text:
Feeling rules
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Feeling rules are socially shared norms that influence how people want to try to feel emotions in given social relations.[1] This concept was introduced by sociologist Arlie Russell Hochschild in 1979. Hochschild's 1983 book, "The Managed Heart: Commercialization of Human Feeling," discusses feeling rules in greater depth, especially in the occupational worlds of flight attendants and bill collectors. Hochschild draws on the work of sociologist Erving Goffman as well as labor scholar Harry Braverman to discuss the dramaturgical demands and emotional labor entailed by jobs in the service sector, in which workers must "perform" certain roles that entail abiding by certain feeling rules (e.g. "friendly and dependable"). She notes that women are more likely to have such jobs than men, and that analysis of feeling rules may therefore be especially relevant to understanding the gendered dimensions of labor. This work foreshadows themes from her later analyses of women's work, both paid and unpaid, e.g. in "The Commercialization of Intimate Life" (2003).
This work is part of the broader sociology of emotions, which notes that socialization plays an important role in how people experience, interpret, and express emotions, including the situations that evoke a range of feelings. All human beings learn certain feeling rules, but these feeling rules may differ widely depending on the society in which one grows up and one's social position and social identity, including gender and ethnic identity and socio-economic status. Feeling rules are flexible and the ways in which they impinge on one's experience in different settings influences one's personality, both in specific contexts (e.g. at work, home, school, or in different social groups) and over time.[2]
Contents
[hide]
1 Effects
1.1 Race and the workplace
1.2 Status
1.3 Gender
2 Exploitation
3 References
4 Further reading
Effects[edit]
Race and the workplace[edit]
Race not only plays an important role in the way that employees act with each other, but also how employees act toward customers based on what race they are associated with. People expect others to behave in a certain manner due to what race they identify or associate with. Race influences and changes the way we see and view others.
Roxana Harlow, a sociologist, conducted extensive research on black colleges and professors. Harlow's research showed that white college students viewed their professors as "unintelligent" and "inferior" simply because of the color of their skin and not the measurement of their knowledge. In a classroom setting, white students were shown to give black professors a hard time and question every statement that their professor made. Whereas, if they were in a classroom with a white professor that had made the same statement that a black professor had made previously, the white professor was not questioned and was viewed as knowledgeable. In spite of this baseless challenge to their authority, the black professor maintained their composure and adhered to the feeling rules demanded by the setting.
In a workplace, feeling rules are established and are expected to be followed, but there is a double standard on the feeling rules applied to the white workers versus black workers.[3]
Status[edit]
Due to feeling rules, people of lower status or standing are expected to behave in an ashamed or emotional manner versus a cold or angry manner. By showing that they are ashamed of their current standing, the people of higher status are more likely to help them out and have pity on them versus those who do not show shame or pity for their current state. People respond better to seeing people on the streets asking for money or rambling through trash to find items. People of higher standings respond back by giving that individual of lower status clothes, food, and money. Our generosity is dependent on the manner of the poor individual. A poor individual who acted in an indifferent or prissy manner would not receive any response from the financially stable individual, not because his or her current situation had changed, in fact that person is still the poor individual you saw a few minutes ago, but in fact your demeanor had changed due to feeling rules.
Feeling rules gives people the expectancy that individuals of lower status should act in a pitiful and ashamed manner just because of their standing. Feeling rules affect our status because it dictates how one should act just because of their economic/ financial standing.
An experiment was conducted to show how people would react if they saw an ad with a person who was angry about being poor and another person who was shameful about being in poverty. After viewing the ad, people were more willingly to give money to the person who ashamed about being poor versus the person who was angry about being poor. Since the individual who was angry about being in poverty broke the feeling rule of what is expected our people of lower class, little to none donations were received in their favor. People of lower status that displayed no sense of self-pity or dissatisfaction gave people of higher status a harder time to sympathize with them thus proving that expressing shame was more effective and when anger was expressed there was little to no help being provided.[4]
Gender[edit]
Around the world, males get paid more than females. Feeling rules require men and women to act a certain way, and in fear of breaking that norm, these rules stay in place. Women are associated with being sweet and innocent, whereas men are associated with being tough and strong. People are assigned jobs based on their gender. Since women are usually seen as beings that can control their anger, they are most likely enlisted in jobs that require them to use their looks or charms. Men, who are seen as tough, are usually in jobs that require them to use that toughness or anger in order to deliver some type of means.[5]
Women in traditional and middle-class families rely on men to make or give them money. In response to the men providing, the women in a sense feel as if they have to repay the men back by hugging, kissing or celebrating the man. Since the women do not have the financial capability of repaying the man, the women use emotional means in order to thank or repay the man for what he has provided for them. If the man had provided the money for the woman and she in return did not act by hugging or kissing him, she would be seen an ungrateful because the feeling rules calls for her to feel joy or happiness for what the man has done for her.
Children learn their habits and emotional skills from their parents. Men are seen as beings that are not capable of controlling their feelings or emotions because they were not taught or required to as a child. Males obtain jobs such as bill collector, taxi driver, and construction worker because many of those jobs do not rely heavily on emotional labor. Hochschild showed that male flight attendants showed more power and tolerated less abuse from passengers than female flight attendants. Since people generally associate males with being tough and associate females with being sweet, feeling rules makes them feel appalled when a women behaves in a tough manner, but when a male behaves in the same way, it is seen as acceptable.[5]
Exploitation[edit]
A large portion of workers have jobs or careers that requires them to use their feelings, or "emotional labor" as Hochschild calls it, in the workplace. Their reactions and actions are based on the way they see how other people react or express their feelings. Companies and corporations see this and use it to exploit workers in order to maximize profits.[5]
Hochschild gives a clear example on how companies maximize their profits through the use of feeling rules by viewing the job of a flight attendant. A flight attendant's job requires emotional labor. The flight attendance uplifts the customer through his or her demeanor and expression of feelings. A flight attendant who is constantly smiling or asking the customer how they are doing is more comforting to a customer versus if a flight attendant who rolls their eyes and rarely smiles. The feeling rules for a flight attendant calls for them to be happy, calm, and to suppress their negative feelings. Customers who see the way the flight attendant upholds themselves are more likely to come back if the experience was pleasant. Which is why many airlines like Delta, which was rated as one of the top airlines calls and requires these feeling rules at the workplace. In a way, this is beneficial to the companies and the customer because the customer is satisfied and keeps coming back, which makes the company more money. However, at the same time, it can be harmful to the flight attendant because they are not able to express their feelings, but rather suppress their feelings for the benefit of others.[5]
References[edit]
Jump up ^ Nomura, Tatsuya (2000), "A proposal of computational approach for sociology for emotions and group dynamics", in Hatano, G.; Okada, N.; Tanabe, H., Affective minds: a collection of papers based on presentations at the 13th Toyota Conference, Shizuoka, Japan, 29 November to 2 December 1999, Amsterdam New York: Elsevier, ISBN 9780444504180. Available from the Faculty of Science and Technology at Ryukoku University.
Jump up ^ Russell Hochschild, Arlie (2001), "Section IX Transitions and challenges: symbolic interactionism: Airlie Russell Hochschild (1940- )", in Adams, Bert; Sydie, R.A., Sociological theory, Thousand Oaks, California: Pine Forge Press, pp. 517–523, ISBN 9780761985570. Available from the University of Regina.
Jump up ^ Wingfield, Adia Harvey (2010-05-01). "Are Some Emotions Marked "Whites Only"? Racialized Feeling Rules in Professional Workplaces". Social Problems. 57 (2): 251–268. doi:10.1525/sp.2010.57.2.251. ISSN 0037-7791.
Jump up ^ Power, C. A.; Cole, E. R.; Fredrickson, B. L. (2010). "Poor women and the expression of shame and anger: The price of breaking social class feeling rules". Feminism & Psychology. 21 (2): 179. doi:10.1177/0959353510384125.
^ Jump up to: a b c d Hochschild, Arlie Russell. "The Managed Heart: Commercialization of Human Feeling" (PDF).
Further reading[edit]
Russell Hochschild, Arlie (November 1979). "Emotion work, feeling rules, and social structure". American Journal of Sociology. University of Chicago Press. 85 (3): 551–575. doi:10.1086/227049. JSTOR 2778583. Pdf.
Russell Hochschild, Arlie (2003). The commercialization of intimate life: notes from home and work. Berkeley: University of California Press. ISBN 9780520214880.
Russell Hochschild, Arlie (2012) [1983]. The managed heart: commercialization of human feeling. Berkeley: University of California Press. ISBN 9780520272941
Retrieved from "https://en.wikipedia.org/w/index.php?title=Feeling_rules&oldid=819965646"
Categories:
Rules
Sociological terminology
Navigation menu
Personal tools
Not logged in
Talk
Contributions
Create account
Log in
Namespaces
Article
Talk
Variants
Views
Read
Edit
View history
More
Search
Navigation
Main page
Contents
Featured content
Current events
Random article
Donate to Wikipedia
Wikipedia store
Interaction
Help
About Wikipedia
Community portal
Recent changes
Contact page
Tools
What links here
Related changes
Upload file
Special pages
Permanent link
Page information
Wikidata item
Cite this page
Print/export
Create a book
Download as PDF
Printable version
Languages
Add links
This page was last edited on 12 January 2018, at 08:09.
Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization.
Privacy policy
About Wikipedia
Disclaimers
Contact Wikipedia
Developers
Cookie statement
Mobile view
Enable previews

values: mw-page-base noprint

values: mw-head-base noprint

values: firstHeading firstHeading en

values: siteSub noprint

values: jump-to-nav mw-jump

values:
/wiki/Norm_(sociology)
mw-redirect
Norm (sociology)

values:
nofollow
external text
//doi.org/10.1525%2Fsp.2010.57.2.251

values:
nofollow
external text
//www.worldcat.org/issn/0037-7791

values:
nofollow
external text
//doi.org/10.1086%2F227049

values:
nofollow
external text
//www.jstor.org/stable/2778583

values: The Managed Heart: the Commercialization of Human Feeling

values:
catlinks mw-normal-catlinks
catlinks mw-normal-catlinks
interface

values: Discussion about edits from this IP address [ctrl-alt-n]

values: A list of edits made from this IP address [ctrl-alt-y]

values: You are encouraged to create an account and log in; however, it is not mandatory

values: You're encouraged to log in; however, it's not mandatory. [ctrl-alt-o]

values:
/wiki/Feeling_rules
View the content page [ctrl-alt-c]
c

values:
p-cactions
navigation
vectorMenu emptyPortlet
p-cactions-label

values:
mw-wiki-logo
/wiki/Main_Page
Visit the main page

values:
/wiki/Main_Page
Visit the main page [ctrl-alt-z]
z

values: Featured content – the best of Wikipedia

values: Find background information on current events

values:
/wiki/Special:Random
Load a random article [ctrl-alt-x]
x

values: portal navigation p-navigation p-navigation-label

values: Guidance on how to use and edit Wikipedia

values: About the project, what you can do, where to find things

values: A list of recent changes in the wiki [ctrl-alt-r]

