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The following 3 states are Partnership Marketplaces. In Partnership Marketplaces, states retain certain essential functionality for operating an insurance marketplace. Arkansas; Georgia; Oregon; State-Based Marketplaces (SBM) Manage Marketplace functions, but rely on Healthcare.gov platform to manage their eligibility and enrollment functions.
The Affordable Care Act has had huge ramifications on self-funded health plans; market reforms have invalidated many plan designs that were previously used, and now that employees are required to have health insurance and many employers are required to offer health benefits as well, [3] the self-funded industry has enlarged.
Of the subtypes of health insurance coverage, employer-based insurance remained the most common, covering 55.1 percent of the population for all or part of the calendar year. Between 2017 and 2018, the percentage of people covered by Medicaid decreased by 0.7 percentage points to 17.9 percent.
States regulate the content of health insurance policies and often require coverage of specific types of medical services or health care providers. [67] [68] State mandates generally do not apply to the health plans offered by large employers, because of the preemption clause of the Employee Retirement Income Security Act.
The U.S. Department of Health and Human Services (HHS) estimated that 20.0 million adults (aged 18–64) gained healthcare coverage via ACA as of February 2016; [6] similarly, the Urban Institute found in 2016 that 19.2 million non-elderly Americans gained health insurance coverage from 2010 to 2015. [203]
But, "for people in poor or fair health, the chances of losing coverage are much greater for people who had small-group insurance than for those who had individual insurance." The authors attribute these results to the combination in the individual market of high costs and guaranteed renewability of coverage.
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