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Presentation: 5:16

Poster attached as supplemental file below


Background & Significance: By implementing the Affordable Care Act (ACA), the intention is to increase the number of insured people every year in the United States. Health Insurance Exchanges (HIE) were created to changed how people obtain insurance. This rapid review will analyze variations of HIEs as a part of the ACA and how these variations impact insurance status and the use of healthcare services. When states and the federal government implement different versions, analysis is needed to compare their effects regarding insurance status and healthcare services.

Methods: PubMed and Scopus searches were conducted of English-language studies published after the implantation of the ACA in 2013 and screened for relevance to the research question. The data collected from the selected studies were analyzed through data extraction, comparison, and qualitative analysis.

Results: Eleven studies met inclusion criteria out of 687 initial citations. The ACA has succeeded in sharply increasing insurance coverage. Since the ACA became law, the uninsured rate has declined by 43%, from 16.0% in 2010 to 9.1% in 2015, with most of that decline occurring after the law’s main coverage provisions took effect in 2014. Despite challenges in the rollout of the Marketplaces, it successfully improved coverage among many long-term uninsured. No variations of HIEs were found to impact insurance status and the use of healthcare services.

Conclusions: Those not insured before the ACA and HIE have benefitted the most. Whether state or federal, HIE status changes yearly, making it hard to conduct a review and analyze outcomes for long-term results.