HealthCare.gov

Name

HealthCare.gov

Legal name

HealthCare.gov (Official website of the United States government, operated by the Centers for Medicare & Medicaid Services)

Website

https://healthcare.gov

Company type

Public

Founded year

2010

Operating status

Operating

Headcount range

1–10 employees

Ownership category

akta.pro rank

Product category

Health Insurance Marketplace

NAICS

Insurance Agencies and Brokerages (524210), Direct Health and Medical Insurance Carriers (524114)

SIC

Hospital & Medical Service Plans (6324), Accident & Health Insurance (6321), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

ACA Marketplace (On-Exchange) Individual Plans (FSAIAEAA)

akta.pro secondary industry

Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH)

Keywords

• Health insurance marketplace
• Aca enrollment platform
• Government health coverage
• Insurance comparison tool
• Medicaid eligibility

Headquarters

HQ city

Baltimore

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Technology or R&D, Operations, Personnel, Infrastructure, Marketing or Sales, Others

Revenue model

1. Platform Operations (Government Funded): HealthCare.gov is a federally-operated platform funded by taxpayer dollars through CMS. The platform itself does not generate revenue but facilitates the purchase of health insurance plans from private insurers. Insurance companies pay fees to participate in the marketplace and offer plans through the platform.

Pricing tiers

Go-to-market motion1 record

Distribution channels6 records

Marketing channels5 records

Core offering

HealthCare.gov is the official U.S. federal Health Insurance Marketplace operated by the Centers for Medicare & Medicaid Services (CMS). It enables individuals, families, and small businesses to compare, select, and enroll in qualified health insurance plans from private insurers, and processes premium tax credits, cost-sharing reductions, and Medicaid/CHIP eligibility determinations. The platform is the sole channel through which consumers can receive income-based ACA subsidies.

Product overview

HealthCare.gov is the official federal portal for the Health Insurance Marketplace®, a platform operated by the Centers for Medicare & Medicaid Services (CMS) that enables individuals, families, and small businesses to shop for, compare, and enroll in affordable health insurance coverage. The core offering is the Health Insurance Marketplace® for individuals and families, complemented by the Small Business Health Options Program (SHOP) for employers with 1-50 employees. The platform integrates eligibility determination for Medicaid & CHIP, offers dental coverage as a stand-alone add-on, and provides access to various savings programs including premium tax credits and cost sharing reductions. Additional services include specialized plan types (Catastrophic plans, High Deductible Health Plans), Special Enrollment Periods for qualifying life events, and support tools such as Find Local Help (navigators/agents), FTE calculators, and tax credit estimators. The platform also provides downloadable plan datasets for researchers and issuers, and supports enrollment through certified Enhanced Direct Enrollment partner websites.

Differentiator

Problem solved

Functional benefit

Brands

• SHOP Marketplace: Small Business Health Options Program for small employers to offer health insurance to employees
• CuidadoDeSalud.gov

Products and services

• Health Insurance Marketplace® The central federal platform where U.S. individuals and families can compare, select, and enroll in qualified health insurance plans from multiple private insurers. Offers premium tax credits and cost-sharing reductions based on income eligibility. Operated by CMS.
• SHOP (Small Business Health Options Program)
• Medicaid & CHIP Coverage
• Dental Coverage
• Enhanced Direct Enrollment (EDE)
• Catastrophic Health Plans

Quantifiable outcome

• Premium tax credits can reduce monthly premiums to as low as $50/month for eligible enrollees earning below $62,600 (400% FPL)

Named customers4 records

Segments6 records

Ideal customer profiles5 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration13 records

Feature4 records

Partnerships

Ten partnerships are on record, tiered core.