values: portal navigation p-interaction p-interaction-label

values: /static/images/wikimedia-button-1.5x.png 1.5x, /static/images/wikimedia-button-2x.png 2x

values: /static/images/poweredby_mediawiki_132x47.png 1.5x, /static/images/poweredby_mediawiki_176x62.png 2x

values:
suggestions
display: none; font-size: 13px;

values: mediawiki ltr sitedir-ltr mw-hide-empty-elt ns-0 ns-subject page-Feeling_rules rootpage-Feeling_rules skin-vector action-view


text:
60th parallel south
From Wikipedia, the free encyclopedia
Jump to: navigation, search
60°
60th parallel south
[show]Map all coordinates using OSM
Map all coordinates using Google
Export all coordinates as KML
Export all coordinates as GPX
Map all microformatted coordinates
Place data as RDF
The 60th parallel south is a circle of latitude that is 60 degrees south of the Earth's equatorial plane. No land lies on the parallel — it crosses nothing but ocean. The closest land is a group of rocks north of Coronation Island (Melson Rocks or Governor Islands) of the South Orkney Islands, which are about 54 km south of the parallel, and Thule Island and Cook Island of the South Sandwich Islands, which both are about 57 km north of the parallel (Thule island slightly closer).
The parallel marks the northern limit of the Southern Ocean (though some organisations and countries, notably Australia, have other definitions) and of the Antarctic Treaty System. It also marks the southern boundary of the South Pacific Nuclear-Weapon-Free Zone and the Latin American Nuclear-Weapon-Free Zone.
At this latitude the sun is visible for 18 hours, 52 minutes during the summer solstice and 5 hours, 52 minutes during the winter solstice. On December 21, the sun is at 53.83 degrees up in the sky and 6.17 degrees on June 21.
The latitudes south of this parallel are often referred to as the Screaming 60s due to the prevailing high-speed, westerly winds which can generate large waves in excess of 15 m (50 ft) and peak wind speeds over 145 km/h (90 mph).[1]
Around the world[edit]
Starting at the Prime Meridian and heading eastwards, the parallel 60° south passes through:
Co-ordinates
Country, territory or sea
Notes
60°0′S 0°0′E / 60.000°S 0.000°E / -60.000; 0.000 (Prime Meridian)
Atlantic Ocean / Southern Ocean boundary
60°0′S 20°0′E / 60.000°S 20.000°E / -60.000; 20.000 (Indian Ocean / Southern Ocean boundary)
Indian Ocean / Southern Ocean boundary
60°0′S 147°0′E / 60.000°S 147.000°E / -60.000; 147.000 (Pacific Ocean / Southern Ocean boundary)
Pacific Ocean / Southern Ocean boundary
60°0′S 67°16′W / 60.000°S 67.267°W / -60.000; -67.267 (Atlantic Ocean / Southern Ocean boundary)
Atlantic Ocean / Southern Ocean boundary
Passing through the Drake Passage between South America and the Antarctic Peninsula
and running close to the southern border of the Scotia Sea
See also[edit]
59th parallel south
61st parallel south
60th parallel north
Jump up ^ Sinert, Richard. "The Furious 50's and Screaming 60's". mydaywithbarkly. Retrieved 2009-07-11.
[show]
v
t
e
Circles of latitude / Meridians
Equator
Tropic of Cancer
Tropic of Capricorn
Arctic Circle
Antarctic Circle
Equator
Tropic of Cancer
Tropic of Capricorn
Arctic Circle
Antarctic Circle
Equator
Tropic of Cancer
Tropic of Capricorn
Arctic Circle
Antarctic Circle
W 0° E
30°
60°
90°
120°
150°
180°
30°
60°
90°
120°
150°
180°
5°
15°
25°
35°
45°
55°
65°
75°
85°
95°
105°
115°
125°
135°
145°
155°
165°
175°
5°
15°
25°
35°
45°
55°
65°
75°
85°
95°
105°
115°
125°
135°
145°
155°
165°
175°
10°
20°
40°
50°
70°
80°
100°
110°
130°
140°
160°
170°
10°
20°
40°
50°
70°
80°
100°
110°
130°
140°
160°
170°
0°
10°
20°
30°
40°
50°
60°
70°
80°
90°
10°
20°
30°
40°
50°
60°
70°
80°
90°
5° N
15°
25°
35°
45°
55°
65°
75°
85°
5° S
15°
25°
35°
45°
55°
65°
75°
85°
45x90
45x90
45x90
45x90
Retrieved from "https://en.wikipedia.org/w/index.php?title=60th_parallel_south&oldid=770653957"
Categories:
Lines of latitude
Hidden categories:
Lists of coordinates
Geographic coordinate lists
Articles with Geo
Navigation menu
Personal tools
Not logged in
Talk
Contributions
Create account
Log in
Namespaces
Article
Talk
Variants
Views
Read
Edit
View history
More
Search
Navigation
Main page
Contents
Featured content
Current events
Random article
Donate to Wikipedia
Wikipedia store
Interaction
Help
About Wikipedia
Community portal
Recent changes
Contact page
Tools
What links here
Related changes
Upload file
Special pages
Permanent link
Page information
Wikidata item
Cite this page
Print/export
Create a book
Download as PDF
Printable version
Languages
العربية
Bosanski
Dansk
Español
فارسی
Français
한국어
Հայերեն
हिन्दी
Ilokano
Bahasa Indonesia
Bahasa Melayu
日本語
Norsk
Norsk nynorsk
Português
Русский
ไทย
Türkçe
中文
Edit links
This page was last edited on 16 March 2017, at 19:30.
Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization.
Privacy policy
About Wikipedia
Disclaimers
Contact Wikipedia
Developers
Cookie statement
Mobile view
Enable previews

key: html

type: local

value: div

attrs: id class

values: mw-page-base noprint

values: mw-head-base noprint

value: a

attrs: id class lang

values: firstHeading firstHeading en

values: siteSub noprint

values: jump-to-nav mw-jump

value: img

attrs: alt src width height srcset data-file-width data-file-height

attrs: href class title

values:
/wiki/File:Earthmap1000x500compac.jpg
image
Line across the Earth

values: position:absolute;z-index:3;border-top: 1px solid red;height:1px;left:0;right:0

value: span

values: position: absolute; z-index: 4; top: -1.5em; left: 25%; width: 50%; text-align: center

