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Despite Republicans’ concerted efforts to repeal and replace the Affordable Care Act, the federal- and state-based exchanges that it created will be in operation at least through 2019. These marketplaces help individuals, families, and small businesses shop for and enroll in affordable medical insurance.

The ACA and its possible replacement, the American Health Care Act, both rely on the same general structure to sell insurance to people who are not covered by insurance through work or other programs. Participants receive income-based subsidies to buy qualified health plans on either a state or federal marketplace ( The decisions that will shape the options available in 2019 are now being made by the Centers for Medicare and Medicaid Services.

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