Who Regulates Health Insurance? 
The answer to this question was much simpler prior to passage of the Affordable Care Act . Insurance was primarily regulated at the state level , but now a variety of federal government departments are involved . The Centers for Medicaid and Medicare -LRB- CMS -RRB- regulate the administration of those two programs in combination with the states . The Department of Health and Human Services issues many interpretations of the law , and was responsible for rolling out the exchange marketplaces . The Internal Revenue Service -LRB- IRS -RRB- will be involved in collecting the penalty from those not purchasing coverage , and determining and validating the income-based subsidies . Other departments are involved as well . 