attrs: href title

value: b

attrs: class style

attrs: id href

attrs: class href

value: th

values:
/wiki/GPS_eXchange_Format
mw-redirect
GPS eXchange Format

values: width: 23em; font-size: 88%; line-height: 1.5em

values:
/wiki/South_Sandwich_Islands
mw-redirect
South Sandwich Islands

values:
/wiki/Prime_Meridian
mw-redirect
Prime Meridian

values: Maps, aerial photos, and other data for this location

attrs: alt src width height data-file-width data-file-height

values: position:absolute; font-size:85%; left:350.4px; top:-11.6px

values: position:absolute; font-size:85%; left:415.2px; top:-11.6px

values: position:absolute; font-size:85%; left:476.4px; top:-11.6px

values: position:absolute; font-size:85%; left:534px; top:-11.6px

values: position:absolute; font-size:85%; left:591.6px; top:-11.6px

values: position:absolute; font-size:85%; left:652.8px; top:-11.6px

values: position:absolute; font-size:85%; left:714px; top:-11.6px

values: position:absolute; font-size:85%; left:296.4px; top:-11.6px

values: position:absolute; font-size:85%; left:235.2px; top:-11.6px

values: position:absolute; font-size:85%; left:174px; top:-11.6px

values: position:absolute; font-size:85%; left:112.8px; top:-11.6px

values: position:absolute; font-size:85%; left:53.4px; top:-11.6px

values: position:absolute; font-size:85%; left:-6px; top:-13.04px

values: position:absolute; font-size:85%; left:368.4px; top:-22.4px

values: position:absolute; font-size:85%; left:386.4px; top:-22.4px

values: position:absolute; font-size:85%; left:408px; top:-22.4px

values: position:absolute; font-size:85%; left:426px; top:-22.4px

values: position:absolute; font-size:85%; left:444px; top:-22.4px

values: position:absolute; font-size:85%; left:465.6px; top:-22.4px

values: position:absolute; font-size:85%; left:487.2px; top:-22.4px

values: position:absolute; font-size:85%; left:505.2px; top:-22.4px

values: position:absolute; font-size:85%; left:526.8px; top:-22.4px

values: position:absolute; font-size:85%; left:544.8px; top:-22.4px

values: position:absolute; font-size:85%; left:562.8px; top:-22.4px

values: position:absolute; font-size:85%; left:584.4px; top:-22.4px

values: position:absolute; font-size:85%; left:602.4px; top:-22.4px

values: position:absolute; font-size:85%; left:624px; top:-22.4px

values: position:absolute; font-size:85%; left:642px; top:-22.4px

values: position:absolute; font-size:85%; left:663.6px; top:-22.4px

values: position:absolute; font-size:85%; left:681.6px; top:-22.4px

values: position:absolute; font-size:85%; left:703.2px; top:-22.4px

values: position:absolute; font-size:85%; left:346.8px; top:-22.4px

values: position:absolute; font-size:85%; left:325.2px; top:-22.4px

values: position:absolute; font-size:85%; left:307.2px; top:-22.4px

values: position:absolute; font-size:85%; left:285.6px; top:-22.4px

values: position:absolute; font-size:85%; left:264px; top:-22.4px

values: position:absolute; font-size:85%; left:246px; top:-22.4px

values: position:absolute; font-size:85%; left:224.4px; top:-22.4px

values: position:absolute; font-size:85%; left:206.4px; top:-22.4px

values: position:absolute; font-size:85%; left:184.8px; top:-22.4px

values: position:absolute; font-size:85%; left:166.8px; top:-22.4px

values: position:absolute; font-size:85%; left:145.2px; top:-22.4px

values: position:absolute; font-size:85%; left:123.6px; top:-22.4px

values: position:absolute; font-size:85%; left:102px; top:-22.4px

values: position:absolute; font-size:85%; left:84px; top:-22.4px

values: position:absolute; font-size:85%; left:62.4px; top:-22.4px

values: position:absolute; font-size:85%; left:44.4px; top:-22.4px

values: position:absolute; font-size:85%; left:22.8px; top:-22.4px

values: position:absolute; font-size:85%; left:4.8px; top:-22.4px

values: position:absolute; font-size:85%; left:375.6px; top:-11.6px

values: position:absolute; font-size:85%; left:397.2px; top:-11.6px

values: position:absolute; font-size:85%; left:433.2px; top:-11.6px

values: position:absolute; font-size:85%; left:454.8px; top:-11.6px

values: position:absolute; font-size:85%; left:494.4px; top:-11.6px

values: position:absolute; font-size:85%; left:516px; top:-11.6px

values: position:absolute; font-size:85%; left:552px; top:-11.6px

values: position:absolute; font-size:85%; left:573.6px; top:-11.6px

values: position:absolute; font-size:85%; left:613.2px; top:-11.6px

values: position:absolute; font-size:85%; left:634.8px; top:-11.6px

values: position:absolute; font-size:85%; left:674.4px; top:-11.6px

values: position:absolute; font-size:85%; left:692.4px; top:-11.6px

values: position:absolute; font-size:85%; left:336px; top:-11.6px

values: position:absolute; font-size:85%; left:318px; top:-11.6px

values: position:absolute; font-size:85%; left:274.8px; top:-11.6px

values: position:absolute; font-size:85%; left:253.2px; top:-11.6px

values: position:absolute; font-size:85%; left:217.2px; top:-11.6px

values: position:absolute; font-size:85%; left:195.6px; top:-11.6px

values: position:absolute; font-size:85%; left:152.4px; top:-11.6px

values: position:absolute; font-size:85%; left:134.4px; top:-11.6px

values: position:absolute; font-size:85%; left:94.8px; top:-11.6px

values: position:absolute; font-size:85%; left:73.2px; top:-11.6px

values: position:absolute; font-size:85%; left:33.6px; top:-11.6px

values: position:absolute; font-size:85%; left:12px; top:-11.6px

values: position:absolute; font-size:85%; left:-13.2px; top:175.6px

values: position:absolute; font-size:85%; left:-13.2px; top:154px

values: position:absolute; font-size:85%; left:-13.2px; top:136px

values: position:absolute; font-size:85%; left:-13.2px; top:114.4px

values: position:absolute; font-size:85%; left:-13.2px; top:96.4px

values: position:absolute; font-size:85%; left:-13.2px; top:74.8px

values: position:absolute; font-size:85%; left:-13.2px; top:56.8px

values: position:absolute; font-size:85%; left:-13.2px; top:35.2px

values: position:absolute; font-size:85%; left:-13.2px; top:13.6px

values: position:absolute; font-size:85%; left:-13.2px; top:-4.4px

values: position:absolute; font-size:85%; left:-13.2px; top:197.2px

values: position:absolute; font-size:85%; left:-13.2px; top:215.2px

values: position:absolute; font-size:85%; left:-13.2px; top:236.8px

values: position:absolute; font-size:85%; left:-13.2px; top:254.8px

values: position:absolute; font-size:85%; left:-13.2px; top:276.4px

values: position:absolute; font-size:85%; left:-13.2px; top:294.4px

values: position:absolute; font-size:85%; left:-13.2px; top:316px

values: position:absolute; font-size:85%; left:-13.2px; top:337.6px

values: position:absolute; font-size:85%; left:-13.2px; top:355.6px

values: position:absolute; font-size:85%; left:-27.6px; top:164.08px

values: position:absolute; font-size:85%; left:-27.6px; top:146.8px

values: position:absolute; font-size:85%; left:-27.6px; top:125.2px

values: position:absolute; font-size:85%; left:-27.6px; top:103.6px

values: position:absolute; font-size:85%; left:-27.6px; top:85.6px

values: position:absolute; font-size:85%; left:-27.6px; top:65.8px

values: position:absolute; font-size:85%; left:-27.6px; top:44.2px

values: position:absolute; font-size:85%; left:-27.6px; top:24.4px

values: position:absolute; font-size:85%; left:-27.6px; top:4.6px

values: position:absolute; font-size:85%; left:-27.6px; top:186.4px

values: position:absolute; font-size:85%; left:-27.6px; top:204.4px

values: position:absolute; font-size:85%; left:-27.6px; top:226px

values: position:absolute; font-size:85%; left:-27.6px; top:244px

values: position:absolute; font-size:85%; left:-27.6px; top:265.6px

values: position:absolute; font-size:85%; left:-27.6px; top:283.6px

values: position:absolute; font-size:85%; left:-27.6px; top:305.2px

values: position:absolute; font-size:85%; left:-27.6px; top:326.8px

values: position:absolute; font-size:85%; left:-27.6px; top:344.8px

values: position:absolute; font-size:85%; left:170.4px; top:85.6px

values: position:absolute; font-size:85%; left:530.4px; top:85.6px

values: position:absolute; font-size:85%; left:170.4px; top:265.6px

values: position:absolute; font-size:85%; left:530.4px; top:265.6px

values: padding:0em 0.25em padding: 2.5em 9em 0em 3em; font-size:80%; margin:0 auto; text-align:left; width:720px; width: 720px; line-height: 1; text-align: center; background-color: #ffffff; position: relative; max-width: 100%; overflow-x: auto;

values: nowraplinks collapsible collapsed navbox-inner

values: Discussion about edits from this IP address [ctrl-alt-n]

values: A list of edits made from this IP address [ctrl-alt-y]

values: You are encouraged to create an account and log in; however, it is not mandatory

values: You're encouraged to log in; however, it's not mandatory. [ctrl-alt-o]

values:
/wiki/60th_parallel_south
View the content page [ctrl-alt-c]
c

values: Discussion about the content page [ctrl-alt-t]

values: p-namespaces navigation vectorTabs p-namespaces-label

values:
p-variants
navigation
vectorMenu emptyPortlet
p-variants-label

values: Past revisions of this page [ctrl-alt-h]

values: p-views navigation vectorTabs p-views-label

values: List of all English Wikipedia pages containing links to this page [ctrl-alt-j]

values: Recent changes in pages linked from this page [ctrl-alt-k]

values:
/wiki/Wikipedia:File_Upload_Wizard
Upload files [ctrl-alt-u]
u

values: A list of all special pages [ctrl-alt-q]

values: Permanent link to this revision of the page

values: Link to connected data repository item [ctrl-alt-g]

values: Printable version of this page [ctrl-alt-p]

values:
uls-settings-trigger
Language settings
0
button
true

values: خط عرض 60° جنوب – Arabic

values: مدار ۶۰ درجه جنوبی – Persian

values: 60-րդ հարավային զուգահեռական – Armenian

values: 60वीं अक्षांश दक्षिण – Hindi

values: 60. sørlege breiddesirkelen – Norwegian Nynorsk

values: 60-я параллель южной широты – Russian

values: เส้นขนานที่ 60 องศาใต้ – Thai

values: mediawiki ltr sitedir-ltr mw-hide-empty-elt ns-0 ns-subject page-60th_parallel_south rootpage-60th_parallel_south vector-experimental-print-styles vector-nav-directionality skin-vector action-view


