With all the stories swirling around the opening of the health care exchanges and revelations that not everyone will be able to keep their current insurance as promised, keeping up with what businesses and individuals need to know, and do, has become a daily challenge. Here is latest on how Idaho is faring with the newest health insurance exchange requirements under the Patient Protection and Affordable Care Act.
Idaho’s health care exchange: Your Health Idaho
A key provision of the ACA is the creation of online state health care exchanges where small businesses and individuals can shop for and purchase health insurance. For the approximately 80 percent of Americans who receive their health insurance through their employers, there is no need to access an exchange. Critically, while small businesses and individuals can purchase policies outside of an exchange, exchanges are the only place where consumers can access premium tax credits, which are subsidies to make insurance more affordable.
States were given the choice of setting up their own exchange, defaulting to the federal exchange, or working in partnership with the federal government in a “hybrid” exchange. By the time Idaho decided to establish its own state-run exchange, there wasn’t enough time to create the technology platform required to fully enable the online application process. As a result, while consumers can go to the Your Health Idaho website to learn about the 61 different individual and family health care plans being offered by four insurance companies in Idaho, the website redirects customers to the federal website, HealthCare.gov, to register for and purchase the policy of their choice.
Idaho is one of 36 states relying on the HealthCare.gov portal, which has been fraught with glitches, delays and malfunctions. Other states that created their own exchanges and technological platforms are experiencing fewer problems and delays. Because Idaho’s exchange is working to create its own portal, Idaho should not have to piggyback on the federal system when open enrollment for 2015 begins Oct. 15, 2014.
Currently, the federal-based exchange is focused on individual plans. Small businesses wishing to participate in the Small Business Health Options Program will not be able to access information about available plans and federal tax credits until later this month. Three insurance companies will offer several different small business health plans in Idaho. The ACA’s mandate that companies with 50 or more full-time employees provide health care coverage for their employees or pay penalties has been delayed to Jan. 1, 2015 (it was originally slated to take effect on Jan. 1, 2014).
The problem-plagued federal website
The problems with the HealthCare.gov website are the result of significantly flawed software and cumbersome processes that have bogged down the application process. HealthCare.gov requires that users create an account before being allowed to view the policies available in their state. In the opening weeks, users could not get through the registration process without encountering multiple error messages and often being shut out of the system entirely.
Currently, the system is working better, allowing users to register, view plans and submit an application, but there are still major glitches when attempting to complete the process and purchase a plan. The federal government is promising a “fix” by Nov. 30.
While the first enrollment figures won’t be published until the week of Nov. 11, the number of consumers who have completed the process is expected to be very low. Estimates for Idaho suggest that fewer than 100 consumers have successfully purchased insurance through the federal website. Given the estimate by the Department of Health and Human Services that 225,000 Idahoans are currently uninsured and eligible to use the exchange, if the website does not improve significantly, consumers will not be able to purchase insurance before the deadline of March 31 to avoid paying a tax penalty.
Kim Stanger is a partner at Holland & Hart in Boise, where he works in the business, corporate and finance; health care; and privacy and information security practices. Contact him at firstname.lastname@example.org