Health Insurance Exchanges 2.0

An examination of ACA implementation across all 50 states.

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Data to measure each state’s key implementation decisions.

State variation in ACA implementation can have important implications for the effectiveness of the law both nationally and within each individual state.

With funding from the Robert Wood Johnson Foundation and the Alfred P. Sloan Foundation, the HIX Research Group at the Leonard Davis Institute of Health Economics of the Wharton School at the University of Pennsylvania and collaborators at other institutions launched the Health Insurance Exchanges (HIX) 2.0 project to examine variation in implementation of the ACA across all 50 states. HIX 2.0 consists of multiple datasets that track each state’s key implementation decisions.

Data collection for HIX 2.0 is an ongoing process with data being collected primarily via primary sources such as statutes and other regulatory decisions, but also from official gubernatorial press releases and other reliable news sources to ensure that the quickly changing nature of exchange implementation is being addressed. Datasets will be posted regularly on this site as they are completed, and completed datasets will be updated, and in some cases combined, as implementation moves forward. Analyses of these datasets can provide insight into what exchange features are most effective and what factors explain state variation.

Completed datasets:

Forthcoming datasets:

  • Insurance Market Characteristics: Infrastructures and interplay between various health insurance markets, including the various exchanges.
  • Adjusted Community Ratings: The extent that states implement ACA rules regarding premium rates.
  • Geographic Scope of Rate-Setting Areas: As above, but specific to the geographic differences in premiums.
  • Brokers: Role of insurance brokers and agents on the exchanges.
  • Determination of Essential Health Benefits: Variation in amount and kind of EHBs offered in a state.
  • Financial Management and Operation of the Exchanges: Variation in budgets and oversight of those budgets between exchanges.
  • Qualified Health Plan Selection and Certification: Substantive content of plans, as well as the variation between plans within and among the states.
  • Risk Adjustment Strategy: How states account for their exchange enrollees' health status and health spending.
  • Small Business Insurance Health Option Program: How participation rules on the small business exchanges vary between states, as well as their relationship to the individual exchanges.

 

Note: If you are using the HIX 2.0 data for research purposes please be sure to include proper citation for the data. Suggested citations are provided on each dataset's website. 

As implementation continues to roll out and implementation decisions are made, the HIX 2.0 datasets will be regularly updated. The date the datasets were last updated will be specified on each dataset's website.

The creation of the datasets is a work in progress. We welcome your suggestions. Please contact Gabbie Nirenburg at gni@wharton.upenn.edu with any questions, comments, or ideas for improvement in the datasets. The datasets are regularly updated and we will attempt to incorporate your comments. 

 

 

Resources

Monitoring & Tracking Series

The Urban Institute monitors, tracks and analyzes trends across diverse states on key health reform implementation issues.

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Quick Strike Series

Urban Institute Quick Strikes are a series of timely briefs that examine a variety of health insurance coverage issues in the United States.

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SHADAC State Health Access Data Assistance Center

SHADAC helps states to monitor rates of health insurance coverage and provides technical assistance.

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Read the Brief

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Final Enrollment Rates Show Federally Run Marketplaces Make Up Lost Ground at End of Open Enrollment

Final enrollment figures reveal that the federally facilitated marketplaces and some of the troubled state-based marketplaces made up some ground in the last four to six weeks of the open enrollment period.

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