text:
Health insurance marketplace
From Wikipedia, the free encyclopedia
Jump to navigation Jump to search
This article needs to be updated. Please update this article to reflect recent events or newly available information. (August 2016)
This article is part of a series on
Healthcare reform in the
United States of America
History
Debate
Legislation[show]
Preceding
Social Security Amendments of 1965
EMTALA (1986)
HIPAA (1996)
Medicare Modernization Act (2003)
PSQIA (2005)
Superseded
Affordable Health Care for America (H.R. 3962)
America's Affordable Health Choices (H.R. 3200)
Baucus Health Bill (S. 1796)
Proposed
American Health Care Act (2017)
United States National Health Care Act (2009, H.R. 676)
Healthy Americans Act (2007, 2009)
Health Security Act (H.R. 3600)
Latest enacted
Affordable Care Act (H.R. 3590)
Health Care and Education Reconciliation Act
(H.R. 4872)
Reforms[show]
Obama administration proposals
Public opinion
Reform advocacy groups
Rationing
Insurance coverage
Systems[show]
Free market
Health insurance exchange
Nationalized insurance
Publicly-funded
Single-payer
Canadian vs. American
Two-tier
Universal
Third-party payment models[show]
All-payer rate setting
Capitation
Fee-for-service
Global payment
United States portal
v
t
e
In the United States, health insurance marketplaces,[1] also called health exchanges, are organizations in each state through which people can purchase health insurance. People can purchase health insurance that complies with the Patient Protection and Affordable Care Act (ACA, known colloquially as "Obamacare") at ACA health exchanges, where they can choose from a range of government-regulated and standardized health care plans offered by the insurers participating in the exchange.
ACA health exchanges were fully certified and operational by January 1, 2014, under federal law.[2] Enrollment in the marketplaces started on October 1, 2013, and continued for six months. As of April 19, 2014,[update] 8.02 million people had signed up through the health insurance marketplaces. An additional 4.8 million joined Medicaid.[3] Enrollment for 2015 began on November 15, 2014 and ended on December 15, 2014.[4]
Private non-ACA health care exchanges also exist in many states, responsible for enrolling 3 million people.[5] These exchanges predate the Affordable Care Act and facilitate insurance plans for employees of small and medium size businesses.
Contents
1 Background
2 History
2.1 Patient Protection and Affordable Care Act regulations
2.1.1 Subsidies
2.2 Guaranteed issue
2.3 Limit to price variation
2.4 Comparable tiers of plans
2.5 2015
3 Economics of health insurance exchanges: the individual mandate
4 Acronym
5 Criticism and controversy
5.1 First week of operation
5.2 Postponement of tax penalty
5.3 Primary concerns
5.4 Congressional reaction
6 Cover Oregon website failure
7 Private health insurance exchanges
8 See also
9 References
10 External links
Background[edit]
Health insurance exchanges in the United States expand insurance coverage while allowing insurers to compete in cost-efficient ways and help them to comply with consumer protection laws. Exchanges are not themselves insurers, so they do not bear risk themselves, but they do determine which insurance companies participate in the exchange. An ideal exchange promotes insurance transparency and accountability, facilitates increased enrollment and delivery of subsidies, and helps spread risk to ensure that the costs associated with expensive medical treatments are shared more broadly across large groups of people, rather than spread across just a few beneficiaries. Health insurance exchanges use electronic data interchange (EDI) to transmit required information between the exchanges and carriers (trading partners), in particular the 834 transaction for enrollment information and the 820 transaction for premium payment.[6][better source needed]
History[edit]
Health insurance exchanges by state.[7][8][needs update]
Creating state-operated exchanges
Establishing state-federal partnership exchanges
Defaulting to federal exchange
Health exchanges first emerged in the private sector in the early 1980s, and they used computer networking to integrate claims management, eligibility verification, and inter-carrier payments. These became popular in some regions as a way for small and medium-sized businesses to pool their purchasing power into larger groups, reducing cost. An additional advantage was the ability of small businesses to offer a range of plans to employees, allowing them to compete with larger corporations. The largest such exchange prior to the ACA is CaliforniaChoice, established in 1996. By 2000, CaliforniaChoice's membership included 140,000 individuals from 9000 business groups.
Obamacare maintained the concept of health insurance exchanges as a key component of health care. President Obama stated that it should be "a market where Americans can one-stop shop for a health care plan, compare benefits and prices, and choose the plan that's best for them, in the same way that Members of Congress and their families can. None of these plans should deny coverage on the basis of a preexisting condition, and all of these plans should include an affordable basic benefit package that includes prevention, and protection against catastrophic costs. I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest."[9] Although the House of Representatives had sought a single national exchange as well as a public option, the Patient Protection and Affordable Care Act (ACA) as passed used state-based exchanges, and the public option was ultimately dropped from the bill after it did not win filibuster-proof support in the Senate.[10] States may choose to join together to run multi-state exchanges, or they may opt out of running their own exchange, in which case the federal government will step in to create an exchange for use by their citizens.[10]
ACA was signed into law on March 23, 2010. The law required that health insurance exchanges commence operation in every state on October 1, 2013.[11][12] In the first year of operation, open enrollment on the exchanges ran from October 1, 2013, to March 31, 2014, and insurance plans purchased by December 15, 2013, began coverage on January 1, 2014.[13][14][15][16] For 2015 open enrollment began on November 15, 2014 and ended on February 15, 2015.[17][18][19]
Implementation of the individual exchanges changed the practice of insuring individuals. The expansion of this market was a major focus of ACA.[20] Over 1.3 million people had selected plans for 2015 marketplace coverage in the first three weeks of the year's open enrollment period, including people who renewed their coverage and new customers.[21]
As of January 3, 2014, 2 million people had selected a health plan through the health insurance marketplaces.[22] By April 19, 2014, 8.0 million people had signed up through the health insurance marketplaces and an additional 4.8 million joined Medicaid.[3] As of February, 2015, about 11.4 million people had signed up for or been automatically renewed for 2015 marketplace coverage.[23] Today, more than 1,400 local outreach events have been conducted in federally facilitated marketplace states across the country.[21]
Patient Protection and Affordable Care Act regulations[edit]
Main article: Provisions of the Patient Protection and Affordable Care Act
Insurers are prohibited from discriminating against or charging higher rates for any individual based on pre-existing medical conditions or gender.[24]
Insurers are prohibited from establishing annual spending caps of dollar amounts on essential health benefits.[25]
All private health insurance plans offered in the Marketplace must offer the following essential health benefits: ambulatory care, emergency services, hospitalization (such as surgery), maternity and newborn care, mental health and substance abuse services, prescription drugs, rehabilitative and habilitative services (services to help people with injuries, disabilities, or chronic conditions to recover), laboratory services, preventive and wellness services, and pediatric services.[26]
Under the individual mandate provision (sometimes called a "shared responsibility requirement" or "mandatory minimum coverage requirement"),[27] individuals who are not covered by an acceptable health insurance policy will be charged an annual tax penalty of $95, or up to 1% of income over the filing minimum,[28] whichever is greater; this will rise to a minimum of $695 ($2,085 for families),[29] or 2.5% of income over the filing minimum,[28] by 2016.[30][31] The penalty is prorated, meaning that if a person or family has coverage for part of the year they won't be liable if they lack coverage for less than a three-month period during the year.[32] Exemptions are permitted for religious reasons, for members of health care sharing ministries, or for those for whom the least expensive policy would exceed 8% of their income.[33] Also exempted are U.S. citizens who qualify as residents of a foreign country under the IRS foreign earned income exclusion rule.[34] In 2010, the Commissioner speculated that insurance providers would supply a form confirming essential coverage to both individuals and the IRS; individuals would attach this form to their Federal tax return. Those who aren't covered will be assessed the penalty on their Federal tax return. In the wording of the law, a taxpayer who fails to pay the penalty "shall not be subject to any criminal prosecution or penalty" and cannot have liens or levies placed on their property, but the IRS will be able to withhold future tax refunds from them.[35]
United States Department of Health and Human Services (HHS) federal poverty level in 2013[36]
Persons in
Family Unit
48 Contiguous States
and D.C.
Alaska
Hawaii
1 $11,490 $14,350 $13,230
2 $15,510 $19,380 $17,850
3 $19,530 $24,410 $22,470
4 $23,550 $29,440 $27,090
5 $27,570 $34,470 $31,710
6 $31,590 $39,500 $36,330
7 $35,610 $44,530 $40,950
8 $39,630 $49,560 $45,570
Each additional
person adds $4,020 $5,030 $4,620
In participating states, Medicaid eligibility is expanded; all individuals with income up to 133% of the poverty line qualify for coverage, including adults without dependent children.[30][37] The law also provides for a 5% "income disregard", making the effective income eligibility limit 138% of the poverty line.[38] States may choose to increase the income eligibility limit beyond this minimum requirement.[38] As written, the ACA withheld all Medicaid funding from states declining to participate in the expansion. However, the Supreme Court ruled in National Federation of Independent Business v. Sebelius (2012) that this withdrawal of funding was unconstitutionally coercive and that individual states had the right to opt out of the Medicaid expansion without losing pre-existing Medicaid funding from the federal government. For states that do expand Medicaid, the law provides that the federal government will pay for 100% of the expansion for the first three years, then gradually reduce its subsidy to 90% by 2020.[39][40] As of April 25, 2013,[update] fifteen states—Alaska, Alabama, Georgia, Idaho, Indiana, Iowa, Louisiana, Mississippi, Nebraska, North Carolina, Oklahoma, South Carolina, Texas, Wisconsin, and Virginia—were not participating in the Medicaid expansion, with ten more—Kansas, Maine, Michigan, Montana, Missouri, Ohio, Pennsylvania, South Dakota, Utah, and Wyoming—leaning towards not participating.[41][needs update]
The Patient Protection and Affordable Care Act eliminates lifetime and annual limits from plans in the individual health benefits exchanges. This effectively eliminates the ceiling on financial risk for individuals in the individual exchanges.[42]
Subsidies[edit]
The subsidies for insurance premiums are given to individuals who buy a plan from an exchange and have a household income between 133% and 400% of the poverty line.[37][43][44][45] Section 1401(36B) of PPACA explains that each subsidy will be provided as an advanceable, refundable tax credit[46] and gives a formula for its calculation:[47]
Except as provided in clause (ii), the applicable percentage with respect to any taxpayer for any taxable year is equal to 2.8 percent, increased by the number of percentage points (not greater than 7) which bears the same ratio to 7 percentage points as the taxpayer's household income for the taxable year in excess of 100 percent of the poverty line for a family of the size involved, bears to an amount equal to 200 percent of the poverty line for a family of the size involved. *(ii) SPECIAL RULE FOR TAXPAYERS UNDER 133 PERCENT OF POVERTY LINE- If a taxpayer's household income for the taxable year is in excess of 100 percent, but not more than 133 percent, of the poverty line for a family of the size involved, the taxpayer's applicable percentage shall be 2 percent.
