What if health insurance was similar to that of reserving a rental car?
You sign on to a Web site, answer a few personal questions about your current age, home address, family, income and more. Then the site supplies a list of plans, insurers and an accompanying list of plan prices and benefits – all the consumer needs to do is pick one from the list and sign up.
That’s essentially how a health benefits exchange works. This time, next year, under the national health law, people with low to moderate incomes will be able to purchase individual plans that will start in 2014. There will also be exchanges for small businesses.
A closer look at the exchange for individual plans:
Each plan rated based on price and quality.
Plan is required to make public disclosures including but not limited to finances, denied claims and enrollee rights.
Tax credits and other government assistance could help those that meet income guidelines but that don’t have access to other affordable coverage to receive lower premiums and out-of-pocket costs.
A program intended to educate people about the exchange would also be available.
Patient Protection and Affordable Act
The Act calls for exchanges in each state. Although anyone can use them to shop individual plans, they are intended to assist uninsured people who earn too much to be eligible for Medicaid, yet struggle to afford coverage. Exchanges also enable smaller employers to offer insurance to their workers.
According to estimates from the Congressional Budget Office, by the year 2019, 24 million people will buy individual plans through an exchange, along with 5 million employed through small businesses.
In Virginia (VA), by 2014, an estimated 283,000 people and 232,000 small business employees could participate in exchanges, says the Urban Institute.
Gov. Bob McDonnell has dodged his preference for Virginia, saying “A lack of information from the federal government makes it difficult to commit to a state-run exchange.”
While there are many pros to exchanges, consumers are concerned about higher premiums. Steve Cindrich of Optima Health says, “He is concerned that the federal subsidies won’t do enough to make plans affordable and as such consumers will opt out and pay the penalty tax for remaining uninsured.” The marketplace needs broad participation by insurers and consumers, to succeed.
About the Editors: The Shapiro, Lewis & Appleton personal injury law firm, whose attorneys work out of offices in Virginia (VA) and North Carolina (NC), edits the injury law blogs Virginia Beach Injuryboard, Norfolk Injuryboard, Eastern Shore Injuryboard, and Northeast North Carolina Injuryboard as a pro bono service.