CRS — Private Health Plans Under the ACA: In Brief

October 1, 2013

Private Health Plans Under the ACA: In Brief (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

The Patient Protection and Affordable Care Act (ACA, P.L. 111-148), as amended, expands federal private health insurance market requirements, and requires the creation of health insurance exchanges (marketplaces) to provide certain individuals and small employers access to private insurance, among other provisions. While some of ACA’s private insurance provisions have already become effective, full implementation begins in 2014 and beyond. Given the breadth of ACA’s reforms to the existing private insurance market and creation of new health insurance marketplaces, there is interest in understanding what types of health plans may be offered once these ACA provisions are fully implemented.

This report provides short descriptions of health plans1 that may be offered inside and outside of exchanges, and includes information about interaction with other selected ACA provisions. The descriptions are displayed in a side-by-side format to facilitate comparison of exchange and nonexchange plans. This report does not attempt to identify all forms of health insurance coverage, but does address all plan types specified under ACA’s exchange provisions, as well as major medical plans and certain limited benefit plans offered outside of exchanges. In addition, this report indicates the applicability of ACA’s market reforms to plans offered in the private market.

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