—  Patient Protection and Affordable Care Act: Title I: Subtitle E: Part I: Subpart A: Premium Calculation[47]
A refundable tax credit is a way to provide government benefits to individuals who may have no tax liability[48] (such as the earned income tax credit). The formula was changed in the amendments (HR 4872) passed March 23, 2010, in section 1001. To qualify for the subsidy, the beneficiaries cannot be eligible for other acceptable coverage. The U.S. Department of Health and Human Services (HHS) and Internal Revenue Service (IRS) on May 23, 2012, issued joint final rules regarding implementation of the new state-based health insurance exchanges to cover how the exchanges will determine eligibility for uninsured individuals and employees of small businesses seeking to buy insurance on the exchanges, as well as how the exchanges will handle eligibility determinations for low-income individuals applying for newly expanded Medicaid benefits.[49][50] Premium caps have been delayed for a year on group plans, to give employers time to arrange new accounting systems, but the caps are still planned to take effect on schedule for insurance plans on the exchanges;[51][52][53][54] the HHS and the Congressional Research Service calculated what the income-based premium caps for a "silver" healthcare plan for a family of four would be in 2014:
Annual Health Insurance Premiums and Cost Sharing under PPACA for Average Family of 4[50][55][56][57][58]
Income
Premium
Additional
Cost-Sharing Subsidy
% of Federal poverty level
Dollars (2014)[a]
Cap (% of Income)
Max Out-of-Pocket
Avg Savings[b]
133% $31,900 3% $992 $10,345 $5,040
150% $33,075 4% $1,323 $9,918 $5,040
200% $44,100 6.3% $2,778 $8,366 $4,000
250% $55,125 8.05% $4,438 $6,597 $1,930
300% $66,150 9.5% $6,284 $4,628 $1,480
350% $77,175 9.5% $7,332 $3,512 $1,480
400% $88,200 9.5% $8,379 $2,395 $1,480
Notes
Jump up ^ In 2014, the FPL is projected to equal about $11,800 for a single person and about $24,000 for a family of four.[59][60] See Subsidy Calculator[clarification needed] for specific dollar amount.[61]
Jump up ^ DHHS and CBO estimate the average annual premium cost in 2014 would be $11,328 for a family of 4 without the reform.[56]
Maximum Out-of-Pocket Premium Payments
Maximum Out-of-Pocket Premium Payments Under PPACA by Family Size and federal poverty level.[55] (Source: CRS)
Maximum Out-of-Pocket Premium as Percentage of Family Income and federal poverty level[55] (Source: CRS)
Guaranteed issue[edit]
State and district exchanges
Arkansas Health Connector
Covered California
Connect for Health Colorado
Access Health CT (Connecticut)
DC Health Link (District of Columbia)
Hawaiʻi Health Connector
Get Covered Idaho
Get Covered Illinois
Kynect (Kentucky)
Maryland Health Connection
Massachusetts Health Connector
MNsure (Minnesota)
Nevada Health Link
BeWellNM (New Mexico)
NY State of Health (New York)
Cover Oregon
HealthSource RI (Rhode Island)
Vermont Health Connect
Washington Healthplanfinder
In the individual market, sometimes thought of as the "residual market" of insurance,[clarification needed] insurers have generally used a process called underwriting to ensure that each individual paid for his or her actuarial value or to deny coverage altogether.[62] The House Committee on Energy and Commerce found that, between 2007 and 2009, the four largest for-profit insurance companies refused insurance to 651,000 people for previous medical conditions, a number that increased significantly each year,[63] with a 49% increase in that time period.[64] The same memorandum said that 212,800 claims had been refused payment due to pre-existing conditions and that insurance firms had business plans to limit money paid based on these pre-existing conditions. These persons who might not have received insurance under previous industry practices are guaranteed insurance coverage under the ACA. Hence, the insurance exchanges will shift a greater amount of financial risk to the insurers, but will help to share the cost of that risk among a larger pool of insured individuals. The ACA's prohibition on denying coverage for pre-existing conditions began on January 1, 2014. Previously, several state and federal programs, including most recently the ACA, provided funds for state-run high-risk pools for those with previously existing conditions.[65][66] Several states have continued their high-risk pools even after the first marketplace enrollment period.[66]
Limit to price variation[edit]
Pricing Factors Allowed in the exchange under the ACA:[67]
Age: 3:1
Smoking status: 1.5:1
Pricing variation will be allowed by area (within a state) and family composition ("tier") as well.
Comparable tiers of plans[edit]
Within the exchanges, insurance plans are offered in four tiers designated from lowest premium to highest premium: bronze, silver, gold, and platinum. The plans cover ranges from 60% to 90% of bills in increments of 10% for each plan. For those under 30 (and those with a hardship exemption), a fifth "catastrophic" tier is also available, with very high deductibles.[68]
Insurance companies select the doctors and hospitals that are "in-network".[clarification needed][69]
Proponents of health care reform believe that allowing comparable plans to compete for consumer business in one convenient location will drive prices down. Having a centralized location increases consumer knowledge of the market and allows for greater conformation to perfect competition. Each of these plans will also cap liabilities for consumers with out-of-pocket expenses at $6,350 for individuals and $12,700 for families.[42]
2015[edit]
A study by Avalere Health says that healthcare insurance premiums of popular plans available under Obamacare for 2015 rose by 3-4% .[70]
According to the US Department of Health & Human Service, as enrollment for the Health Insurance Marketplace began on November 15, about 11.4 million people have explored their options, learned about the financial assistance available, and signed up for or renewed a health plan that meets their needs and fits their budget. As of February, 2015, $268 was the average monthly tax credit for people who qualify for financial assistance in 37 states using HealthcCare.gov through January 30.[71]
Economics of health insurance exchanges: the individual mandate[edit]
The health insurance advocacy group America's Health Insurance Plans was willing to accept these constraints on pricing, capping, and enrollment because of the individual mandate: The individual mandate requires that all individuals purchase health insurance.[72][73] This requirement of the ACA allows insurers to spread the financial risk of newly insured people with pre-existing conditions among a larger pool of individuals.
Additionally, a study done by Pauly and Herring estimates that individuals with pre-existing conditions in the 99th percentile of financial risk represented 3.95 times the average risk (mean).[62] Figures from the House Committee on Energy and Commerce would indicate that approximately 1 million high-risk individuals will pursue insurance in the health benefits exchanges.[63] Congress has estimated that 22 million people will be newly insured in the health benefits exchanges.[74] Thus the high-risk individuals do not number in high enough quantities to increase the net risk per person from previous practice. It is thus theoretically profitable to accept the individual mandate in exchange for the requirements presented in the ACA.
Acronym[edit]
HIX (Health Insurance eXchange) is emerging as the de facto acronym across state and federal government stakeholders, and the private sector technology and service providers that are helping states build their exchanges.[citation needed] The acronym HIX differentiates this topic from health information exchange, or HIE.[75]
The de facto acronym of HIX[76] will be replaced with HIEx in the 3rd Edition of the HIMSS Dictionary of Healthcare Information Technology Terms, Acronyms and Organizations, to be released in March 2013.[update][citation needed]
Criticism and controversy[edit]
First week of operation[edit]
This section may lend undue weight to certain ideas, incidents, or controversies. Please help to create a more balanced presentation. Discuss and resolve this issue before removing this message. (February 2014)
The message, "Please try again later", greeted many people who tried to view information on marketplace websites across the United States during the first week of operation. Websites were reported to have either crashed or to offer very sluggish response times. A statement by Todd Park, U.S. Chief Technology Officer, resolved the initial disagreement about whether the culprit was the high volume of views or deeper technical issues[citation needed]: he asserted that glitches were caused by unexpected high volume at the federal health exchange (HealthCare.gov), when the site drew 250 thousand visitors instead of the 50-60 thousand expected, and claimed that the site would have worked with fewer visitors. More than 8.1 million people visited the site from October 1–4, 2013.[77]
On the date the Patient Protection and Affordable Care Act of 2010 was enacted,[when?] only a few health insurance exchanges across the country were up and running. Among them were the Massachusetts Health Connector, the New York HealthPass - a non-profit exchange, and the Utah Health Exchange.[78] Advocates claim these exchanges make these "markets" more efficient, providing oversight and structure, arguing that previous health insurance markets in the United States are poorly-organized and deal with wide variations in coverages and requirements among different companies, employers, and policies.[79]
It was unknown how many people in total successfully enrolled in the first week. The federal marketplace website was scheduled for maintenance on the weekend.[80][81] Some reporters nicknamed the program "Slowbamacare".[82]
CGI Group came under media scrutiny as a developer behind several marketplace websites,[83] after numerous issues[84] surfaced with the federal health insurance marketplace, HealthCare.gov.
On October 1, 2013, the state-run marketplaces also opened to the public, and some of them reported first statistics. During the first week of enrollment:
28,699 people enrolled in the California health plan marketplace[82]
17,300 people enrolled in the Kentucky health plan marketplace[82]
More than 40,000 people enrolled in the NY State of Health marketplace[82]
On October 8, 2013, The Seattle Times reported that more than 9,400 people had enrolled in the Washington health plan marketplace.[82] However, a later report clarified that many included in that count were Medicaid enrollees. By October 21, 2013, only 4,500 Washington residents had enrolled in private insurance through the state marketplace.[85]
Postponement of tax penalty[edit]
On October 23, 2013, The Washington Post reported that Americans with no health insurance would have an additional six weeks before they would be penalized.[86] That deadline was extended to March 31, and those who do not enroll by then may still avoid incurring penalties and getting locked out of the healthcare enrollment system this year. Exemptions and extensions apply to:[87][88]
Those living in states that use federal exchange, who may avail themselves of a "special entrollment period" that allows individuals to avoid penalties and enroll in a health plan by checking a blue box by mid-April 2014, stating they tried to enroll before the deadline (doing so provides a yet-undetermined amount of time to actually sign up after that). The New York Post reports: "This method will rely on an honor system; the government will not try to determine whether the person is telling the truth". State-run exchanges have their own rules; several will be granting similar extensions.[87][88]
Members of the Pre-Existing Condition Insurance Program, who were given a one-month extension until the end of April 2014.[87][88]
Those who have successfully applied for exemption status based on criteria published by HealthCare.gov, who are not required to pay a tax penalty if they don't enroll in a health insurance plan.[89][90]
Primary concerns[edit]
Medicaid expansion by state.[91][92][needs update]
Expanding Medicaid
Not expanding Medicaid
Still debating Medicaid expansion
Exclusion of many lower-income individuals
NPR reported that large numbers of low income people were excluded in states that did not offer Medicaid expansion to 133% of the poverty line.[93][94]
High premiums for single young adults
There was some speculation that for single people between the ages of 18-35 costs of insurance would rise.[95]
Data security
Minnesota's healthcare exchange was reported to have accidentally e-mailed personal information of more than 2,400 insurance agents to an insurance broker, according to the Minnesota Star Tribune.[96]
Loss of group coverage for part-time employees
