An exchange was originally a physical marketplace that brought buyer and seller together. Any flea market qualifies, but perhaps the best known is the New York Stock Exchange. The NYSE can be traced all the way back to 1792 and a couple of dozen stockbrokers who helped found it. It was soon joined by many others, like the American Stock Exchange (AMEX) and the Chicago Mercantile Exchange, known by those in the know as the Merc. By 1971 buyers and sellers realized they no longer had to be in physical proximity to one another as electronic means could create a virtual marketplace, and the NASDAQ was born. The HIX's now being created by states can trace its roots too all of these earlier exchanges, most notably the latter.
There are a few things to remember: Coverage bought between now and the end of the year does not become effective until Jan. 1, 2014, so there's no need to worry if your state or default HIX crashes when it's supposed to go live at the end of this month. Which is good, because early on the sites will probably crash or hang up, think of Mitt Romney's election day ORCA system. Lastly, if your (red) state is dragging its feet on its respective HIX, don't worry! There will still be a default HIX for you. Join us below for more basics.
From the point of view of a consumer looking for affordable health care, the HIX is just a large website with many internal sublinks and outbound hyperlinks which lists various health insurance policies and the individual details of those policies, all of which meet or exceed the basic benchmarks set out by Obamacare. They are intended to make the health care market more efficient through competition side by side comparison and easier for consumers to find and enroll in by virtue of being online. If your state does not have an exchange, that HIX will be run by the federal government. In which case you can use the main Health care website and choose the state search here to find alternatives. There are basically four steps to successfully use the HIX online:
- Set up a password protected account
- Fill out the online or printed forms
- Pick a policy from those listed at the HIX
- Follow the enrollment steps for that policy
There will be prompts to guide you through the process. Note that you don't have to sign up online. When the HIX is up and running and the bugs have been worked out, there will be printable forms you can fill out by hand and a mailing address provided, it should let you know what your premiums will be, what the benefits of various policies are such as network info and deductibles, and how much of that premium you have to cover. To get an idea on the latter visit the KFF subsidy calculator here.
Despite all the effort on online prompts geared to help consumers enroll, there's going to be a lot of confusion, especially among folks who are not as familiar with the idiosyncrasies of online registration and payment. To help the millions of people who will be trying to understand their options, HHS has given dozens of organizations grants to create an army of specialists to help consumers navigate and enroll in Obamacare:
Navigators have a vital role in helping consumers prepare electronic and paper applications to establish eligibility and enroll in coverage through the Marketplaces and potentially qualify for an insurance affordability program. They also provide outreach and education to raise awareness about the Marketplace, and refer consumers to health insurance ombudsman and consumer assistance programs when necessary.HHS funded navigators will be assisted by agents and brokers working on behalf of insurance agencies and specific companies. These guys will probably be available by phone, live chat and email. That contact info will be listed in various places on the exchange and on insurance company websites and we hope members here on Daily Kos with a facility for this stuff will pitch in as well.
From a big picture political perspective, the usual suspects have gone all in, betting their entire political future on Obamacare failing so that they can reverse it. They're going to do everything they can to prevent access to health care for as many people as possible. Expect them to trumpet and exaggerate every site crash and glitch, and probably fabricate a few on the side. Since this is a massive undertaking, they won't have to look hard to find a few cases where something goes snafu.
There's been a lot of talk about how the law will become more popular as people are able to enroll. And that probably will happen. But don't engage in wishful thinking, even if it gains substantial majority support, the GOP will continue misinforming those who benefit most. And even in the event it becomes overwhelmingly popular by the end of Obama's term, they're not going to stop trying to kill this. One tactic the usual suspects may roll out might be something along the lines of replacing Obamacare with a voucher deal, and then using that as a springboard to eventually do the same for Medicare.
Expect the worst headlines you can imagine backed up by YouTube videos about how Obamacare killed my children and/or turned me into a homeless Satanist.
Pushing back, correcting the record as needed, and writing about the successes will all be very important. But one of the easiest ways to insure Obamacare prevails in the end is to get as many eligible people enrolled as possible. A good first step is to become familiar with your state's exchange or alternative option when they go live on or about Oct 1 (After Oct 1 on 'graduation day' for this series, we will have all exchanges linked and listed alphabetically, maybe some other helpful tools).
This is good progressive politics and good for the welfare of We the People. In part because every single person enrolled is a potential pissed off voter when the GOP starts talking about spiking the ACA. In part because each new insured person is a new customer for the health services sector, that means lots of middle class jobs, many of which cannot be easily outsourced. But the most important reason: every single person you help get enrolled is a potential life saved.