Health Insurance Marketplaces

Health insurance marketplaces (or "Marketplaces" (formerly Health insurance exchanges or Exchanges)) are a fundamental component of the Affordable Care Act (ACA). Section 1311 of the ACA created the Health Insurance Marketplaces to provide competitive marketplaces for individuals and small employers to directly compare available private health insurance options on the basis of price, quality, service, and other factors. The primary purpose of the Marketplaces is to enhance competition in the health insurance market, improve choice of affordable health insurance, and give small business the same purchasing clout as large business. The Marketplaces will become operational in every state by January 1, 2014, and their readiness will be evaluated by the federal Department of Health and Human Services (HHS) one year prior to opening. If a state does not receive approval or conditional approval of its Marketplace plan by January 1, 2013, a "federally-facilitated exchange" may operate in that state.

An important component of the Marketplace is the Essential Health Benefits (EHB) package, which ensures that most plans offered within the Marketplaces provide a baseline of coverage, benefits, and services to their enrollees. For more information on this component, please visit APTA's resource on EHB.

The following resources help explain the Marketplaces initiative and how it will affect providers of physical therapy services. If you have questions about this information, contact

General Resources

APTA Summaries

APTA Comments

Related APTA Resources

Other Related Resources