ACA Health Insurance Marketplaces: Enhancing State-Federal Dialogue and Preparing for the New Administration


The upcoming presidential election is sure to have implications for the future of the Affordable Care Act’s health insurance marketplaces. Depending on the outcome, the new administration may simply focus on changes that address technical issues or instead may seek to dramatically reform or even abolish current state marketplaces. The bipartisan National Governors Association’s Center for Best Practices is uniquely situated to inform the incoming administration—regardless of its chosen strategy—about states’ experiences with the range of marketplace structures and the likely effects of proposed reforms. The NGA is also well situated to make state-responsive recommendations for the future. The Center for Best Practices will convene three workgroups for states, organized by the marketplace model they use—federally facilitated, state-based, or state-based using the federal platform. The workgroups will focus on key operational issues and challenges, as well as areas for discussion with federal partners. Topics might include: transitioning between exchange models, vendor contracting, or support for states using the federal platform. Workgroups will maintain the flexibility to address other needs as the new administration establishes its agenda. States will receive technical assistance from NGA, as requested, and have opportunities to learn from each other. NGA also will host a regional meeting or experts’ roundtable with state and federal policymakers to develop a set of recommendations for the incoming administration.

Grant Details

Grantee Organization:
National Governors Association Center for Best Practices
Principal Investigator:
Frederick Isasi, J.D., M.P.H.
Award Amount:
Approval Date:
April 12, 2016

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