From the President and CEO: Time to Prepare for Insurance Marketplaces

May 17, 2013  |  Foundation News

Message From the President and CEO

May 21, 2013

Over the past three years, we have heard references to the Health Insurance Exchange, Health Benefits Exchange, State Health Exchange, Federally Facilitated Exchange and now—drum roll, please—the Health Insurance Marketplace.  All of these terms refer to the same thing—an online portal for individuals currently without health insurance to find an insurance plan that is right for them and their families. I recently participated in a conference call hosted by Health and Human Services that provided more details on this new tool.

Beginning October 1, 2013, uninsured individuals and families will be able to use the Health Insurance Marketplace to shop for health coverage plans that will begin on January 1, 2014. Consumers will be able to fill out an online application (about 3 pages in length) and see a range of health insurance policy options. Paper applications also will be available for those without access to computers or who need additional help completing the application.

Based on an initial preview of the application, it seems streamlined and straightforward, although it has not yet been tested.  In most cases, consumers should need only a Social Security Number and a pay stub or a W-2 to complete the process. You can view the sample Individual Short Form here: 

http://cciio.cms.gov/resources/other/files/AttachmentB_042913.pdf

As is the case with any introduction of a new technology, there are likely to be glitches at the start. Even so, with the online marketplace, consumers will finally have the opportunity to shop for health insurance—something everyone needs but most rarely understand—packaged in an electronic form much like the online tools consumers already use to shop for household appliances, cars, and other products and services. 

The marketplace will present coverage plans that meet federal requirements and are approved by the respective states. The number of health plans offered will vary by state. Consumers will see side-by-side comparisons of the available coverage plans, with their benefits, deductibles, out-of-pocket costs and provider networks. The marketplace will be able to screen consumers to determine if they are eligible for their states’ Medicaid and Children’s Health Insurance Plan. Tax credits that can help pay for premiums (which may translate into tax refunds for some low-income consumers) also will be automatically determined.

It is hard to predict how smoothly the launch of this new system will go. And with the launch of the marketplace just a few months away, there remains a lot of confusion about this tool and how it will work. Therefore, our health and human service organization partners will play a critical role in educating their staffs, volunteers and clients so that eligible individuals and families can sign up for coverage. 

Read full text of President and CEO message

Recent Articles:

“Kansas Insurers Gearing Up to Market New Plans on the Exchange,” KHI News, May 27, 2013

“Knowledge Gap:  The ACA Marketplace is Coming But Who Knows?” KHI News, May 13, 2013

Kaiser Health Tracking Poll:  April 2013, The Henry J. Kaiser Family Foundation, April 30, 2013

“Implementing Health Reform: Proposed Regulations for Exchange ‘Navigators,’ “ Health Affairs blog, April 4, 2013

Additional Reading:

The Center for Consumer Information and Insurance Oversight (CCIIO) is charged with helping implement many provisions of the Affordable Care Act. In late April, CCIIO released answers to some of the most Frequently Asked Questions (FAQs) related to exchanges, as well as some of the new market wide reforms, including the modified community rating standard, the status of state high risk pools, and the definition of association health plans

Fact Sheet: Navigators: Guiding People Through the Exchange, Community Catalyst

State Exchange Profiles: 

Kansas: http://kff.org/health-reform/state-profile/state-exchange-profiles-kansas/

Missouri: http://kff.org/health-reform/state-profile/state-exchange-profiles-missouri/