EXPERT AVAILABLE: MU Health Care Insurance Expert Explains Obamacare Health Insurance Exchanges

October 24th, 2013

The views and opinions expressed in this “for expert comment” release are based on research and/or opinions of the researcher(s) and/or faculty member(s) and do not reflect the University’s official stance.

Editor’s Note: This is the second in a series of releases on the Affordable Care Act (ACA). The first in the series covers a number of issues relating to the ACA and can be viewed here.

COLUMBIA, Mo. – As a part of the Affordable Care Act (ACA), adults are required to have health insurance by Jan. 1, 2014. Insurance exchanges, also called competitive marketplaces, allow individuals and small businesses to purchase insurance. However, Bridget Kevin-Myers, a research assistant professor at the University of Missouri Institute of Public Policy (IPP) in Truman School of Public Affairs and an expert on health care law, says that many Americans are uneducated or confused about these health insurance exchanges; she has provided valuable information online about the types of insurance exchanges available and what people should expect when enrolling.

“The main goal of these insurance exchanges is to provide customers, whether they are individuals or small business owners, with more control, and a better understanding of their options when making decisions concerning their health insurance,” Kevin-Myers said.

Kevin-Myers says two types of exchanges exist:

• Health insurance exchanges for individuals. These exchanges opened on Oct. 1, with coverage starting on Jan. 1, 2014.

• Small Business Health Options Program (SHOP). Small business owners will not be able to make online purchases as a part of SHOP until Nov. 1, but government officials are currently accepting information via fax or email. SHOP will be open to businesses with 50 or fewer full- time employees. By 2016, the SHOP marketplace will be open to employers with as many as 100 full-time employees.

Kevin-Myers says the primary responsibilities for governing and operating the exchanges belong to a minority of states, though the minimum standards are set by the federal government including the U.S. Department of Health and Human Services. However for 36 states, including Missouri, the exchanges are operated entirely by the federal government.

“By using the power of a larger insurance pool, the hope is that exchanges will be able to generate competition among insurers to make higher quality plans available at lower prices,” Kevin-Myers said. “Americans will be able to see the specific insurance options available for them if they use the exchanges and provide information, such as income and the number of dependents. If participants qualify for Medicaid, they will be notified during this process and have the option to apply for that coverage. They also will be alerted if they qualify for premium tax credits or cost-sharing reductions, which could lower insurance premiums. Basically, the Insurance Marketplace will allow comparisons of health plans offered by private health insurance companies and allow individuals to choose one that best meets their needs and the needs of their family.”

Kevin-Myers is advising people who need to use the health care exchanges to wait a few weeks before trying to use them to register for insurance, since the online systems are currently experiencing technical glitches.

To read more of Kevin-Myers’ advice and informational materials about the ACA, visit: http://ipp.missouri.edu/new.html

Editor’s Note: Contact Nathan Hurst to speak with Bridget Kevin-Myers about issues related to Obamacare