The Opening of the Healthcare Exchanges

By Linda Laarman & Karen Nordahl

 Healthcare exchanges, established as a key component of the Affordable Care Act, officially opened on Tuesday, Oct. 1. According to federal officials, there were more than 2.8 million visitors to the government’s official http://www.healthcare.gov site between midnight and late afternoon that day. 

The flood of interested consumers overwhelmed the online marketplaces. Due to long wait times and technical glitches, not all who visited were able to obtain the information they were seeking or enroll for insurance. 

Oct. 1 was simply the starting point, and consumers have until Dec. 15 to enroll in a plan that will offer coverage beginning Jan 1, 2014. The exchanges will remain open for enrollment through March of 2014.

In addition to the information available online, other free-of-charge resources are available to individuals and small businesses seeking to understand and make decisions regarding health insurance options. “Navigators ” and “application counselors” are trained and credentialed to educate consumers about their options, help consumers complete electronic and paper forms to establish eligibility for the federal exchange and public assistance programs, and help consumers enroll in federal exchange coverage. Another function of navigators is providing outreach and education to raise awareness about the federal exchange.

Insurance agents meeting certain training and other criteria can qualify to be navigators or application counselors. But agent functions  – which involve representing one or more insurance companies and receiving commissions for sales of insurance –  are required by law to be separate from educational and other functions undertaken for consumers in the role of navigator or application counselor. And anyone providing navigator or application counselor services should  be impartial with respect to the options offered – not giving any advice as to the best plans to buy or selling any insurance.

In Wisconsin, six entities received federal navigator grants. Among these, Partners for Community Development, Inc. (partners4cd.com; 800-584-8172) will be specifically focused on facilitating the enrollment of the uninsured in Door, Kewaunee, Manitowoc, Ozaukee and Sheboygan Counties.  The emphasis will be on outreach efforts for difficult-to-reach consumers, including families with limited English proficiency. Application counselors for the exchange will typically be found in settings such as federally qualified health centers, hospitals, healthcare providers, social service agencies, local health departments, and Indian Health Services.

Individuals and others seeking to learn about or apply for health insurance should be cautious about avoiding scams. They should never share personal or financial information with someone offering assistance without first verifying that the party is appropriately qualified and not seeking illegal or otherwise unwarranted financial gain.

The primary government website with information about the healthcare marketplace.