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New era for U.S. healthcare begins as insurance exchanges open

Amid reports of technical glitches, health insurance exchanges opened for business Oct. 1 after a 3 1/2-year buildup since the passage of the Affordable Care Act.

The exchanges, a core component of the ACA, offer individuals a forum to compare and buy health insurance policies if they do not have insurance through an employer. Most Americans must have insurance by March 31, 2014, the end of the open enrollment period, or pay a penalty on their following year’s tax return. For those who buy insurance by Dec. 15, coverage takes effect starting Jan. 1, 2014.

The exchanges — more formally known as health insurance marketplaces — represent “a new, simpler way for uninsured Americans and their families to purchase health insurance in one place,” according to the Department of Health and Human Services.

“For years, the financial, physical or mental health of millions of Americans suffered because they couldn’t afford the care they or their family needed,” HHS Secretary Kathleen Sebelius said in a news release. “But thanks to the healthcare law, all of that is changing. Today’s launch begins a new day when healthcare coverage will be more accessible and affordable than ever before.”

The function for creating an account at, which hosts the exchanges for the 34 states that declined to operate their own exchange, was slow or inaccessible for much of the day, according to various reports. The HHS twitter feed sent out several dozen tweets responding to consumer complaints, apologizing for the delays and promising to fix the glitches.

Marilyn Tavenner, RN, BSN, MHA, administrator for the Centers for Medicare & Medicaid Services, said 2.8 million people visited the site between midnight and the afternoon of Oct. 1, although it was unclear how many actually bought insurance.

Tavenner said the site’s performance improved during the day. “We certainly had a high volume creating accounts this morning,” she said. “We added capacity and made adjustments.”

Available coverage

Coverage offered through the exchanges includes a range of options, allowing consumers to pick a plan that best meets the needs of themselves and their families, and that fits into their budget, according to HHS. With one application, consumers can see whether they qualify for lower costs on health insurance based on income or free or low-cost coverage available through Medicaid or the Children’s Health Insurance Program. Consumers in every state can use the exchanges to apply for coverage, compare options and enroll.

“Today marks the start of an intense six-month-long open enrollment and public education campaign for the marketplace,” Tavenner said in a news release. “We want consumers to know that they can find and compare options, check if they qualify for lower costs and get covered.”

Consumers will be able to choose from an average of 53 health plans in the federally-run exchanges, according to a report released by HHS, and the vast majority will have a choice of two or more health insurance companies. Premiums nationwide will be around 16% lower than originally projected — with about 95% of eligible uninsured living in states with lower-than-expected premiums — before taking into account financial assistance. Nearly 60% of uninsured Americans will be able to get insurance for $100 or less per month, using financial assistance or expanded access to Medicaid.


Consumers can get more information through or Consumers can participate in online web chats or speak with trained customer service representatives, with translation services available in 150 languages.

Community health centers, navigators and other assisters are available in local communities to provide in-person help with coverage choices. Many local libraries will help consumers learn about their options and hundreds of designated Champions for Coverage — businesses and organizations across the country — are helping people learn about their options and enroll in affordable coverage.

Contact by phone: 800-318-2596 toll free (TTY: 1-855-889-4325). Assistance is available in 150 languages around the clock.

In person: visit to find in-person assistance near you.


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By | 2013-10-02T00:00:00-04:00 October 2nd, 2013|Categories: Nursing Careers and Jobs, Specialty|0 Comments

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