Millions of Americans have gained access to comprehensive and affordable health coverage through health insurance “marketplaces” created by the Affordable Care Act. Marketplaces provide a one-stop shopping experience on a trusted government website, allowing consumers to enroll in federally subsidized health plans that meet a common set of coverage standards.
Recent federal ACA policy changes have made it harder to enroll in marketplace coverage and dramatically more expensive, leading to the first marketplace enrollment declines since 2020. Amid federal changes, state policymakers retain a range of policy options to support marketplace coverage, for example by facilitating plan comparisons, reducing enrollment barriers, and improving coverage affordability. The interactive maps below summarize key state policy decisions that affect coverage through federal and state-run marketplaces.