer the essential health benefits, comply with cost-sharing limits, and meet certain market reforms. Exchanges may also offer other types of health insurance plans such as catastrophic and dental-only plans. \nThis report provides an overview of the various components of the health insurance exchanges. The report includes summary information about how exchanges are structured, the intended consumers for health insurance exchange plans, and consumer assistance available in the exchanges, as specified in the ACA. The report also describes the availability of financial assistance for certain exchange consumers and small businesses and outlines the range of plans offered through exchanges. Moreover, the report provides a brief summary of the implementation and operation of exchanges in 2014 and 2015.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R44065", "sha1": "cb60a198bd7e63fbe827806d17f715009fb5bd13", "filename": "files/20150630_R44065_cb60a198bd7e63fbe827806d17f715009fb5bd13.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R44065", "sha1": "679d483e6477924e4b0b7b505ca5ca857979a780", "filename": "files/20150630_R44065_679d483e6477924e4b0b7b505ca5ca857979a780.pdf", "images": null } ], "topics": [ { "source": "IBCList", "id": 3746, "name": "Health Care Reform" } ] }, { "source": "University of North Texas Libraries Government Documents Department", "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc812546/", "id": "R44065_2015Jun10", "date": "2015-06-10", "retrieved": "2016-03-19T13:57:26", "title": "Overview of Health Insurance Exchanges", "summary": null, "type": "CRS Report", "typeId": "REPORT", "active": false, "formats": [ { "format": "PDF", "filename": "files/20150610_R44065_384afb3b28b43530c592c34347cd0c1a247e5dca.pdf" }, { "format": "HTML", "filename": "files/20150610_R44065_384afb3b28b43530c592c34347cd0c1a247e5dca.html" } ], "topics": [] } ], "topics": [ "Health Policy" ] }