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Health Care Reform:

Health Insurance & Affordable Care Act

State Didn't Set Up a Marketplace? Relax

Not all states created their own  Marketplace for health insurance. If your state didn't set up a Marketplace, what does that mean for you?

No matter which state you live in, you can buy insurance through a Marketplace.

The way you use the Marketplace will be similar in every state. You'll access a web site, or call, or see someone in person. And you'll have tools to compare health plans.

But Marketplaces won't be the same in every state. There are three ways your state's Marketplace can be managed -- and this affects your choice of health plans and coverage.

State-run Marketplaces

States that created their own Marketplaces have a lot of local control.

Each state decides which insurance companies can sell policies on its Marketplace.

States also choose the core benefits each plan has to offer. They can set extra requirements for health plans, like benefits that are more generous or more affordable limits on your out-of-pocket costs.

The state is also in charge of getting people to use the Marketplace.  

Partnerships Between a State and the Government

A few states teamed up with the federal government to develop Marketplaces. 

The federal government:

  • Sets up the Marketplace web site and in-person sites
  • Decides which health plans will be sold in the partner state
  • Sets the benefit levels
  • Runs the Marketplace

The states:

  • Monitor health plans
  • Help people find the best insurance for their needs
  • Handle complaints

Federal-run Marketplaces

Some states decided not to set up their own Marketplaces. In those states, the federal government is running the marketplaces directly. It makes all the decisions: how the Marketplace will work, what plans are sold, and how to promote the Marketplace. You can get to those marketplaces through Healthcare.gov.

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