According to NPR, some employers such as Trader Joe's and Home Depot have decided to terminate health insurance for their part-time workers.[97]
Scams
Scams were expected because of confusion over enrollment.[98][99]
Restricted and narrow networks
Some exchanges have been criticized for offering health plans that necessitate too many out-of-network claims. On October 5, 2013, Seattle Children's hospital filed a lawsuit for "failure to ensure adequate network coverage" when only two insurers included Children's in their marketplace plan.[100]
Concerns have also been raised about insurance carriers' efforts to limit the number of providers in their networks to reduce costs. A study of the California marketplace confirmed these concerns, but also showed that geographic access was similar and quality at times superior in marketplace-based plans.[101]
"Cherry-picking"
The private health insurance industry fears that restricted eligibility and a market size that is too small could result in higher premiums, encourage "cherry-picking" of customers by insurers, and force a clearance of the exchange. That is what some believe will happen in Texas and California in their failed exchanges.[102] One of these factors, "cherry-picking" of customers, will not be possible in the state-run exchanges mandated by the ACA, because all insurance plans will be "guaranteed issue" in 2014. Furthermore, the law will bring millions of new enrollees into the marketplace by way of the individual mandate requirement for all citizens to purchase health insurance and increase market size.[103]
Congressional reaction[edit]
On October 28 and 29, 2013, Sen. Lamar Alexander (R-TN) and Rep. Lee Terry (R, NE-2) introduced the Exchange Information Disclosure Act (S. 1590 and H.R. 3362, respectively).[104][105] Terry's bill would have required the United States Department of Health and Human Services to submit weekly reports to Congress on the status of HealthCare.gov including "…weekly updates on the number of unique website visitors, new accounts, and new enrollments in a qualified health plan, as well as the level of coverage," separating the data by state, as well as reports on efforts to fix the broken portions of the website.[106] The reports would have been due every Monday until March 31, 2015, and would have been available to the public.[107]
On January 16, 2014, Terry's bill passed the House of Representatives; 226 Republicans and 33 Democrats voted yes.[108] Alexander's bill died in committee.[104]
Cover Oregon website failure[edit]
Main article: Cover Oregon website failure
In March 2015, Oregon officially abolished its health insurance marketplace.[citation needed]
Private health insurance exchanges[edit]
This section relies largely or entirely upon a single source. Relevant discussion may be found on the talk page. Please help improve this article by introducing citations to additional sources. (September 2017) (Learn how and when to remove this template message)
A private health insurance exchange is an exchange run by a private sector company or nonprofit. Health plans and insurance carriers in a private exchange must meet certain criteria defined by the exchange management. Private exchanges combine technology and human advocacy, and include online eligibility verification and mechanisms for allowing employers who connect their employees or retirees with exchanges to offer subsidies. They are designed to help consumers find plans personalized to their specific health conditions, preferred doctor/hospital networks, and budget. These exchanges are sometimes called marketplaces or intermediaries, and work directly with insurance carriers, effectively acting as extensions of the carrier.[citation needed] The largest and most successful[peacock term] private health care exchange is CaliforniaChoice, established by the Word & Brown General Agency in 1996.[109]
Private health exchanges predate the Affordable Care Act. One example of an early health care exchange is International Medical Exchange (IMX), a company venture financed in Louisville, Kentucky, by Standard Telephones and Cables, a large British technology company (now Nortel), to develop the exchange concept in the U.S. using on-line technology. The product was created in the mid-1980s. IMX developed an eligibility verification system, a claims management system, and a bank-based payments administration system that would manage payments between the patient, the employer, and the insurance carrier. Like proposed exchanges today, it focused on standards of care, utilization review by a third party, private insurer participation, and cost reduction for the health care system through product simplification. The focus was on creating local or regional exchanges that offered a series of standardized health care plans that reduced the complexity and cost of acquiring or understanding health care insurance, while simplifying claims administration. The system was modeled after the standardized stock exchange and banking industry back office processes. The major difference was that IMX health care exchanges would provide their products through a national network of existing commercial banks rather than setting up a duplicate payment and administration systems network as proposed today. The IMX product rights were acquired by Anthem (then Blue Cross and Blue Shield of Kentucky). The exchange product became the basis for inter-carrier claims settlement between commercial insurance carriers and Blue Cross organizations. The founders of IMX were from top management at Humana, and top management of First Tennessee National Corp (now First Horizon).
In overlapping markets, the co-existence of public and private exchange plans can lead to confusion when speaking of an "exchange plan." In California, Anthem Blue Cross offers HMO plans through both the state-run Covered California exchange and the private CaliforniaChoice exchange, but doctor networks are not identical. Physicians advertising acceptance of Anthem Blue Cross Exchange HMOs may misinform individuals enrolled in Anthem Blue Cross Exchange HMOs through the private exchange.
See also[edit]
Health care reform in the United States
Health system
Universal health coverage by country
References[edit]
Jump up ^ "What is the Health Insurance Marketplace?". Healthcare.gov. U.S. Centers for Medicare & Medicaid Services.
Jump up ^ Lewis, Nicole (July 12, 2011). "HHS Proposes Health Insurance Exchange Rules". InformationWeek: Healthcare. UBM TechWeb. Archived from the original on July 14, 2011.
^ Jump up to: a b Mangan, Dan (May 1, 2014). "Latest score: Obamacare enrolls 8.02 million by April 19". CNBC.
Jump up ^ Alonso-Zaldivar, Ricardo (November 9, 2014). "Higher bar for health law in 2nd sign-up season". CBS Money Watch. CBS Interactive. Archived from the original on November 10, 2014.
Jump up ^ Carrns, Ann (June 14, 2014). "Private Health Care Exchanges enroll more than Predicted". New York Times (New York ed.). p. B6. Retrieved 16 July 2014.
Jump up ^ Scholl, Martin (October 16, 2014). "Take advantage of the emerging market place of the Health Benefit Exchanges". HIPAA Suite. Archived from the original on November 24, 2014.
Jump up ^ "State Decisions For Creating Health Insurance Exchanges, as of May 28, 2013 - Table". Kaiser Family Foundation. May 28, 2013.
Jump up ^ "State Decisions For Creating Health Insurance Exchanges, as of May 28, 2013 - Map". Kaiser Family Foundation. May 28, 2013.
Jump up ^ Hass, Christopher (June 3, 2009). "President Obama Reiterates Support for Public Option and Health Insurance Exchange". Obama for America. Archived from the original on August 20, 2012. Retrieved February 7, 2014.
^ Jump up to: a b Grier, Peter (March 10, 2010). "Health care reform bill 101: What's a health 'exchange'?". Christian Science Monitor.
Jump up ^ "Welcome to the Marketplace". Healthcare.gov.
Jump up ^ "What is the Health Insurance Marketplace?". Healthcare.gov.
Jump up ^ Luhby, Tami (April 23, 2013). "Millions eligible for Obamacare subsidies, but most don't know it". CNN.
Jump up ^ "Establishing Health Insurance Marketplaces: An Overview of State Efforts". Kaiser Family Foundation. May 2, 2013.
Jump up ^ "How can I get ready to enroll in the Marketplace?". Healthcare.gov. Archived from the original on June 26, 2013.
Jump up ^ Morgan, David; Begley, Sharon (September 30, 2013). "Obamacare push accelerates as government shutdown nears". Reuters. Retrieved October 1, 2013. Sebelius said on Monday that 'the key date really is the 15th of December,' the deadline for buying coverage that starts on January 1.
Jump up ^ "Glossary: Open Enrollment Period". Healthcare.gov. Retrieved October 4, 2013.
Jump up ^ Young, Jeffrey (September 25, 2013). "Obamacare Benefits Enrollment Will Start Slowly, White House Predicts". The Huffington Post. Retrieved October 2, 2013.
Jump up ^ Cohn, Jonathan (August 5, 2013). "Burn Your Obamacare Card, Burn Yourself". The New Republic.
Jump up ^ Goldstein, Amy (2010). "Priority One: Expanding Coverage". In The Staff of the Washington Post. Landmark: The Inside Story of America's New Health-Care Law and What It Means for Us All. New York: Public Affairs. pp. 73–83. ISBN 9781410428998.
^ Jump up to: a b "Open Enrollment Outreach and Education Round-Up". HHS.gov/HealthCare. U.S. Department of Health & Human Services. December 15, 2014. Archived from the original on January 4, 2015.
Jump up ^ Acosta, Jim; Cohen, Tom (December 31, 2013). "More than 2 million enrolled under Obamacare". CNN.
Jump up ^ content
Jump up ^ "I have been denied coverage because I have a pre-existing condition. What will this law do for me?" (PDF). Health Care Reform Frequently Asked Questions. New Hampshire Insurance Department. p. 2. Retrieved June 28, 2012.
Jump up ^ Binckes, Jeremy; Wing, Nick (March 22, 2010). "The Top 18 Immediate Effects Of The Health Care Bill". The Huffington Post. Retrieved March 22, 2010.
Jump up ^ "What does Marketplace health insurance cover?". Healthcare.gov.
Jump up ^ "Minimum Coverage Provision". American Public Health Association.
^ Jump up to: a b "Technical Explanation of The Revenue Provisions of the Reconciliation Act of 2010, as Amended, in Combination With the Patient Protection And Affordable Care Act". Joint Committee on Taxation. March 21, 2010. Generally, in 2010, the filing threshold is $9,350 for a single person or a married person filing separately and is $18,700 for married filing jointly.
Jump up ^ Doyle, Brion B. (March 5, 2013). "Understanding the Impacts of the Patient Protection and Affordable Care Act". The National Law Review. Retrieved 17 April 2013.
^ Jump up to: a b Galewitz, Phil (March 26, 2010). "Consumers Guide To Health Reform". Kaiser Health News.
Jump up ^ Downey, Jamie (March 24, 2010). "Tax implications of health care reform legislation". The Boston Globe. Retrieved March 25, 2010.
Jump up ^ Luhby, Tami (August 13, 2013). "Uninsured next year? Here's your Obamacare penalty". CNN.
Jump up ^ Kliff, Sarah; Klein, Ezra (March 27, 2012). "Individual mandate 101: What it is, why it matters". Wonkblog at the Washington Post. Retrieved July 2, 2012.
Jump up ^ "Requirement to maintain minimum essential coverage". Cornell University Law School Legal Information Institute. September 18, 2013. Described in 26 USC § 5000A(f)(4)(A)
Jump up ^ Sahadi, Jeanne (June 29, 2012). "How health insurance mandate will work". CNN. Retrieved July 12, 2013.
Jump up ^ "2013 Poverty Guidelines". United States Department of Health and Human Services.
^ Jump up to: a b Rice, Sabriya (March 25, 2010). "5 key things to remember about health care reform". CNN. Retrieved May 21, 2010.
^ Jump up to: a b "Medicaid Expansion: 5. Is Medicaid eligibility expanding to 133 or 138 percent FPL, and what is MAGI?". American Public Health Association.
Jump up ^ Luhby, Tami (July 1, 2013). "States forgo billions by opting out of Medicaid expansion". CNN.
Jump up ^ "Is Medicaid Expansion Good for the States?". U.S. News & World Report.
Jump up ^ Kliff, Sarah (April 25, 2013). "The outlook for Medicaid expansion looks bleak". Washingtonpost.com. Retrieved July 17, 2013.
^ Jump up to: a b MacGillis, Alec (2010). "The Insurers: More Customers, More Restrictions". In The Staff of the Washington Post. Landmark: The Inside Story of America's New Health-Care Law and What It Means for Us All. New York: Public Affairs. pp. 93–98. ISBN 9781410428998.
Jump up ^ Peterson, Chris L.; Gabe, Thomas (April 6, 2010). "Health Insurance Premium Credits Under PPACA (P.L. 111-148)" (PDF). Congressional Research Service.
Jump up ^ Galewitz, Phil (March 22, 2010). "Health reform and you: A new guide". msnbc.com. Retrieved March 23, 2010.
Jump up ^ Grier, Peter (March 20, 2010). "Health care reform bill 101: Who gets subsidized insurance?". The Christian Science Monitor.
Jump up ^ wikisource:Patient Protection and Affordable Care Act/Title I/Subtitle E/Part I/Subpart A
