NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH

CMS Health Insurance Marketplace Data -- ACA Exchange Data

CMS' Center for Consumer Information & Insurance Oversight produces the Health Insurance Marketplace Public Use Files (Marketplace PUF) to increase transparency in the Health Insurance Marketplace and to support benefit and rate analysis.

The Marketplace, also known as the Affordable Insurance Exchange, is a key component of the Affordable Care Act (ACA).

CMS describes the Marketplace PUF data in the following way:

"The Marketplace PUF includes plan and issuer level information for certified Qualified Health Plans (QHPs) and stand-alone dental plans (SADPs) offered to individuals and small businesses through the Health Insurance Marketplace. The Marketplace PUF includes data from states participating in the Federally Facilitated Marketplaces (FFM), which include State Partnership Marketplaces (SPMs), and states whose State-based Marketplaces rely on the federal information technology platform for QHP eligibility and enrollment functionality. The Marketplace PUF does not contain any data on plans offered in states that established and operate their own Marketplace (State-based Marketplace) and do not rely on the federal platform for QHP eligibility and enrollment functionality, nor does it contain enrollment or claims data."

CMS offers a Factsheet and a FAQ and makes some overall and file-specific disclaimers: User Agreement, Machine-readable URL, and Transparency in Coverage.

File NameFile Descriptions
Benefits and Cost SharingPlan-level data on essential health benefits, coverage limits, and cost sharing
RatePlan-level data on individual rates based on an eligible subscriber's age, tobacco use, and geographic location
Plan AttributesPlan-level data on maximum out of pocket payments, deductibles, cost sharing, HSA eligibility, formulary ID, and other plan attributes
Business RulesPlan-level data on the application of rates, such as allowed relationships (e.g., spouse, dependents) and tobacco use
Service AreaIssuer-level data on the geographic coverage or service area (i.e., where the plan is offered) including state, county, and zip code
NetworkIssuer-level data identifying provider network URLs
Plan ID CrosswalkPlan-level data mapping plans offered in the previous year to plans offered in the current year
Machine-readable URLIssuer-level URL locations for machine-readable plan network provider and formulary information
Transparency in CoverageIssuer-level claims, appeals, and active URL data
QualityQuality ratings for plans

 

Year Description Source
Stata
SAS
CSV
Desc
Documentation
2017 Benefits and Cost Sharing
zip
dta
sas7bdat
csv
desc
pdf
2017 Rate
zip
dta
sas7bdat
csv
desc
pdf
2017 Plan Attributes
zip
dta
sas7bdat
csv
desc
pdf
2017 Business Rules
zip
dta
sas7bdat
csv
desc
pdf
2017 Service Area
zip
dta
sas7bdat
csv
desc
pdf
2017 Network
zip
dta
sas7bdat
csv
desc
pdf
2017 Plan ID Crosswalk
zip
dta
sas7bdat
csv
desc
pdf
2017 Machine-readable URL
zip
dta
sas7bdat
csv
desc
pdf
2017 Transparency in Coverage
zip
dta
sas7bdat
csv
desc
pdf
2017 Quality
zip
dta
sas7bdat
csv
desc
pdf
2016 Benefits and Cost Sharing
zip
dta
sas7bdat
csv
desc
pdf
2016 Rate
zip
dta
sas7bdat
csv
desc
pdf
2016 Plan Attributes
zip
dta
sas7bdat
csv
desc
pdf
2016 Business Rules
zip
dta
sas7bdat
csv
desc
pdf
2016 Service Area
zip
dta
sas7bdat
csv
desc
pdf
2016 Network
zip
dta
sas7bdat
csv
desc
pdf
2016 Plan ID Crosswalk
zip
dta
sas7bdat
csv
desc
pdf
2016 Machine-readable URL
zip
dta
sas7bdat
csv
desc
pdf
2015 Benefits and Cost Sharing
zip
dta
sas7bdat
csv
desc
pdf
2015 Rate
zip
dta
sas7bdat
csv
desc
pdf
2015 Plan Attributes
zip
dta
sas7bdat
csv
desc
pdf
2015 Business Rules
zip
dta
sas7bdat
csv
desc
pdf
2015 Service Area
zip
dta
sas7bdat
csv
desc
pdf
2015 Network
zip
dta
sas7bdat
csv
desc
pdf
2015 Plan ID Crosswalk
zip
dta
sas7bdat
csv
desc
pdf
2014 Benefits and Cost Sharing
zip
dta
sas7bdat
csv
desc
pdf
2014 Rate
zip
dta
sas7bdat
csv
desc
pdf
2014 Plan Attributes
zip
dta
sas7bdat
csv
desc
pdf
2014 Business Rules
zip
dta
sas7bdat
csv
desc
pdf
2014 Service Area
zip
dta
sas7bdat
csv
desc
pdf
2014 Network
zip
dta
sas7bdat
csv
desc
pdf

Updates and changes.

To report problems or if you have comments or suggestions , e-mail Jean Roth at jroth@nber.org

Last Update Created by Jean Roth February 25, 2014
 
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