First implemented in 2014 as a cornerstone of the Affordable Care Act (ACA), public exchanges were envisioned as a new health insurance marketplace where millions of uninsured Americans could shop for, compare and purchase affordable, stable health coverage. The new exchanges sought to provide subsidized coverage to Americans who were not eligible for Medicaid.
Since implementation, public exchange coverage has proven to be significantly more costly and less sustainable than envisioned.
Medicaid Has Expanded Access to Care by Delivering Affordable, Stable, and Sustainable Coverage
While public exchanges have fallen short of providing consumers with affordable, high-quality, stable coverage options, the ACA’s Medicaid Expansion has succeeded in providing sustainable and effective coverage. Since 2013, more than 16 million additional people have enrolled in Medicaid.
Exchange beneficiaries, as well as the remaining uninsured, would gain the most from being in suitably managed state-based public and private market structures which are more stable, efficient, and effective than exchanges. Transitioning to a simpler, flexible, and more sustainable coverage system can help advance the important goals of providing more affordable coverage options, improving health outcomes, and achieving federal and state budget savings.