Committed to improving the health and well-being of all people across every state.

NASHP Insurance Marketplace Resources

State-based health insurance marketplaces (SBMs) have emerged as successful models in delivering health insurance to consumers. They consistently outperform other states that use the federal platform in areas of enrollment, affordability, and increased plan offerings and competition. Their flexible structure allows SBMs to focus marketing and outreach efforts and promote policies that generate more health coverage choices at lower costs. The resources below explore the SBM model and how recent state and federal actions are impacting state insurance markets.

Tools

SBM Performance

State-Based Health Insurance Marketplace Performance, June 30, 2020. This slideshow details data about current state-based marketplace models, enrollment trends, premium growth, and impacts of reinsurance.

State-based Marketplace Leaders Share their Success and Growth with Federal Leaders September 23, 2019 SBM executives came to Washington DC to share how they are succeeding, sustainable, and growing in number.

Slideshow: State Marketplaces Outperform the Federal Marketplace, April 1, 2019. This slideshows examines how state-based marketplaces outperform the federal marketplace model based on enrollment, affordability, and plan competition.

Chart: Individual Enrollment in Federal and State Health Insurance Marketplaces 2018-2019, April 1, 2019. This chart illustrates how the three marketplace models performed in every state between 2018 and 2019.

Blog: Is New Jersey’s Conversion to a State-based Insurance Exchange a Harbinger?, April 1, 2019. This blog explores why states like New Jersey are considering converting to a state-based marketplace model.

Blog: State-based Exchange Directors Share their Marketplace Success with Congress, March 11, 2019. This blog explores topics shared by marketplace executives with Congressional leaders during a series of meetings in Washington, DC.

State-based Marketplace Resource List, March 6, 2019. State-based marketplace (SBM) resources highlight strategies to support market stability and affordability, the 2019 enrollment period, and how state flexibility enables their success.

Blog: State-based Marketplaces Open for Business, Dec. 19, 2018. This blog describes how SBMs are still at work, even in light of a federal district court ruling striking down aspects of the Affordable Care Act. Includes information on enrollment deadlines for each state.

Blog: How Massachusetts SHOP-ed for a New Small Group Marketplace, May 1, 2017. This blog describes how Massachusetts leveraged Washington, DC’s marketplace technology to create a joint platform for its Small business Health Options Program (SHOP).

Transitioning to an SBM

New Jersey and Pennsylvania Approve Legislation to Launch State-Based Insurance Marketplaces July 9, 2019 This blog recaps recently enacted legislation in New Jersey and Pennsylvania to transition the states to the SBM model.

Blog: So You Want to Build a State-based Marketplace? Here’s How! — Advice from Marketplace Leaders, May 21, 2019. This blog highlights advice from state-based marketplace (SBM) leaders about how to transition to the SBM model.

Webinar: So You Want to Build a State-based Marketplace? Here’s How! May 10, 2019. During this webinar, state-based marketplace (SBM) leaders from Idaho, Massachusetts, Nevada, and Washington, DC discuss what states should know if they’re considering transition to the SBM model.

Blog: Is New Jersey’s Conversion to a State-based Insurance Exchange a Harbinger?, April 1, 2019. This blog explores why states like New Jersey are considering converting to a state-based marketplace model.

Q&A Nevada’s Insurance Director Talks about Transitioning to a State-based Marketplace and Saving Millions, April 24, 2018. Q & A with Heather Korbulic, Executive Director of Nevada’s Marketplace, about the decisions driving Nevada’s conversion to the SBM model.

Blog: How Massachusetts SHOP-ed for a New Small Group Marketplace, May 1, 2017. This blog describes how Massachusetts leveraged Washington, DC’s marketplace technology to create a joint platform for its Small business Health Options Program (SHOP).

Issue Brief: Building a More Efficient Marketplace: Lessons from DC Health Link’s Experience with Open Source Code, March 21, 2016. Issue brief detailing the savings and efficiencies generated from Washington DC’s conversion to an open source system for its marketplace.

Federal Impact on Markets

State Officials Fear Final Public Charge Rule Could Deter Health Coverage Enrollment September 10, 2019 This blog reviews the Administration’s recently enacted “public charge” rule and how the rule may impact enrollment in coverage programs including Medicaid, CHIP and health insurance marketplaces.

Changes to Poverty Measure Could Disqualify Thousands from State and Federal Programs June 17, 2019 This blog examines a proposal issued by the Office of Management and Budget that could impact the annual poverty measure used to assess eligibility for several state and federal programs.

Blog: Annual Federal Insurance Rule Includes Proposals to Address Prescription Drug Cost, Feb. 11, 2019. This blog details the ways the 2020 Notice of Benefit and Payment Parameters proposes to address prescription drug costs through changes in benefit requirements and limits on coupons for prescription drugs.

Chart: Deadline Looms for State Comments on Fed’s Latest Insurance Rules, Jan. 29, 2019. This chart contains details of all the federal changes to insurance market regulations proposed under the 2020 Notice of Benefit and Payment Parameters.

Blog: New Federal Health Reimbursement Proposal Adds New Variables to State Health Insurance Markets, November 6, 2018. This blog describes how proposed regulations grant additional flexibility over the administration of Health Reimbursement Accounts (HRAs).

Blog: Administration Proposes Significant Policy Changes for State Insurance Markets through New 1332 Waiver Guidance, Oct. 23, 2018. This blog explains how new federal guidance changes the requirements for states under section 1332 State Relief and Empowerment Waivers.