• ExperiancoreTechnology or IntegrationIdentity proofing and authentication contractor that verifies consumer information provided during the Marketplace application process to confirm identity eligibility.
• SymanteccoreTechnology or IntegrationIdentity verification contractor working with Experian to authenticate consumer information and secure the enrollment process.
• Help On Demand (formerly BigWave Systems)coreTechnology or IntegrationCMS contractor operating a real-time referral system that connects consumers with Marketplace-registered and state-licensed insurance agents/brokers for enrollment assistance.
• Social Security Administration (SSA)coreTechnology or IntegrationFederal agency that participates in electronic verification process for eligibility determination regarding Affordable Care Act coverage.
• Internal Revenue Service (IRS)coreTechnology or IntegrationFederal agency that participates in electronic verification process and handles premium tax credit reconciliation.
• Department of Homeland Security (DHS)coreTechnology or IntegrationFederal agency that participates in eligibility verification for immigration status and coverage determination.
• State Medicaid and CHIP AgenciescoreTechnology or IntegrationState agencies that receive referrals from the Marketplace for Medicaid/CHIP eligibility and may transfer applications to the Marketplace when applicants are ineligible for public programs.
• Equifax Workforce SolutionscoreTechnology or IntegrationParticipates in electronic income verification process authorized by the Affordable Care Act.
• Enhanced Direct Enrollment (EDE) PartnerscoreChannel Partner/ Reseller/ DistributorInsurance companies and licensed agents/brokers authorized to submit consumer applications through their own websites, facilitating enrollment in Marketplace qualified health plans without requiring consumers to use HealthCare.gov directly.
• Navigators and AssisterscoreChannel Partner/ Reseller/ DistributorTrained organizations and individuals who provide free in-person enrollment assistance to consumers, funded through CMS grants.

Scale indicators3 records

Recent moves5 records

Expansion highlights4 records

Direct peers

• Covered California: California's state-based ACA marketplace and the largest alternative to HealthCare.gov. Operates the same fundamental value proposition — qualified health plans, premium tax credits, cost-sharing reductions, and Medicaid handoffs — but at the state level, competing head-to-head for the same ACA-eligible consumer.
• NY State of Health: New York's state-based ACA marketplace. Directly comparable product, regulatory framework, and consumer base to HealthCare.gov's function, serving individual market, small group (SHOP equivalent), and Medicaid eligibility determination within a single state.
• Massachusetts Health Connector: Massachusetts' state-based ACA marketplace and one of the longest-running state exchanges. Provides qualified health plans, premium tax credits, and small business coverage functionally identical to HealthCare.gov's offerings.
• Washington Healthplanfinder: Washington's state-based ACA marketplace. Competes with HealthCare.gov for ACA-eligible residents in Washington, offering the same qualified health plans, subsidy processing, and integrated Medicaid/CHIP eligibility.
• Maryland Health Connection: Maryland's state-based ACA marketplace. Operates in the same geographic/regulatory neighborhood as CMS (CMS HQ is in Baltimore) and offers an apples-to-apples substitute for HealthCare.gov for Maryland residents.
• Connecticut Access Health CT: Connecticut's state-based ACA marketplace. Comparable in scope to HealthCare.gov — individual qualified health plans, APTC processing, and integrated Medicaid eligibility — for the state of Connecticut.

Broad incumbents

• eHealth: Largest publicly traded private online health insurance marketplace and a CMS-certified Enhanced Direct Enrollment (EDE) partner. Competes for the same ACA-eligible consumers HealthCare.gov serves, with a broader multi-carrier portfolio spanning Medicare, dental, and ancillary products.

Emerging players

• Healthcare.com: Digital-first insurance comparison and enrollment platform focused on ACA, Medicare, and supplemental coverage. Competes with HealthCare.gov for individual ACA shoppers via a more modern, vertically integrated consumer experience.
• GoHealth: Online health insurance marketplace leveraging an agent-assisted tele-sales model. Overlaps with HealthCare.gov's enrollment target market, particularly among ACA and Medicare-eligible consumers who prefer guided purchase.
• GetInsured: Private SaaS-based health insurance exchange platform that powers multiple state-based marketplaces (e.g., Georgia, Pennsylvania, Virginia). Competes with HealthCare.gov both as a technology vendor to SBEs and as an EDE partner reaching ACA consumers.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat4 records

Key risks5 records

Key highlights5 records

Customer concentration

• Xx.com/HealthCareGov
• YouTubeyoutube.com/HealthCareGov
• Facebookfacebook.com/Healthcare.gov
• LinkedInlinkedin.com/company/premium-health-care

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about HealthCare.gov