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Health Care Reform:

Health Insurance & Affordable Care Act

Health Insurance Marketplaces Open for Business

Health Reform and the Government Shutdown

Opponents of the law seized on its problems as evidence that the administration has bungled the launch.

“The reality is that [Democrats] passed a law that said that there would be [health insurance] Exchanges up and running by Oct. 1, and they aren’t running,” said Douglas Holtz-Eakin, president of American Action Forum, a center-right policy think tank based in Washington, D.C.

Meanwhile, Congress reached an impasse on funding the federal government over the launch of the Marketplaces, and at midnight Monday, the federal government shut down non-essential services. The shutdown doesn’t directly affect the rollout of the Marketplaces because funding for the Affordable Care Act falls under “mandatory” spending that isn’t affected by the current budget debate.

Whether the problems will affect long-term enrollment in the Exchanges isn’t clear. Groups hired by various Marketplaces to help people with enrollment, called “navigator” organizations, said they weren’t very busy with calls, even though there seemed to be lots of interest on web sites.

Lin Jenkins, a consumer assistance supervisor  at Avita, a full-service hospital in Crawford County, Ohio, said at 1 p.m. Tuesday that neither she nor her staff had fielded any phone calls, emails, or instant messages.

"I have seen nothing today, and my email address is the one online. I’m kind of surprised by that, since we were first up on the list. Whether it's because it's the first day and people are just kind of waiting, or they're confused because of the government shutdown, I'm not quite sure," Jenkins said.

Erin Loubier, director of public benefits at the Whitman-Walker Health, a navigator organization based in Washington ,D.C., said “many people just need to time to feel comfortable with it and get information about policies before they jump in a buy something.”

Premium Prices

When people were able to access the Marketplaces, there was detailed information about the premiums for insurance products. One of the keys to whether the Marketplaces will work is if there is affordable coverage. 

William Custer, director of the Center for Health Services Research at Georgia State University, said the premiums he has seen from Marketplaces across the country look “really affordable and are equal or less than what many people are paying now” for insurance on the individual market. 

Federal tax credits to pay for premiums are a big part of that. For example, Custer said a person under 30 who is making $24,000 a year will receive about $200 a month in federal subsidies to pay for coverage.

Still, the price for insurance for many young people may be more than they are willing to pay. Custer said policies for those under 30 who are healthy are about 10% to 15% more expensive than what they can buy in individual insurance markets currently, but they will receive more benefits than are offered in most policies.

Holtz-Eakin thinks those higher prices will be a problem for getting healthy people to buy insurance. “The prices are bad news for the young and healthy,” he said.

Kathleen Doheny and Julie Edgar contributed reporting.

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