Healthcare Reform - Lesson 20 - Open Erollment is Here!

The exchanges are open, the exchanges are open!  This is the largest event in domestic policy since Medicare opened up for business,  "for those Americans who until now were shut out of the health insurance market through no fault of their own, Tuesday was a big day. No longer do they have to fear bankruptcy after a lifetime of work because of health and employment factors outside their control — an unnecessarily cruel feature of the system under which the nation has operated." Chicago SunTimes  and medicare actually has a lot of responsibility in making the Affordable Care Act Work.

Health Insurance Marketplaces officially opened in all 50 states!  The interest level of the American public was very high, for example before 7:00 a.m. on Tuesday, October 1, more than 1 million people had already visited the websites.
Some of the states had better results on the websites than others.  There are three types of websites on the public Marketplaces.

courtesy of renjith krishnan  digitalimages.net

1. State Run Marketplace
2. Federally Run Marketplace
3. State/Federal partnership Marketplaces.  

To figure out which your state runs, you can pretty much just look at your states' governor.  Republicans have pushed back against this law since day 1, and republican governors have not created exchanges, so those states are ran by the federal government.

Enough about that, oh wait, just one more thing...The shut down of the federal government!   How does the shut down effect the Affordable Care Act?  Well from what I have read the expenditures in the Affordable Care Act have been categorized as mandatory and therefore are not immediately affected by funding pitfalls.  And therefore the employess integral to the Affordable Care Act, such as website developers and navigators, are still working.  All of the insurance companies selling insurance on the public exchange are private companies, so obviously are not affected by a government shutdown

The volume of visitors has continued to be very high.  This is not all good news since the websites have been difficult to access due to high traffic volume.  The official numbers of actual insurance applications completed has not been publicized, but from everything I have heard, it is a very low number.  If people are unable to access the websites and purchase health insurance on-line then the system could be in big trouble.  We can only hope that the accessibility and functionality issues will increase over time.  They should be able to handle millions of people a day, because they do serve a very large country of over 300,000,000 people.

I have personally receive phone calls from people trying to get onto the exchange and asking for my help to get insured.  I can help them, but it is hard when the technology is not working.  Just to put some peoples minds at ease, the insurance that is purchased on the exchange will not go into effect until Janaury 1.  The deadline for applying for a January 1st effective date is December 15th.  And the open enrollment period goes all the way through March 31 of 2014.  This first enrollment period is a marathon, not a sprint.

The technolgy on the marketplace has not been avaialble to brokers/agents until October 1.  so I have not received a lot of training on that yet.  I have receive a lot of product training on the providers and product on the exchange.  One of the most significant developments that I have learned during company wide meetings with insurance company executives over the last month is about the variations in network coverage between plans that are sold on the Public Marketplace - vs - on the Private Marketplace.  It turns out that the plans on the publice marketplace have very narrow networks and mostly are HMO style plans.  The plans on the Private Marketplace have the same robust networks and PPO style options that people have become accustomed to.  So this is a big buying decision.  For thos individuals and families that do not qualify for a subsidy based on their income, time should not be spent searching for plans through the public marketplace.  Better plans will be available on the private marketplace with all of the same mandated coveraes but with better doctors and pharmacy networks.

One other thing before I wrap up.  One of the questions driving traffic to the Marketplace is "How expensive is it".  That information is on the exchange, it is just clunky and difficult to access right now.  But it is expensive...unless you qualify for a subsidy.  Which means the government will pay for some of the cost of your premium.  If yo do not qualify for a premium than people are much better off buying insurance on the private exchange, just like today.

My last 19 blog posts are listed below.  If you want to find out more about a specific lesson, then scroll down through and learn to your hearts delight.

Lesson #1 - Introduction
Lesson #2 - Basic Reason for creating the Patient Protection and Affordable Care Act
Lesson #3 - Public exchanges for Purchasing Insurance
Lesson #4 - Essential Health Benefits that will be added to all Health Insurance policies in 2014
Lesson #5 - Tax Credits to Help Pay for Health Insurance
Lesson #6 - Enforcement and Penalties in the Affordable Care Act
Lesson #7 - Preparing for the Affordable Care Act
Lesson #8 -  Options for Small Businesses
Lesson # 9 - Will my Insurance Premiums change in 2014?
Lesson #10 - What Will Happen to Small Groups in 2014?
Lesson # 11 - Why Should I Buy Insurance Before the Deadline?
Lesson #12 - What does the Delay in the Employer Mandate Really Mean? 
Lesson #13 - Can I keep my Current Health Insurance Plan?
Lesson # 14 - Who is Providing Insurance During Open Enrollment?
Lesson #15 - Out of Pocket Spending Limits - Law Change
Lesson 16 - SHOP - Marketplaces for Small Businesses 

Lesson #17 - Options for Individuals and Small Businesses

Lesson 18 - Advice from an expert

Lesson # 19 - Top Three Questions About the Law