The Affordable Care Act goes into full effect in 2014. As of January 1, 2014, states will have been required to have their health care “Exchanges” established. These Exchanges will consist of a group of competing insurance agencies that will allow citizens to shop for health insurance on-line, the same way you can shop for airline tickets on-line. For those who can’t afford to pay for insurance through the Exchanges, they will receive subsidies from Medicare.
As of late July, 2012, only 18 states had begun establishing their Exchanges. Twenty five other states are studying options and six Republican governors are simply refusing to go along with the law. If a state doesn’t create an Exchange by January 1, 2014, the ACA empowers the federal government to create an Exchange for them. Allowing the government to make sure each state establishes an Exchange empowers them to get tougher with insurers to reign in costs.
The Exchanges will provide a package of essential benefits and consumer protections like guaranteed coverage for pre-existing conditions and create an insurance option for people who lack affordable coverage through an employer. Individuals and families with incomes between 133 percent and 400 percent of the federal poverty level will be eligible for federal tax subsidies to make insurance affordable.
It could be that states are not moving quickly on their Exchanges because they want to see who is elected in November. However, this is a risky action because states must tell the Secretary of Health and Human Services by Nov. 16, 2012, just 10 days after the election, whether or not they plan to set up their own exchanges. The Secretary must then certify by Jan. 1, 2013, whether states are on track to start enrolling by Oct. 1, 2013, and open for business on Jan. 1, 2014. The federal government is working with each states to ensure their success with the implementation.