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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] As of April 14, 2020, 11.41 million people had signed up through the health insurance marketplaces.[5]
Private non-ACA health care exchanges also exist in many states, responsible for enrolling 3 million people.[6] These exchanges predate the Affordable Care Act and facilitate insurance plans for employees of small and medium size businesses.