^ Jump up to: a b Patient Protection and Affordable Care Act: Title I: Subtitle E: Part I: Subpart A: Premium Calculation
Jump up ^ "Refundable Tax Credits". Bread for the World Institute. Archived from the original on March 5, 2012.
Jump up ^ "Health Insurance Premium Tax Credit" (PDF). Federal Register. Washington, D.C.: Government Printing Office. 77 (100): 30377–30400. May 23, 2012.
^ Jump up to: a b "Treasury Lays the Foundation to Deliver Tax Credits to Help Make Health Insurance Affordable for Middle-Class Americans" (PDF) (Press release). United States Department of the Treasury. August 12, 2011.
Jump up ^ Pear, Robert (August 12, 2013). "A Limit on Consumer Costs Is Delayed in Health Care Law". The New York Times.
Jump up ^ Cohn, Jonathan (August 13, 2013). "The Latest Right-Wing Freakout Over Obamacare". The New Republic.
Jump up ^ Goddard, Teagan (August 13, 2013). "Just Another Obamacare Delay". Roll Call.
Jump up ^ Chait, Jonathan (August 15, 2013). "George Will: Now Obama Is Worse Than Nixon". New York.
^ Jump up to: a b c "Private Health Insurance Provisions in PPACA (P.L. 111-148)" (PDF). Congressional Research Service. April 15, 2010.
^ Jump up to: a b "Health Insurance Premiums: Past High Costs Will Become the Present and Future Without Health Reform" (PDF). HealthCare.gov. January 28, 2011. Archived from the original (PDF) on January 15, 2013.
Jump up ^ "Financing Center of Excellence | SAMHSA | Health Insurance Premiums: Past High Costs Will Become the Present and Future Without Health Reform". Substance Abuse and Mental Health Services Administration. March 14, 2011. Retrieved June 29, 2012.
Jump up ^ "Health Insurance Premium Credits Under PPACA" (PDF). Congressional Research Service. April 28, 2010. Archived from the original (PDF) on October 27, 2010.
Jump up ^ "An Analysis of Health Insurance Premiums Under the Patient Protection and Affordable Care Act". Congressional Budget Office. November 30, 2009.
Jump up ^ "Policies to Improve Affordability and Accountability". whiteHouse.gov. Archived from the original on 2012-12-30.
Jump up ^ "Subsidy Calculator: Premium Assistance for Coverage in Exchanges". Kaiser Family Foundation.
^ Jump up to: a b Pauly, Mark V.; Herring, Bradley (May 2007). "Risk Pooling and Regulation: Policy and Reality in Today's Individual Health Insurance Market". Health Affairs. 26 (3): 770–779. doi:10.1377/hlthaff.26.3.770.
^ Jump up to: a b Waxman, Henry A.; Stupak, Bart (October 12, 2012). "Re: Coverage Denials for Pre-Existing Conditions in the Individual Health Insurance Market [Memorandum]" (PDF). United States House Committee on Energy and Commerce. Retrieved December 15, 2012.
Jump up ^ Hall, Jean P. (October 19, 2010). "Affordable Care Act Options for People with Preexisting Conditions". The Commonwealth Fund.
Jump up ^ Vesely, Rebecca (February 28, 2011). "States try it again". Modern Healthcare. 41 (9): 17.
^ Jump up to: a b Haeder, Simon (2013). "Making the Affordable Care Act Work: High-Risk Pools and Health Insurance Marketplaces". The Forum. 11 (3). doi:10.1515/for-2013-0056.
Jump up ^ "Compilation of Patient Protection and Affordable Care Act" (PDF). Office of the Legislative Counsel. June 9, 2010.
Jump up ^ "How do I choose Marketplace insurance?". HealthCare.gov. Retrieved October 28, 2013. There are 5 categories of Marketplace insurance plans: Bronze, Silver, Gold, Platinum, and Catastrophic.
Jump up ^ Somashekhar, Sandhya; Kliff, Sarah (September 24, 2013). "Premiums unveiled show wide range for health overhaul plans". The Seattle Times. Archived from the original on December 18, 2014.
Jump up ^ Tergesen, Anne. "Obamacare premiums for 2015 include some big changes".
Jump up ^ "By the Numbers: Open Enrollment for Health Insurance". HHS.gov/HealthCare. U.S. Department of Health & Human Services. February 13, 2015. Archived from the original on February 15, 2015.
Jump up ^ Japsen, Bruce (June 17, 2012). "Mandate To Buy Coverage: Health Insurance Industry's Idea, Not Obama's". Forbes. Retrieved February 7, 2014.
Jump up ^ "Individual Responsibility - Glossary". HealthCare.gov. Archived from the original on June 19, 2013. Retrieved 3 June 2013.
Jump up ^ Board, Editorial (February 7, 2014). "The CBO report does not show the new health-care law is failing". The Washington Post.
Jump up ^ Dimick, Chris (June 1, 2010). "Accrediting HIEs". Journal of AHIMA.
Jump up ^ See more information on the HIMSS Dictionary at 2nd Edition of the HIMSS Dictionary of Healthcare Information Technology Terms, Acronyms and Organizations.
Jump up ^ Mullaney, Tim (October 6, 2013). "Obama adviser: Demand overwhelmed HealthCare.gov". USA Today.
Jump up ^ "State Health Insurance Exchanges".
Jump up ^ Blumberg, Linda J.; Pollitz, Karen (April 1, 2009). "Health Insurance Exchanges: Organizing Health Insurance Marketplaces to Promote Health Reform Goals". Urban Institute.
Jump up ^ Lohr, Kathy (October 5, 2013). "Glitches Slow Health Exchange Sign-ups". NPR.
Jump up ^ Goldstein, Amy; Sun, Lena H.; Somashekhar, Sandhya (October 1, 2013). "Rush of interest continues on insurance Web sites". The Washington Post.
^ Jump up to: a b c d e Westneat, Danny (October 8, 2013). "Obamacare is here, GOP, ready or not". The Seattle Times.
Jump up ^ Auerbach, David (October 8, 2013). "What really went wrong with healthcare.gov?". Slate. Retrieved February 7, 2014.
Jump up ^ Periroth, Nicole (October 2, 2013). "Problems at Health Care Web Site Not From Online Attack, Experts Say". New York Times.
Jump up ^ Landa, Amy Snow (October 21, 2013). "Washington Healthplanfinder: more than 35,000 have enrolled in 3 weeks". The Seattle Times.
Jump up ^ Somashekhar, Sandhya; Goldstein, Amy; Eilperin, Juliet (October 23, 2013). "Americans will have an extra six weeks to buy health coverage before facing penalty". The Washington Post.
^ Jump up to: a b c SARA MORRISON (March 25, 2014). "Obamacare: Enrollees Get Post-Deadline 'Special Enrollment Period' Extension".
^ Jump up to: a b c "Obama Administration Announces Health Care Extension". Fox News. March 25, 2014.
Jump up ^ DAN RITTER (March 25, 2014). "I'll Take the Tax: 10 Obamacare Exemptions You Don't Want". Wall Street Cheat Sheet.
Jump up ^ "How do I qualify for an exemption from the fee for not having health coverage?". HealthCare.gov. Retrieved March 26, 2014.
Jump up ^ "Status of State Action on the Medicaid Expansion Decision, as of July 1, 2013 - Table". Kaiser Family Foundation. June 20, 2013.
Jump up ^ "Status of State Action on the Medicaid Expansion Decision, as of July 1, 2013 - Map". Kaiser Family Foundation. June 20, 2013.
Jump up ^ Allen, Greg (October 1, 2013). "In Florida, Insurer And Nonprofits Work On Enrollment". NPR.
Jump up ^ "Subsidy Calculator". Kaiser Family Foundation.
Jump up ^ Bastasch, Michael (October 3, 2013). "Study: Obamacare spikes young people's health insurance costs". The Daily Caller.
Jump up ^ Condon, Stephanie (October 2, 2013). "Obamacare marketplaces raise data security concerns". CBS.
Jump up ^ Ydstie, John (October 4, 2013). "Part-Time Workers Search New Exchanges For Health Insurance". NPR.
Jump up ^ Thompson, Connie (September 30, 2013). "Scammers newest ruse: Health care reform". KLEW-TV.
Jump up ^ Tarpley, Tiffany (October 1, 2013). "Protecting yourself from healthcare law scams". WDJT-TV.
Jump up ^ Landa, Amy Snow (October 4, 2013). "Left off many networks, Seattle Children's sues". The Seattle Times.
Jump up ^ Haeder, Simon; Weimer, David; Mukamel, Dana (2015). "California Hospital Networks Are Narrower In Marketplace Than In Commercial Plans, But Access And Quality Are Similar". Health Affairs. 34 (5): 741–748. doi:10.1377/hlthaff.2014.1406.
Jump up ^ McGarr, Cappy (October 5, 2009). "A Texas-Sized Health Care Failure". The New York Times. Retrieved October 6, 2009.
Jump up ^ "The Affordable Care Act: The Individual Mandate" (PDF). University of Missouri. Retrieved February 23, 2014.
^ Jump up to: a b "S.1590 - Exchange Information Disclosure Act: Actions Overview". Congress.gov. Library of Congress. Retrieved February 17, 2017.
Jump up ^ "H.R. 3362 - All Actions". United States Congress. Retrieved January 7, 2014.
Jump up ^ Kasperowicz, Pete (January 4, 2014). "House GOP to demand O-Care updates". The Hill. Retrieved January 7, 2014.
Jump up ^ "Text of H.R. 3362". GovTrack. Retrieved January 7, 2014.
Jump up ^ "H.R. 3362 (113th): Exchange Information Disclosure Act — House Vote #23". GovTrack. Civic Impluse, LLC. January 16, 2014.
Jump up ^ "About Us". CaliforniaChoice. Retrieved September 13, 2017.
External links[edit]
HealthCare.gov
Status of Federal Funding for State Implementation of Health Insurance Exchanges Congressional Research Service
C-SPAN Video Library: Search Health Insurance Exchange
See "Clips" tab then "Clips Timeline" drop-down for abstracts of edited clips from the following videos:
Health Care Law Exchanges Apr 22, 2013, Jenny Gold, Kaiser Health News correspondent, Interview
Report Video Issue Health Insurance Exchanges Jul 25, 2013, Politico Pro Health Care Breakfast Briefing
Update on the Health Care Law Jul 1, 2013, Julie Rovner, National Public Radio health policy correspondent, Interview
HealthInsurance.org's guide to U.S. state health exchanges
Overview of Health Insurance Exchanges, Congressional Research Service, July 1, 2016
Group Health Insurance Since 1977
hide
v
t
e
Affordable Care Act
Key articles
Affordable Care Act (Patient Protection and Affordable Care Act and Health Care and Education Reconciliation Act of 2010)
Provisions of the Patient Protection and Affordable Care Act
Health insurance marketplace
Contraceptives mandate
Executive Order 13535
Provisions
Essential health benefits
Physician Payments Sunshine Act
Authority for Mandate Delay Act (H.R. 2667; 113th Congress)
Contraceptive mandate (United States)
Patient-Centered Outcomes Research Institute
Constitutional challenges
Constitutional challenges to the Patient Protection and Affordable Care Act
National Federation of Independent Business v. Sebelius
Coons v. Geithner
Health insurance marketplaces
HealthCare.gov, an option for all states
AR (Arkansas Health Connector)
CA (Covered California)
CO (Connect for Health Colorado)
CT (Access Health CT)
DC (DC Health Link)
HI (Hawaii Health Connector)
ID (Your Health Idaho)
IL (Illinois Health Benefits Exchange)
KY (Kynect)
MD (Maryland Health Connection)
MA (Health Insurance Connector)
MN (MNsure)
NV (Nevada Health Link)
NM (New Mexico Health Insurance Exchange)
NY (NY State of Health)
OR (Cover Oregon)
RI (HealthSource RI)
VT (Vermont Health Connect)
WA (Washington Healthplanfinder)
Federal insurance exchange
HealthCare.gov
Other reform proposals
from the 111th Congress
Affordable Health Care for America Act
America's Affordable Health Choices Act of 2009
America's Healthy Future Act
Healthy Americans Act
United States National Health Care Act
See also
Health care reform in the United States
Medicaid
Medicare
SCHIP
Retrieved from "https://en.wikipedia.org/w/index.php?title=Health_insurance_marketplace&oldid=852649887"
Categories:
Healthcare reform in the United States
Health insurance marketplaces
CGI Group
Hidden categories:
Wikipedia articles needing clarification from February 2014
Wikipedia articles in need of updating from August 2016
All Wikipedia articles in need of updating
Articles containing potentially dated statements from April 2014
All articles containing potentially dated statements
All articles lacking reliable references
Articles lacking reliable references from February 2017
Wikipedia articles in need of updating from February 2014
Articles containing potentially dated statements from April 2013
All articles with unsourced statements
Articles with unsourced statements from February 2014
Articles containing potentially dated statements from March 2013
Articles needing POV-check from February 2014
All articles with vague or ambiguous time
Vague or ambiguous time from March 2014
Articles with unsourced statements from September 2017
Articles needing additional references from September 2017
All articles needing additional references
All articles with peacock terms
Articles with peacock terms from September 2017
Navigation menu
Personal tools
Not logged in
Talk
Contributions
Create account
Log in
Namespaces
Article
Talk
Variants
Views
Read
Edit
View history
More
Search
Navigation
Main page
Contents
Featured content
Current events
Random article
Donate to Wikipedia
Wikipedia store
Interaction
Help
About Wikipedia
Community portal
Recent changes
Contact page
Tools
What links here
Related changes
Upload file
Special pages
Permanent link
Page information
Wikidata item
Cite this page
Print/export
Create a book
Download as PDF
Printable version
In other projects
Wikimedia Commons
Languages
Add links
This page was last edited on 30 July 2018, at 12:58 (UTC).
Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization.
Privacy policy
About Wikipedia
Disclaimers
Contact Wikipedia
Developers
Cookie statement
Mobile view
Enable previews

