The federal Patient Protection and Affordable Care Act (Affordable Care Act), occasionally referred to as "Obamacare", provides the framework, policies, regulations and guidelines for implementation of comprehensive health care reform. The Affordable Care Act expands access to quality, affordable insurance and health care.
If the enrollment for the health plan is performed within a government-run marketplace for insurance, it is known as an on-exchange health plan. If the enrollment does not take place within the government-run marketplace for insurance, it is known as an off-exchange health plan.
Plans sold off-exchange must offer the same essential health benefits as plans sold on the exchanges, but the primary difference between buying plans on- or off-exchange is that only on-exchange plans are eligible for government subsidies. These subsidies, however, are only available to certain income groups and then only if their monthly insurance premium exceeds a predetermined portion of their income. Cost-sharing reduction plans are also only available on exchange for low-income individuals.