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January 29, 2013

New health insurance markets are on the way

WASHINGTON — Buying your own health insurance will never be the same.

This fall, new insurance markets called exchanges will open in each state, marking the long-awaited and much-debated debut of President Barack Obama’s health care overhaul.

The goal is quality coverage for millions of uninsured people in the United States. What the reality will look like is anybody’s guess — from bureaucracy, confusion and indifference to seamless service and satisfied customers.

Exchanges will offer individuals and their families a choice of private health plans resembling what workers at major companies already get. The government will help many middle-class households pay their premiums, while low-income people will be referred to safety-net programs they might qualify for.

Most people will go online to pick a plan when open enrollment starts Oct. 1. Counselors will be available at call centers and in local communities, too. Some areas will get a storefront operation or kiosks at the mall. Translation to Spanish and other languages spoken by immigrants will be provided.

When you pick a plan, you’ll no longer have to worry about getting turned down or charged more because of a medical problem. If you’re a woman, you can’t be charged a higher premium because of gender. Middle-aged people and those nearing retirement will get a price break: They can’t be charged more than three times what younger customers pay, compared with six times or seven times today.

If all this sounds too good to be true, remember that nothing in life is free and change isn’t easy.

Starting Jan. 1, 2014, when coverage takes effect in the exchanges, virtually everyone in the country will be required by law to have health insurance or face fines. The mandate is meant to get everybody paying into the insurance pool.

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