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Health Insurance

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NCSL Coronavirus (COVID-19) Resources

NCSL is committed to providing our members with timely responses to state research requests and the essential knowledge needed to guide state action regarding the coronavirus. This page tracks state and federal action related to coronavirus, including introduced and enacted bills and appropriations.

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Stabilizing the Individual Health Care Market

The individual health care market established by the Affordable Care Act is experiencing increasing premiums and declining enrollment. Some states are attempting to stabilize the market by establishing reinsurance programs, mandating coverage or providing subsidies, while others are working on alternative health insurance plans.

HEALTH INSURANCE

Health Insurance

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Health Reinsurance

Health insurance coverage and affordability continues to be a top issue across the country, with states increasingly taking the lead in helping more residents obtain insurance at reasonable rates. Federal Section 1332 waivers allow states to establish a reinsurance program to help lower premiums.

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Legislation Related to 1332 Waivers

Learn how states can use "Section 1332" health innovation waivers to go beyond the current features in parts of the Affordable Care Act.

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Overview

Back in 2013 some 197 million Americans had commercial or private market health insurance, through employers, individual purchases or policies with public subsidies. Since then federal health reform has added to existing state regulation, mandates and consumer protections. ACA-authorized Health insurance Marketplaces or Exchanges led to about 12 million individuals obtaining new health policies between October 2013 and winter 2018 and an HHS calculation of 218 million with such coverage. The past two years included complexities with the repeal of the individual mandate to have insurance and the administration decision to withhold all payments for lower-income subsidies termed "CSR" payments. Large employers continue to have a requirement to offer health insurance, while smaller employers can obtain an incentive subsidy if they opt to offer coverage. NCSL has extensive information describing current laws, pending bills and latest federal guidance and rules from HHS.