The Marketplaces Are Open...Ready, Set, WAIT?!

Johanna Gray, Vice President

Health_Insurance_Pic.jpg

Today, we are about two weeks into the open enrollment period for plans offered on the new Health Insurance Marketplaces (formerly called exchanges) created by the Affordable Care Act (ACA).  Consumers, health care providers and advocates can now explore the health insurance plans available in each state’s marketplace.  Or, at least, this was the plan!

Of course, it turns out that open enrollment hasn’t gone very smoothly in some states. I won’t repeat the countless press articles about website malfunctions, call-in number wait times and the existential question of whether it’s truly “open” enrollment if no one can access plans.  Experts are divided about whether these are natural growing pains of new websites that didn’t anticipate the crushing demand of un- and under-insured people desperate for new health insurance plans (well, and the countless media and lobbyist types like me who are also logging on to gather information) or whether these reflect fatal flaws that will impede consumer access to plans and ultimately cause the health insurance death spiral (as with all ACA topics, hyperbolic opinions are the norm).  Regardless of the cause, I continue to hear from clients who are wondering how to advise their constituents about how to proceed. 

For consumer groups, my #1 piece of advice is that everyone should be patient!  Consumers have until December 15 to enroll in a plan that starts on January 1, 2014, and until March 31, 2014 to pick a plan that begins in May.  While I wouldn’t encourage anyone who needs coverage next January to wait until December 14 to make a selection, if consumers wait until late-October or November to begin exploring plans, they should be fine.  Open enrollment periods are typically only a few weeks, so consumers have much longer than normal to pick a plan. 

On the provider side, it can be just as frustrating to learn about plans being offered in their state and whether they are included on the plan networks.  In this case, I’d advise providers to do a bit of research and reach out to insurers in their state directly to see what plans they’re offering and whether the provider is in network. If your marketplace’s website isn’t working smoothly, and a simple Google search doesn’t turn up anything useful, then providers also could simply get in touch with any insurers they currently contract with to see whether they are offering any plans on the marketplace. 

The bottom line is that there is plenty of time left for consumers to pick a plan and for providers to better evaluate how the marketplaces will affect their patients.  And if anyone is feeling impatient in the meantime, then my final recommendation is that you check out: http://adorablecareact.tumblr.com  (an example is to the side).  Because, politics and hyperbole aside, everyone can agree on the calming effects of cute animal pictures!

Lisa Ellington

Big Thinkery, LLC, 1011 Kenilworth Court Northwest, Concord, NC, 28027