Technology Opportunities for the ACA Marketplaces

Prepared with support from the Robert Wood Johnson Foundation

Technological innovation has always been at the center of the Affordable Care Act (ACA) Marketplaces and has never been more important than it is now. Changes brought on by the coronavirus pandemic have clearly illustrated a critical need to expand outreach and provide coverage to millions of people who have lost their employer-based insurance and may be best served by Medicaid or Marketplace coverage. Technology is one part of meeting this challenge, and the ACA Marketplaces have made important technological gains that can help do so.

In “Technology Opportunities for the ACA Marketplaces,” a new policy brief developed with support from the Robert Wood Johnson Foundation, Manatt Health’s Joel S. Ario and Amy Zhan explore the evolution of the Marketplaces from a technology perspective, drawing from interviews conducted with state Marketplace leaders, technology companies and consumer advocates. While there has been a resurgence in states transitioning to State-based Marketplace (SBM) status over the past two years, the Biden Administration could change the calculus for some states by pursuing a stronger role for Healthcare.gov in driving coverage improvements. For some states, the best option might be an SBM on the federal platform (SBM-FP), a hybrid option that combines the local control elements of an SBM with reliance on Healthcare.gov as a technology platform.

The paper is divided into three sections covering the history of the Federally Facilitated Marketplace (FFM) and SBM tracks, the technology opportunities available today, and the choices states have, given the current state of technology. The paper also includes a series of recommendations and considerations on what the Biden Administration could do to make the FFM a better partner for the states and how states can best navigate their options within the FFM and SBM tracks as those tracks evolve.

To access the full policy brief, click here.

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