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New resources explain the ABCs of state insurance exchanges

July 20, 2011 | 12:33 pm

STETHOSCOPE JUNE Confused by all the chatter about the nation's new healthcare overhaul and the centerpiece of the reform: state insurance exchanges?

Not to worry.

Two good sources of information may provide some clarity.

A new primer from the nonprofit Kaiser Family Foundation answers many basic questions about the online exchanges, where millions of individuals and small businesses will be able to shop for insurance plans starting in 2014, in straightforward terms.

Want to know, for example, if your business will be eligible to buy policies on the exchanges? Answer: As long as the business has 100 or fewer employees.

Similarly, will buyers be able to buy different levels of insurance coverage? Answer: Yes.

Health plans will have to offer established sets of "essential benefits," including coverage for hospital stays, maternity care, lab services and other care. But benefit offerings also will be broken down by levels and classified as bronze, silver, gold and platinum.

If you have still more questions, you might want to check out a private foundation called the Commonwealth Fund, which offers its own sets of facts and figures.

Are you wondering, for example, how soon you can start signing up for insurance under the state exchanges?

Answer: Under rules proposed by the Obama administration, the initial enrollment period will begin Oct. 1, 2013.

The new healthcare law requires most Americans to have health insurance starting in 2014 or pay fines.

But remember, the exchanges are for people who do not have employer-sponsored health coverage. The federal government expects more than 11 million people, many of them low-income, to sign up the first year. An estimated 27 million Americans are projected to get insurance through exchanges by 2018.

Low-income individuals and families will be able to apply for federal subsidies through online marketplaces.

"The exchanges are the centerpiece of the reform law," the Commonwealth Fund writes on its website, noting that they will be "the main portals for people without employer-sponsored or public insurance" to find coverage for years to come.

-- Duke Helfand

 

 

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