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Health Care Reform Explained

The New Health Care Law and Affordable Health Insurance

Your questions answered

Healthcare.gov is a one-stop health insurance shopping resource. — Photo by Image Source/Corbis

Q. I need health insurance now. Can the health reform law help me find an affordable policy?

A. The website Healthcare.gov, launched in the summer of 2010, takes much of the mystery and frustration out of shopping for a health plan. For the first time, consumers can find and compare prices and benefits for thousands of private insurance policies as well as community health services and public health programs like Medicaid or Medicare.

The one-stop shopping website — required by the new health care law — has details on more than 4,400 plans across the country from more than 225 insurers and will be updated monthly. For anyone who's searched online for airplane tickets or books, the process will be very familiar. And a novice should be able to get the hang of it pretty easily.

First, you select your state, and indicate whether you're looking for coverage for a family, a healthy individual, an individual with a medical condition, a senior, a young adult under 26, a small-business employer or someone who is self-employed. After providing ZIP code, birth date, and answering a few more quick questions, you'll see a list of plans you can narrow down based on premiums, deductibles, overall out-of-pocket expenses, doctor choice, drug coverage and other factors.

(You won't have to give your name, and any other personal information you enter is used only to produce a customized list for you and is not retained.)

Insurance companies have had to certify that the plan details provided to the government are accurate.

The website also points you to other options. Young adults under age 26 can find out that they can enroll in their parents' plan if their job doesn't offer health coverage. People with preexisting health conditions can learn more about getting coverage through the new Pre-Existing Conditions Insurance Plan. Low-income people can find out if they are eligible for Medicaid.

"Unlike health insurance sales sites, we're not selling you anything," says Todd Park, chief technology officer at the U. S. Department of Health and Human Services. The website does not rate or recommend plans. "We're a totally objective, unbiased source of information focused maniacally on the consumer."

Many people don't realize that the price quoted by insurance companies may not be the price they eventually pay, says Park. The website warns you can be charged more or even be turned down based on your medical conditions. Such actions will be prohibited when health reform takes full effect in 2014. In the meantime, the website will tell you the percentage of applications each plan rejects and the percentage of applicants who had to pay a surcharge because of a medical condition. This information has never been made public before and helps people choose coverage "with their eyes wide open," he says.

For example, more than 26 percent of Texans — some 6 million people — are uninsured, the highest percentage in the country. A search for coverage for an individual with a health problem between the ages of 26 and 64 in El Paso produced a list of 148 plans, with maximum annual out-of-pocket costs ranging from $1,000 to more than $10,000. But one plan rejected as many as 55 percent of applications, and of those people accepted, as many as 25 percent paid surcharges.

Park demonstrates how to shop for coverage in an online video on the health care website.

The website is intended as a temporary bridge to 2014, when insurance options will be quite different, says Steve Findlay, senior health policy analyst at Consumers Union. That's when health reform's consumer protection provisions take effect for plans offered in new online purchasing marketplaces called exchanges. Subsidies will also be available for people with low and moderate incomes who purchase insurance through the exchanges. And most plans will have to accept all applicants, without charging extra for people with health problems.

See also: Health Reform: What's in Effect, What's to Come.

Susan Jaffe of Washington, D.C., covers health and aging issues. She is the author of the Bulletin's weekly column, Health Care Reform Explained: Your Questions Answered.

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