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Understanding Obamacare: Health Insurance Exchanges

Written by Michelle Stoffel Huffman on May 28, 2013 in Insurance  |   No comments

Nearly four years after Congress passed the federal Patient Protection and Affordable Care Act, one of its most prominent features will begin in October—the Health Insurance Marketplace. According to a recent survey done for InsuranceQuotes.com by Princeton Survey Research Associates International, only 10 percent of…

health insurance insurance policyNearly four years after Congress passed the federal Patient Protection and Affordable Care Act, one of its most prominent features will begin in October—the Health Insurance Marketplace.

According to a recent survey done for InsuranceQuotes.com by Princeton Survey Research Associates International, only 10 percent of Americans claim to be very knowledgeable about the Affordable Care Act, commonly known as Obamacare.

“People in general are not very well informed about the [Affordable Care Act], and I think the primary reason is the most significant parts of the law haven’t gone into effect,” said Alan Weil, executive director of the National Academy for State Health Policy.

Many of the survey respondents weren’t aware of when changes would go into effect, and they also didn’t know when they’d need to sign up for health insurance exchanges.

These exchanges are government-run marketplaces—primarily online—where people can compare and purchase an insurance policy, with a set of in-person options to help customers navigate the marketplace.

“There’s certainly an understanding that you can’t make this work if all you do is sort of send people to a website,” Weil said.

Exchanges will be run by individual states, by the federal government when states have chosen that option, or by a partnership between a state and the federal government.

However the exchange is run, the options and benefits available in the exchanges will be virtually the same, Weil explained. “Their functions are identical. They’ll find out if you’re eligible for a subsidy, give you options of plans, and get you enrolled.”

In general, plans offered through the exchanges will look much like private insurance plans do now, although they’ll be more structured and there will be some improvements in the nature of coverage.

According to Weil, insurers in the exchanges are required to offer “essential health benefits,” which are the types of services that have traditionally been covered by typical employer-sponsored health plans.

The health insurance plans offered will vary from state to state, but all plans will be required to offer certain federally-mandated options, like coverage for preventative services, maternity services, and pharmaceutical services.

Depending on income and family size, people may qualify for free or significantly discounted insurance plans through an exchange. According to healthcare.gov, a website set up by the federal government to explain recent and ongoing changes in health care laws, a new kind of tax credit will also become available.

People will not be required to purchase insurance through the exchanges—insurance through the private market will still be available.

“Very, very few people who have insurance through a job will want to switch over. I wouldn’t even encourage those people to give it much thought in the first year,” advised Weil. “It’s very unlikely someone with employer-covered health insurance would find themselves better off in the exchange—unless they’re getting very skimpy coverage through work.”

Those with comprehensive coverage through an employer aren’t eligible for most subsidies in the exchange. In fact, the primary targets of the exchanges are uninsured people or people—often those who are self-employed—that are currently buying insurance on their own.

Information on insurance plans that will be available through the Health Insurance Marketplace can be accessed now at healthcare.gov.

Enrollment in the new health exchanges will begin Oct. 1, 2013, and coverage through the exchanges will begin Jan. 1, 2014.

Michelle Stoffel Huffman is a researcher and staff writer for Think Glink Inc. Prior to joining Think Glink, Michelle worked for the Chicago Tribune as a daily news reporter and community manager, covering local government, business, tax issues and crime. She now specializes in real estate industry news, consumer financial reporting and home design and decor. She is a graduate of DePaul University in Chicago.

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