TUESDAY, Oct. 1 (HealthDay News) -- The Affordable Care Act's
new health insurance exchanges opened for business Tuesday amid the
first federal government shutdown in 17 years and a push by
Republicans in the House of Representatives to delay further
implementation of "Obamacare."
The rollout of the exchanges, or marketplaces, marks a crucial
step in the expansion of health insurance access to millions of
uninsured Americans beginning in 2014. Under the law, most people
without insurance face the prospect of a fine.
Despite the Capitol Hill clash between Republicans and
Democrats, the exchanges will be up and running -- with varying
degrees of success -- on Tuesday because the Affordable Care Act
doesn't rely exclusively on annual appropriations from
Some health insurance exchanges were open but not fully
functional. Officials in Colorado, Oregon and the District of
Columbia announced computer system problems prior to the kickoff of
open enrollment, which runs through March 31, 2014.
People in Oregon, for example, can't apply for coverage online
for several weeks. Those who want to apply immediately must connect
with one of the exchange's licensed agents or community
Jesse Ellis O'Brien, a health-care advocate with the Oregon
State Public Interest Research Group Foundation, said he "wouldn't
be surprised" if other states found their websites weren't quite
ready to go live, either.
"I think the key thing is October 1st is a starting point -- it's not a finish line," he said.
Federal health officials also confirmed last week that small
businesses won't be able to apply online for coverage in federally
run small business insurance exchanges until November, and that the
Spanish-language version of HealthCare.gov, the government's health
reform website, won't be ready to enroll people for a few
Nicole Kaeding, state policy manager for Americans for
Prosperity, a conservative advocacy group in Arlington, Va., said
she expects these sorts of stories to persist. "Piling thousands of
pages of regulation onto an insurance market is an unworkable
solution. We're beginning to see just how unworkable it is," she
Not even proponents of the health reform law had expected such
an immense undertaking to get off the ground without a hitch.
"You know, I think it would be foolish to say that everything is going to go perfectly," Gary Cohen, director of the Center for Consumer Information and Insurance Oversight at the U.S. Centers for Medicare and Medicaid Services, said during a news briefing last week. "On any big IT [information technology] project, there always are going to be things that you can improve on and make better," he said.
The new health exchanges offer one-stop shopping for health
insurance coverage. Eligible Americans can compare health plans and
prices and choose the coverage that suits them best.
The exchanges will also determine whether people are eligible
for public health coverage under Medicaid or the Children's Health
Some 7 million people are expected to enroll in private health
coverage through the exchanges in 2014, according to estimates by
the nonpartisan Congressional Budget Office. Another 9 million will
enroll in Medicaid and the Children's Health Insurance Program,
according to the research outfit's projections.
If you are uninsured, here's how the exchanges are designed to
How smoothly enrollment goes is likely to vary somewhat by
Pennsylvania, for example, is one of 27 states where the federal
government is running the state's health insurance exchange.
The U.S. Department of Health and Human Services awarded a
little more than $2.5 million in grants -- a third of what some
states received -- to train so-called "navigators" to provide
in-person assistance to people who need enrollment help, according
to Antoinette Kraus, director of the Pennsylvania Health Access
"Our concern is that there will not be nearly enough (navigators) to keep up with the demand," she said. Her organization is encouraging community organizations to get certified to help educate consumers and assist them in applying for coverage.
"We will need an all-hands-on-deck approach to getting the word out," Kraus said.
Visit the official federal government website for details on
coverage under the
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