Today, December 14, 2012 is decision day for states to notify Washington if they will set up their own insurance exchanges under the federal health care law. Half the states have said that they will participate in some way.
17 states and Washington, D.C., say they want to set up and run their own markets. The administration has already started granting approvals. Eight other states have indicated they want to pursue a partnership with Washington, and more may do so. Six remain undecided.
An Exchange is a mechanism for organizing the health insurance marketplace to help consumers and small businesses shop for coverage in a way that permits easy comparison of available plan options based on price, benefits and services, and quality. By pooling people together, reducing transaction costs, and increasing transparency, Exchanges create more efficient and competitive markets for individuals and small employers. They are the gateway to the new health care law for individuals and families who buy their own health insurance, as well as for small businesses. They are supposed to make picking health insurance like buying an airline ticket from an online travel site like Orbitz or Expedia.
There will be a website, and you'll be able to put in your ZIP code and get a list of available health plans. There will be a section where you can find out if you qualify for subsidies, or for Medicaid. There will be cost calculators to enable you to compare different levels of coverage: platinum, gold, silver and bronze. There will be tools that enable you to see if your doctor or hospital is with a particular plan. Middle-class consumers will be able to find out if they are eligible for government help with their premiums for private insurance. Initially, nearly 9 of every 10 taking part will get assistance.
Low-income people can use the exchanges to find out whether they are eligible for expanded Medicaid coverage under the law. In addition to deciding how to implement exchanges, states must also decide whether to accept the Medicaid expansion. There's no deadline set for that decision, and most are still weighing options.
California, New York and Kentucky are among the states that have opted to create their own exchanges. Among those passing are Texas, Georgia and Kansas. Partnership states include Illinois and West Virginia. Many governors rejecting state exchanges have cited a variety of reasons. Some say the administration has not provided enough information. Others say there's too much federal regulation. Most have concerns about costs.
Open enrollment for exchange plans starts next Oct. 1, and coverage begins Jan. 1, 2014.