October 1, 2013
As a congressional disagreement over the Affordable Care Act caused
the government to shut down early Tuesday morning, the
health insurance marketplace mandated by the law opened for
business.
The law, better known as Obamacare, created insurance exchanges where
individuals and families can shop for insurance coverage. By law, the
health care plans on offer cannot deny people coverage due to
pre-existing conditions. In addition, they cover a list of "essential
health benefits," such as prescription drugs, lab services and maternity
care.
The rollout of the exchanges comes after a long and tortuous path for
the Affordable Care Act. Since the law's passage in 2010, the House of
Representatives has voted more than 40 times to repeal or block the act
in other ways.
[READ:
A Consumer’s Guide to Obamacare]
In addition, much of the act survived a Supreme Court challenge, in a
high-profile June ruling. Obamacare is also currently a sticking point
in Congress' ongoing fiscal fights. House Republicans on Sunday voted to
continue funding the government in exchange for a one-year delay in the
act's implementation, a bill the Senate voted down, creating a
government shutdown that started at midnight Tuesday.
In a Tuesday afternoon briefing, President Obama referred to the
bill's staying power, despite its many challenges over three years.
"This is a law that passed both houses of Congress, a law that bears
my signature, a law that the Supreme Court upheld as constitutional, a
law that voters chose not to repeal last November," he said.
Amid the sound and fury over the broader law, the exchanges will open
quietly, awaiting customers in need of insurance. As with any new
initiative, there will likely be some speedbumps, says one expert.
[READ:
10 Effects of a Federal Government Shutdown]
"It's got a lot of moving parts to it, and in things with a lot of
moving parts, something usually goes wrong initially," says James
Brasfield, professor of management at Webster University in St. Louis.
He says the program may largely run smoothly but there will likely also
be some complications as private insurers and the government work
together to coordinate information. In addition, there is the
possibility for technical glitches in the exchange websites, Brasfield
says.
Consumers will have help in making their choices, however, in
navigators – people and organizations trained to assist exchange users
in making insurance choices.
"Navigators are going to be key," says Kate Bicego, consumer program
assistance manager at Healthcare for All Massachusetts, a nonprofit
organization that promotes healthcare access. "They spread across
statewide and helped people, helped to educate people about the law and
helped to enroll and keep their coverage. ... They were pivotal to the
success of healthcare reform."
[STUDY:
Consumers May Spend $9 Billion More Than Necessary on Obamacare]
Customers will be able to
purchase insurance
starting Tuesday, but the coverage will not go into effect until Jan. 1,
2014. That means customers don't have to start shopping immediately on
Oct. 1. And in fact, Brasfield says, it might be best if everyone didn't
jump in all at once. A gradual entry of consumers could make it easier
for administrators to work out any glitches.
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