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April 11, 2013

The Basics: ACA Health Insurance Exchanges

The Congressional Budget Office (CBO) estimates that approximately 30 million people will purchase their own coverage through the new insurance exchanges by 2019, and there will be roughly 15 million more enrollees in Medicaid and CHIP than is projected under current law.

The Tennessee Government's website notes, "The federal health reform requires every state to have an Insurance Exchange.... an organized marketplace where individuals [and small businesses] can search for and purchase health insurance for themselves and their family members. While the law requires each state to have an Insurance Exchange, states have the option of either running their own Exchange, or handing that authority over to the federal government."

When the American Health Benefit Exchanges for individuals and Small Business Health Options Program (SHOP) exchanges are fully in place, they will provide access to health insurance for 24-30 million Americans. The exchanges will be primarily markets where individuals and employees of small businesses will be able to ‘shop’ for a range of affordable health insurance choices. In addition, it will be a place for lower and middle-income uninsured Americans to go to apply for premium assistance tax credits and cost-sharing reduction subsidies to make health insurance affordable. The two groups will sponsor navigator programs to educate and inform health insurance consumers and to facilitate health insurance purchasing. Finally, they will play a regulatory role, requiring the Qualified Health Plans (QHPs) they offer to meet certain quality and information disclosure requirements and reviewing QHP premiums and performance.

Click here to view the status of your state on health insurance exchanges.


Before you determine how much the Affordable Care Act will cost you, have a discussion with someone who understands the details surrounding the reform. CBIZ Memphis has a specialized team of individuals trained in all facets of healthcare reform. Schedule a meeting with one of our experts by contacting Megan Murdock, 901.685.5575.

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