values: mw-page-base noprint

values: mw-head-base noprint

values: firstHeading firstHeading en

values: siteSub noprint

values: mw-jump-link #mw-head

values: mw-jump-link #p-search

value: td

value: i

value: small

value: tr

value: tbody

value: table

attrs: class role

values: plainlinks metadata ambox ambox-content ambox-Update

values: History of health care reform in the United States

values: Healthcare reform debate in the United States

values: padding:0.3em 0.4em 0.3em;font-weight:bold;border-top: 1px solid #aaa; border-bottom: 1px solid #aaa;display:block; margin-bottom:0.3em;

values: Emergency Medical Treatment and Active Labor Act

values: Health Insurance Portability and Accountability Act

values: Medicare Prescription Drug, Improvement, and Modernization Act

values: Patient Safety and Quality Improvement Act

values: America's Affordable Health Choices Act of 2009

values: Patient Protection and Affordable Care Act

values: Health Care and Education Reconciliation Act of 2010

values: font-size: 105%; padding: 0.2em 0px 0.4em; text-align: center; display: none;

values: Health care reforms proposed during the Obama administration

values: Public opinion on health care reform in the United States

values: List of healthcare reform advocacy groups in the United States

values: Healthcare rationing in the United States

values: Health insurance coverage in the United States

values:
/wiki/Free_market_healthcare
mw-redirect
Free market healthcare

values:
/wiki/Health_insurance_exchange
mw-redirect
Health insurance exchange

values:
/wiki/Publicly-funded_health_care
mw-redirect
Publicly-funded health care

values:
/wiki/Single-payer_health_care
mw-redirect
Single-payer health care

values: Comparison of the health care systems in Canada and the United States

values:
/wiki/Two-tier_health_care
mw-redirect
Two-tier health care

values:
/wiki/Global_payment
mw-redirect
Global payment

attrs: alt src width height class srcset data-file-width data-file-height

values: Template:Healthcare reform in the United States

values: Template talk:Healthcare reform in the United States

values: float:right;clear:right;width:22.0em;margin:0 0 1.0em 1.0em;background:#f9f9f9;border:1px solid #aaa;padding:0.2em;border-spacing:0.4em 0;text-align:center;line-height:1.4em;font-size:88%

values: plainlinks noexcerpt noprint asof-tag update

values: checkbox button toctogglecheckbox toctogglecheckbox display:none

values: Source is a blog post; text is incomplete. (February 2017)

values: noprint Inline-Template noprint noexcerpt Template-Fact

values: The date of the event predicted near this tag has passed. (February 2014)

values: Wikipedia:Manual of Style/Dates and numbers

values: display:inline-block; width:1.5em; height:1.5em; margin:1px 0; border:1px solid black; background-color: #232; color:black; font-size:100%; text-align:center;

values: -webkit-column-break-inside: avoid;page-break-inside: avoid;break-inside: avoid-column

values: display:inline-block; width:1.5em; height:1.5em; margin:1px 0; border:1px solid black; background-color: #898; color:black; font-size:100%; text-align:center;

values: display:inline-block; width:1.5em; height:1.5em; margin:1px 0; border:1px solid black; background-color: #C8C8C8; color:black; font-size:100%; text-align:center;

values:
/wiki/Preexisting_condition
mw-redirect
Preexisting condition

values:
/wiki/U.S._House_of_Representatives
mw-redirect
U.S. House of Representatives

values: Edit section: Patient Protection and Affordable Care Act regulations

values: Provisions of the Patient Protection and Affordable Care Act

values:
/wiki/Emergency_services
mw-redirect
Emergency services

values:
/wiki/Prescription_drugs
mw-redirect
Prescription drugs

values: United States Department of Health and Human Services

values: margin-left: 1em; text-align: center; float: right

values: National Federation of Independent Business v. Sebelius

values: s:Patient Protection and Affordable Care Act/Title I/Subtitle D/Part I

values:
/wiki/Federal_poverty_level
mw-redirect
Federal poverty level

values: The text near this tag may need clarification or removal of jargon. (February 2014)

values:
noprint Inline-Template
margin-left:0.1em; white-space:nowrap;

values:
reflist mw-references-wrap
list-style-type: lower-alpha;

values: text-align:left; background:white; border-top:1px solid black; padding:0 1em;

values: margin: 1em auto 1em auto;text-align:right

values:
/wiki/Idaho_Health_Insurance_Exchange
mw-redirect
Idaho Health Insurance Exchange

values:
/wiki/Maryland_Health_Benefit_Exchange
mw-redirect
Maryland Health Benefit Exchange

values: margin-left: 1em; text-align: center; float:right;

values: "thought of"? "residual market"? (February 2014)

values:
/wiki/Actuarial_Science
mw-redirect
Actuarial Science

values: "in-network" needs link or definition (February 2014)

values:
/wiki/Insurance_premium
mw-redirect
Insurance premium

values: Edit section: Economics of health insurance exchanges: the individual mandate

values: This claim needs references to reliable sources. (February 2014)

values:
noprint Inline-Template Template-Fact
white-space:nowrap;

values:
plainlinks metadata ambox ambox-content
presentation

values: The time period mentioned near this tag is ambiguous. (March 2014)

values: Utah Health Exchange (page does not exist)

values:
/wiki/Kentucky_health_plan_marketplace
mw-redirect
Kentucky health plan marketplace

values: Edit section: Postponement of tax penalty

values:
/wiki/Minnesota_Star_Tribune
mw-redirect
Minnesota Star Tribune

values: Edit section: Cover Oregon website failure

values:
/wiki/Cover_Oregon_website_failure
mw-redirect
Cover Oregon website failure

values: This claim needs references to reliable sources. (September 2017)

values: Edit section: Private health insurance exchanges

values: plainlinks metadata ambox ambox-content ambox-one_source

values:
/wiki/Health_plan
mw-redirect
Health plan

values:
/wiki/Insurance_carrier
mw-redirect
Insurance carrier

values: Exchange management (page does not exist)

values: Unverified descriptions (September 2017)

values: Wikipedia:Manual of Style/Words to watch

values: International Medical Exchange (page does not exist)

values:
/wiki/Anthem_(insurance)
mw-redirect
Anthem (insurance)

values:
nofollow
external text
https://www.cnbc.com/id/101633662

values: Barack Obama presidential campaign, 2012

values:
/wiki/Christian_Science_Monitor
mw-redirect
Christian Science Monitor

values:
/wiki/The_Huffington_Post
mw-redirect
The Huffington Post

values:
/wiki/Joint_Committee_on_Taxation
mw-redirect
Joint Committee on Taxation

values: s:Patient Protection and Affordable Care Act/Title I/Subtitle E/Part I/Subpart A

values: United States Department of the Treasury

values: Substance Abuse and Mental Health Services Administration

values:
nofollow
external text
http://www.cbo.gov/doc.cfm?index=10781

values:
nofollow
external text
//doi.org/10.1377/hlthaff.26.3.770

values: United States House Committee on Energy and Commerce

values:
nofollow
external text
//doi.org/10.1515/for-2013-0056

values: American Health Information Management Association

values:
nofollow
external text
http://www.urban.org/url.cfm?ID=411877

values:
nofollow
https://www.healthcare.gov/exemptions/
external text

values:
nofollow
external text
//doi.org/10.1377/hlthaff.2014.1406

values:
nofollow
external text
https://www.calchoice.com/AboutUs.aspx

values: -moz-column-width: 30em; -webkit-column-width: 30em; column-width: 30em; list-style-type: decimal;

values:
nofollow
external text
https://www.healthcare.gov

values:
nofollow
external text
https://fas.org/sgp/crs/misc/R43066.pdf

values:
nofollow
external text
https://fas.org/sgp/crs/misc/R44065.pdf

values:
nofollow
http://cookinc.com/
external text

values: Authority for Mandate Delay Act (H.R. 2667; 113th Congress)

values: Patient-Centered Outcomes Research Institute

values:
/wiki/District_of_Columbia
mw-redirect
District of Columbia

values: State Children's Health Insurance Program

values: nowraplinks collapsible expanded navbox-inner mw-collapsible mw-made-collapsible

values: Category:Healthcare reform in the United States

values: Category:Wikipedia articles needing clarification from February 2014

values: Category:Wikipedia articles in need of updating from August 2016

values: Category:All Wikipedia articles in need of updating

values: Category:Articles containing potentially dated statements from April 2014

values: Category:All articles containing potentially dated statements

values: Category:All articles lacking reliable references

values: Category:Articles lacking reliable references from February 2017

values: Category:Wikipedia articles in need of updating from February 2014

values: Category:Articles containing potentially dated statements from April 2013

values: Category:All articles with unsourced statements

values: Category:Articles with unsourced statements from February 2014

values: Category:Articles containing potentially dated statements from March 2013

values: Category:Articles needing POV-check from February 2014

values: Category:All articles with vague or ambiguous time

values: Category:Vague or ambiguous time from March 2014

values: Category:Articles with unsourced statements from September 2017

values: Category:Articles needing additional references from September 2017

values: Category:All articles needing additional references

values: Category:All articles with peacock terms

values: Category:Articles with peacock terms from September 2017

values: Discussion about edits from this IP address [ctrl-alt-n]

values: A list of edits made from this IP address [ctrl-alt-y]

values: You are encouraged to create an account and log in; however, it is not mandatory

values: You're encouraged to log in; however, it's not mandatory. [ctrl-alt-o]

values:
/wiki/Health_insurance_marketplace
View the content page [ctrl-alt-c]
c

values:
p-cactions
navigation
vectorMenu emptyPortlet
p-cactions-label

values:
mw-wiki-logo
/wiki/Main_Page
Visit the main page

values:
/wiki/Main_Page
Visit the main page [ctrl-alt-z]
z

values: Featured content – the best of Wikipedia

values: Find background information on current events

values:
/wiki/Special:Random
Load a random article [ctrl-alt-x]
x

values: portal navigation p-navigation p-navigation-label

values: Guidance on how to use and edit Wikipedia

values: About the project, what you can do, where to find things

values: A list of recent changes in the wiki [ctrl-alt-r]

values: portal navigation p-interaction p-interaction-label

values: portal navigation p-wikibase-otherprojects p-wikibase-otherprojects-label

values: /static/images/wikimedia-button-1.5x.png 1.5x, /static/images/wikimedia-button-2x.png 2x

values: /static/images/poweredby_mediawiki_132x47.png 1.5x, /static/images/poweredby_mediawiki_176x62.png 2x

values:
suggestions
display: none; font-size: 13px;

values: mediawiki ltr sitedir-ltr mw-hide-empty-elt ns-0 ns-subject page-Health_insurance_marketplace rootpage-Health_insurance_marketplace skin-vector action-view