The Affordable Care Act (ACA) expands health insurance coverage options to millions of uninsured individuals, and makes significant changes to state eligibility and enrollment processes. Many of these changes were implemented by October 1, 2013, with the beginning of the first open enrollment period for health insurance marketplaces. This brief describes states’ experiences—including challenges and strategies to address them—during the first three months of open enrollment. These early state experiences help to document the evolution of health reform in the states and may prove instructive for states at different stages of ACA implementation as well as for planning for the next open enrollment period.
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