Where will you buy health insurance in 2014?
Pretend it’s January 2014 and you need health insurance. You don’t qualify for Medicaid and you don’t get coverage through an employer. You know you’re supposed to buy it on your own. You’ve also heard that you may qualify for government subsidies to help you afford it.
Where are you going to turn?
The answer you’re most likely to hear these days is “your government-run state health insurance exchange.” Depending on what happens in the next few months, however, you may have some additional choices when it comes to shopping for coverage and getting the subsidy assistance you’re entitled to.
There’s a little known provision of the Affordable Care Act (Rule Subpart C § 155.220) allowing states, if they choose, to work with licensed online health insurance marketplaces to enroll subsidy-eligible consumers in qualified health plans.
We’re finally starting to see some discussion in the public square on this issue. A Fox Business article by Elizabeth MacDonald makes the case for state exchanges to work with online marketplaces like eHealthInsurance.com. Our company CEO, Gary Lauer, was also recently spoke about the issue on MSNBC’s Morning Joe. TechNet CEO Rey Ramsey also penned an op-ed in the San Francisco Chronicle talking about this idea in the context of “smart government.”
In the interest of full-disclosure, yes, we’d love to see private-sector online marketplaces like eHealthInsurance work with states to enroll subsidy-eligible consumers in the health plans in 2014. We believe this can be done with strong consumer protections and in a way that supports the overall goal of the Affordable Care Act.
The rule allowing such cooperation puts pretty tight restrictions on any private entities that state exchanges choose to work with. Whether you’re shopping for coverage through the state exchange or a qualified online marketplace, the basic consumer experience needs to be the same. No advertising allowed.
According to the rule, online marketplaces enrolling consumers in coverage must provide consumers with the ability to view all the qualified health plans and plan data available through the exchange itself, and meet all applicable standards for the display of that information and the protection of consumer privacy and security.
We agree with all of this. We also believe there’s a real public benefit in cooperation between online marketplaces and state exchanges.
First of all, it can help state health insurance exchanges meet the ambitious enrollment goals of the Affordable Care Act. It’s not easy enrolling millions of Americans in health insurance. We know because we’ve done it already – eHealth has enrolled over 3 million Americans in coverage, about 40% of whom were previously uninsured before coming to eHealth’s website.
Second, by working with online health insurance marketplaces to enroll subsidy-eligible consumers in coverage, state exchanges will provide lower-income persons with equal access to health insurance products and services available to higher-income consumers who may not qualify for subsidies. Consumer choice is a good thing.