Blog: Lower Cost, Short-Term Insurance Plans Approved, but at What Cost to State Markets and Consumers, Aug. 7, 2018. This blog summarizes changes to federal regulations governing short-term limited duration insurance plans, state actions to regulate these plans, and what implications these changes may have for states’ markets.

Blog: The New Association Health Plan Rule: What Are the Issues and Options for States, June 26, 2018. This blog details all the changes made under a new federal rule regulating association health plans (AHPs)

Blog: New Insurance Rules Allow States to Revise Marketplace Coverage as Rate-Filing Deadlines Near, April 17, 2018. This blog provides a detailed summary of changes made by the 2019 Notice of Benefit and Payment Parameters, the federal rule governing health insurance in 2019.

Blog: How Elimination of Cost-Sharing Reduction Payments Changed Consumer Enrollment in State-based Marketplaces, March 20, 2018. This blog provides an update on how state regulators adjusted their insurance markets in response to the federal decision to eliminate funding for the cost-sharing reduction program. An accompanying chart documents resulting shifts in enrollment by metal level in state-based marketplace states.

SBM Responses to Federal Actions
Blog: State-based Exchange Directors Share their Marketplace Success with Congress, March 11, 2019. This blog explores topics shared by SBM executives with Congressional leaders during a series of meetings in Washington, DC.

Letter: State Exchange Leaders Express Concern about Potential Rule Changes, February 19, 2019. Letter from 13 SBM executives to the U.S. Department of Health and Human Services regarding changes proposed under the 2020 Notice of Benefit and Payment Parameters.

Letter: Twelve State-based Exchanges Outline Strategies to Stabilize Individual Market, August 29, 2018. Letter from 12 SBM executives to the Senate Health, Education, Labor and Pensions Committee detailing consensus strategies to bring stability to the individual insurance market.
Letter: State-based Marketplace Directors Ask Senate Leaders to Support a Reinsurance Program, February 6, 2018. Letter from 10 SBM executives to the Senate Health, Education, Labor and Pensions Committee to support Congressional efforts to stabilize insurance markets.

How States Stabilize Markets

State Officials Fear Final Public Charge Rule Could Deter Health Coverage Enrollment September 10, 2019 This blog reviews the Administration’s recently enacted “public charge” rule and how the rule may impact enrollment in coverage programs including Medicaid, CHIP and health insurance marketplaces.

Changes to Poverty Measure Could Disqualify Thousands from State and Federal Programs June 17, 2019 This blog examines a proposal issued by the Office of Management and Budget that could impact the annual poverty measure used to assess eligibility for several state and federal programs.

Blog: Annual Federal Insurance Rule Includes Proposals to Address Prescription Drug Cost, Feb. 11, 2019. This blog details the ways the 2020 Notice of Benefit and Payment Parameters proposes to address prescription drug costs through changes in benefit requirements and limits on coupons for prescription drugs.

Chart: Deadline Looms for State Comments on Fed’s Latest Insurance Rules, Jan. 29, 2019. This chart contains details of all the federal changes to insurance market regulations proposed under the 2020 Notice of Benefit and Payment Parameters.

Blog: New Federal Health Reimbursement Proposal Adds New Variables to State Health Insurance Markets, November 6, 2018. This blog describes how proposed regulations grant additional flexibility over the administration of Health Reimbursement Accounts (HRAs).

Blog: Administration Proposes Significant Policy Changes for State Insurance Markets through New 1332 Waiver Guidance, Oct. 23, 2018. This blog explains how new federal guidance changes the requirements for states under section 1332 State Relief and Empowerment Waivers.

Blog: Lower Cost, Short-Term Insurance Plans Approved, but at What Cost to State Markets and Consumers, Aug. 7, 2018. This blog summarizes changes to federal regulations governing short-term limited duration insurance plans, state actions to regulate these plans, and what implications these changes may have for states’ markets.

Blog: The New Association Health Plan Rule: What Are the Issues and Options for States, June 26, 2018. This blog details all the changes made under a new federal rule regulating association health plans (AHPs)

Blog: New Insurance Rules Allow States to Revise Marketplace Coverage as Rate-Filing Deadlines Near, April 17, 2018. This blog provides a detailed summary of changes made by the 2019 Notice of Benefit and Payment Parameters, the federal rule governing health insurance in 2019.

Blog: How Elimination of Cost-Sharing Reduction Payments Changed Consumer Enrollment in State-based Marketplaces, March 20, 2018. This blog provides an update on how state regulators adjusted their insurance markets in response to the federal decision to eliminate funding for the cost-sharing reduction program. An accompanying chart documents resulting shifts in enrollment by metal level in state-based marketplace states.

SBM Responses to Federal Actions
Blog: State-based Exchange Directors Share their Marketplace Success with Congress, March 11, 2019. This blog explores topics shared by SBM executives with Congressional leaders during a series of meetings in Washington, DC.

Letter: State Exchange Leaders Express Concern about Potential Rule Changes, February 19, 2019. Letter from 13 SBM executives to the U.S. Department of Health and Human Services regarding changes proposed under the 2020 Notice of Benefit and Payment Parameters.

Letter: Twelve State-based Exchanges Outline Strategies to Stabilize Individual Market, August 29, 2018. Letter from 12 SBM executives to the Senate Health, Education, Labor and Pensions Committee detailing consensus strategies to bring stability to the individual insurance market.
Letter: State-based Marketplace Directors Ask Senate Leaders to Support a Reinsurance Program, February 6, 2018. Letter from 10 SBM executives to the Senate Health, Education, Labor and Pensions Committee to support Congressional efforts to stabilize insurance markets.

Search

Sign Up for Our Weekly Newsletter

* indicates required
Please enter a valid email address.
Areas of Interest