It’s the third year these marketplaces, also called exchanges, have been running. The marketplaces are the go-to option for people under 65 who don’t get health insurance through work or qualify for Medicaid.
This time around, there’s a last-minute wrinkle: The Trump administration has halted advertising and outreach for HealthCare.gov, the federally run exchange, in the last week of enrollment, when sign-ups typically surge.
But the states that control their own exchanges also control their own promotion and, for now, their destiny.
All told, 11 states and the District of Columbia run their own marketplaces. Under the ACA, the marketplaces were supposed to become self-sustaining businesses within a few years, supported by fees insurers pay to offer plans on the sites.
But the election of Donald Trump as president and Republican majorities in both houses of Congress mean that proposition, like the rest of the health law, is now in doubt.
Here’s what five exchange chiefs are looking at now and for the future.
Peter Lee, executive director, Covered California
More than 5 million Californians — about a quarter of all Americans now covered under Obamacare — gained insurance either through Medicaid expansion or on the state’s exchange, called Covered California.
With the Affordable Care Act now on the political chopping block, California has a lot to lose.
But Covered California’s executive director, Peter Lee, says he is planning for a different scenario. He hopes to position California as a leader in a new model for health coverage nationwide.
“I do think that we have a number of the ingredients of what can make the individual market work,” Lee says. “And we want to take those lessons to members of Congress and to policy leaders.”
In particular, Lee believes California’s market-based approach is one that would …