Last Updated
September 13, 2019

Note: This graphic identifies states that have adopted certain specific actions intended to promote a competitive ACA marketplace. In particular, only those states that: (1) have merged their individual and small-group markets; (2) require that all individual market coverage be sold through the ACA marketplace; or (3) leverage insurers’ participation in state public health insurance programs, such as Medicaid, or state insurance markets to encourage or require participation in the ACA marketplace. Other factors and state actions not identified here also may affect the competitiveness of a state's ACA marketplace.