|What states are doing|
|Assess your exchange|
|Federal exchange option|
|Costs remain unclear|
|More ACA protections|
|Essential health benefits|
|Your State Exchange|
The health reform law did many other things besides mandate the creation of state health insurance exchanges – also known as health insurance marketplaces. There were some important consumer protections that will give people buying insurance a little more assurance they may be treated fairly in the marketplace.
The most important one, says Praeger, is guaranteed issue – as of 2014, insurance companies will have to sell you a health plan, they can't say no. "To me that is the best part of health reform," she says.
A related change in the ACA is community rating, which is a limitation on the variation of rates among different kinds of people. So insurance companies can't charge an older woman many times more for a premium than a young man.
Another consumer-friendly initiative, launched in September by the Department of Health and Human Services, helps states fight huge premium hikes by insurance companies. "This is having an impact," says Sandy Praeger, Kansas Insurance Commissioner and a strong supporter of reform.
The rate review program requires companies to justify their rate hikes and "companies are being more cautious knowing they have to defend an increase," she says.
The Obama administration touts these as a "patient's bill of rights," drawn from the Affordable Care Act:
Many individuals and small businesses turn to a broker to help them buy health insurance, and that can be helpful, given how complicated a purchase it can be.
The role of brokers is unclear at this point, and really depends on how each state designs its health insurance exchange. For the most part, an exchange removes the need for a broker, providing easy-to-understand information and comparisons of health plans for consumers to use online. Brokers have been unhappy about losing their place in the health care system, so some states may find a way to keep them involved.
There is another way for consumers to get personalized assistance with the exchange, though. The federal government is providing grants to non-profit organizations that will serve as navigators to help people understand and enroll in coverage. There will also be a toll-free hotline to take consumer questions and consumer assistance programs to help with grievances against health plans.
By Steve Anderson
September 25, 2009
There’s something about this huge debate on health care that’s been sorely lacking and … and that something is a discussion of what health reform could mean to entrepreneurs. Remember the American Dream? Where you come up with a great product or service and then open your own business? You work harder, not smarter? The ...(continue reading)