What type of exchange does my state have?

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What type of health insurance exchange does my state have?

  • December 7, 2016

Q: What type of health insurance exchange does my state have?

A: As of 2017, there are 12 state-based marketplaces, five state-based marketplaces that use the federal platform (SBM-FP), six state-federal partnership marketplaces, and 28 federally-run marketplaces.

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Open enrollment for 2017 began on November 1, 2016, and there were some changes in the structure of a few exchanges at that point:

  • Arkansas switched from having a state-federal partnership exchange to an SBM-FP.
  • Hawaii switched from an SBM-FP to the federally-run exchange
  • Kentucky switched from a state-based exchange to an SBM-FP

From a user perspective, the enrollment platform in Kentucky has changed from Kynect to HealthCare.gov. But users aren’t likely to notice a difference in Hawaii or Arkansas, where enrollees are continuing to use HealthCare.gov, just as they did for 2016.

There have been other transitions since the marketplaces first opened for business in the fall of 2013.  Idaho used HealthCare.gov for enrollment in 2014, but switched to being a fully state-run exchange prior to the 2015 open enrollment period.

Nevada and Oregon both had state-run exchanges in 2014, but due to technical difficulties they both opted to become federally-supported state-based exchanges prior to the 2015 open enrollment period (the enrollment platform is HealthCare.gov, but the state still retains control over its own exchange). For 2016, Hawaii opted to do the same thing, and enrollments in Hawaii have been completed through Healthcare.gov. since November 2015. But for 2017, Hawaii has dropped the state-based aspect of their exchange.

Federal

Alabama
Alaska
Arizona
Florida
Georgia
Hawaii
Indiana
Kansas*
Louisiana
Maine*
Mississippi (state operates small business – SHOP – exchange)
Missouri
Montana*
Nebraska*
New Jersey
North Carolina
North Dakota
Ohio*
Oklahoma
Pennsylvania
South Carolina
South Dakota*
Tennessee
Texas
Utah (state operates small business – SHOP – exchange)
Virginia*
Wisconsin
Wyoming

States with an asterisk have a marketplace plan management exchange.  Their exchanges are federally-run, but the state retains oversight of the plans, and is active in certifying QHPs for sale in the exchange.

State

California
Colorado
Connecticut
District of Columbia
Idaho
Maryland
Massachusetts
Minnesota
New York
Rhode Island
Vermont
Washington

State-based, federal platform (SBM-FP)

Arkansas (state runs its own small business SHOP exchange)
Kentucky
Oregon
Nevada
New Mexico (state runs its own small business SHOP exchange).



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