The Affordable Care Act has just passed a new milestone: All states have committed to what kind of health insurance marketplace, also referred to as an exchange, will be running in their states starting in January 2014.
Seven states including Michigan have submitted applications for a state–federal partnership marketplace. Under this arrangement, the state might oversee the selection and management of health plans and assisting people with enrollment. The federal government would have primary responsibility for the remaining marketplace operations, including managing the marketplace, their websites and call centers, accepting applications, and determining eligibility for premium subsidies. Approval for these marketplaces is under review.
Twenty-six states including Ohio have indicated that they will neither operate their own marketplaces nor apply for a state–federal partnership. Ohio is among 11 states that have submitted a letter to HHS stating that they would not operate their own marketplace. In states that chose not to run their own marketplaces or partner with the federal government, HHS will operate a federally facilitated marketplace in their state. In future years, states may elect either of these operational approaches, or even decide to shift from a state-run or partnership arrangement to a federally facilitated marketplace.
Starting in October 2013, people who currently buy coverage on their own or are without affordable health insurance through their employer or through Medicare will be able access these marketplaces to compare and enroll in private health plans or Medicaid. They also will be able to apply for subsidies to help them pay for the cost of their coverage. (Excerpted from The Commonwealth Fund: www.commonwealthfund.org)