2014 key-features-timelineStarting in 2014, consumers and small businesses in every state will have access to quality, affordable health insurance ­­– known as qualified health plans – offered through an Exchange – a marketplace where consumers can choose a private health insurance plan that fits their health needs.

The marketplace will provide consumers and small businesses one stop shopping for health insurance with better information about plan benefits, quality and cost­­ – simplifying the process for buying health insurance.

obama affordable-care-actOn March 23, 2010, President Obama signed the Affordable Care Act.

The law puts in place comprehensive health insurance reforms that will roll out over four years and beyond.


  • Coming in 2013: Affordable Insurance Exchanges  –  An Exchange is a new transparent and competitive insurance marketplace where individuals and small businesses can buy affordable and qualified health benefit plans. Open enrollment begins in the Fall of 2013.
  • Coming in 2014: Tax Credits for Families –  Tax credits to help the middle class afford insurance will become available for those with income between 100% and 400% of the poverty line who are not eligible for other affordable coverage.

Last week marked a milestone for states setting up their own marketplace – it was the deadline to submit their Blueprint applications to run a type of marketplace called a State-based Exchange. We have received State-based Exchange Blueprint applications from the following states: California, Hawaii, Idaho, Minnesota, Mississippi, Nevada, New Mexico, Rhode Island, Vermont, and Utah. We look forward to reviewing these applications, as well as working with other states as they continue to develop a marketplace that best meets the needs of their residents.

On Friday, we also announced that the District of Columbia, Kentucky, and New York have made significant progress setting up their marketplaces, and conditionally approved their plans. These states are on track to meet all exchange deadlines and be ready for open enrollment in ten months. Previously, HHS conditionally approved Colorado, Connecticut, Massachusetts, Maryland, Oregon, and Washington.

2014-promotingindividualresponsibilityWe know that some states will need more time before being ready to run their own marketplace or want to run part but not all of the exchange in 2014. These states can choose to enter into a State Partnership Exchange in which the State assumes responsibility for plan management and/or consumer assistance. A partnership exchange allows states to make key decisions and tailor the marketplace to local needs and market conditions. States have until February 15, 2013 to choose a state partnership exchange.

Many states have received planning and establishment grant awards to help them modernize and develop IT systems and the business systems needed for exchange establishment. We recently released the Health Insurance Market Rules, Essential Health Benefits Rules, and Payment Parameters Notice to ensure states have more information to continue their work. We will continue to provide states with as much support and guidance as they need.

We continually strive to give states the resources, flexibility and guidance to design and build a marketplace that meets the needs of their state. While last week was one milestone, we are not taking an “all or nothing” approach to exchanges. Many states are making impressive progress and we are committed to working with all states as we approach open enrollment in October 2013.


We’re looking forward to January 1, 2014, when consumers and small businesses will be enrolled through the Exchanges in private health insurance plans and millions more Americans will have the coverage they need and deserve.

(AIDS.gov Note: For more information on the Affordable Care Act and people living with HIV, read this fact sheet (PDF) and blog post.)


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