Home > Employee Benefits > Marketplaces open amid government’s closed doors

Marketplaces open amid government’s closed doors

marketplaceIn the midst of the first government shutdown in 17 years, the Health Insurance Marketplace opened for business on time, unlike many other Patient Protections and Affordable Care Act (PPACA) provisions. However, the first day for the Health Insurance Marketplace was a bit bumpy, to say the least. Due to high volume and possible design flaws, consumers experienced significant delays and technical problems. As millions of Americans flocked to the government-run Marketplace website to search for and compare health plans and apply for coverage, many of them were greeted with error messages, leaving individuals skeptical and frustrated.

The individual mandate, a key provision of PPACA, requires Americans to obtain qualified health insurance or pay a penalty. The Marketplace is meant to be a one stop shop where individuals can easily compare and purchase an affordable qualified health plan. It is expected to appeal to low to middle-income consumers, and previously uninsured individuals, who may qualify for government-subsidized premium.

According to data released last week by the Department of Health and Human Services, individuals in the 36 states where HHS runs or supports a Marketplace will have access to an average of 53 qualified health plans, and in most cases, consumers will be able to choose between two or more health insurance providers. For proponents of the Marketplace, this statistic means increased consumer choice and a higher likelihood of finding the right health plan for each individual, while detractors fear that consumers may be overwhelmed by the sheer number of plans.

Based on information from the 36 Marketplaces supported by the federal government and 12 state-run Marketplaces, the average individual monthly premium for the second lowest cost silver plan (a plan that pays 70% of medical costs) is $328. Individuals who qualify for subsidies may pay even less, and within states, premiums may vary dramatically depending on an individual’s rating region. However, for those individuals who are not eligible for government-subsidized premium, coverage through the Marketplace may cost more than what they are willing or able to pay.

At this point in time, the future of PPACA remains to be seen. The individual mandate, while passing muster in the US Supreme Judicial Court, is still the main bone of contention in stalled Congressional budget talks. After one day of business and numerous setbacks, it’s still too early to determine whether or not the Health Insurance Marketplace will be a success. That being said, if the high volume of traffic is any indication (with 4.7 million Americans visiting Healthcare.gov and call centers receiving more than 190,000 phone calls in the first 24 hours) it seems that Americans are at least interested in what the Health Insurance Marketplace has to offer.


About the Author

Alison Coleman is a Client Service Manager at William Gallagher Associates (WGA) in the Employee Benefits Group. She assists several Client Service Managers with the renewal and marketing processes, day-to-day service of clients, and client-specific special projects.

617.646.0373 | AColeman@wgains.com |
Connect with Alison on LinkedIn

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