Health Insurance Marketplaces

The Affordable Care Act created Health Insurance Exchanges/Marketplaces, where individuals, families, and small businesses that do not provide health care coverage to their employees can learn about affordable health coverage, compare insurance plans, and enroll in coverage. As part of Marketplace coverage, many enrollees receive financial help through tax credits, increased preventive care, the right to appeal when denied coverage, and choice of doctors. Furthermore, eliminating barriers to care such as denial of benefits for pre-existing conditions ensures affordable, quality health care coverage for everyone.

Marketplaces can be created by individual states but the federal government will step in to operate the marketplace for any state that opts out. For more information on the Marketplace in your state, visit healthcare.gov.

Share Your Story on Health Care Marketplace Affordability

Have you or your patients faced challenges with Marketplace affordability? Your experiences can help inform policymakers and strengthen advocacy for more affordable coverage options. Share your story to raise awareness about how Marketplace affordability impacts self-employed individuals, rural residents, and working families.

Qualified Health Plans (QHP)

Health plans offered through the Marketplaces are known as Qualified Health Plans (QHP). The requirements for QHPs depend on the type of exchange (State-based, State Partnership and Federally Facilitated) within the state, creating some slight differences in rules that apply to participating plans. This can impact the provision of care by health centers insofar as network adequacy, contracting, and payment are concerned.

Webinar

Marketplace Open Enrollment 13: Mobilizing Health Centers to Connect Patients & Communities to Coverage

The 13th Open Enrollment Period for the federal Health Insurance Marketplace (HealthCare.gov) begins on November 1, 2025. Community Health Centers are trusted partners in connecting individuals and families to affordable coverage and care, and their role is more important than ever.

This webinar covered effective strategies for enrolling patients and community members, supporting year-round coverage retention, and ensuring access to care.

Important Links

healthcare.gov– The federal government’s health care coverage website. Individuals, families, and small businesses can sign up for insurance.

Important Resources

The State Marketplace Network is a consortium of state leaders and staff dedicated to the operation of State-based Health Insurance Marketplaces and State-based Marketplaces that use the federal platform.