Kansas State University


Issues in Health Reform

Time for ACA Open Enrollment: State vs Federal Exchanges

In the past week a new distinction in implementation success between states that had chosen to facilitate their own new insurance marketplaces (also called Exchanges) and those that did not has become apparent.  Previously much was written about how much it really did NOT matter if the Exchange was going to be run by a state or run by the feds.  After all, there were going to be marketplaces with a collection of new insurance policies for consumers to choose regardless of who was doing the facilitating.  Negotiating with the different insurance companies happened.  States have lots of policies being offered in these Exchanges.  But getting access to them online has been quite a different experience for those trying to access a state facilitated Exchange vs those accessing healthcare.gov to get to their states’ federally facilitated Exchanges.

Early on it was apparent that the burden of having the feds do it for over half of the states was going to take its toll on the administrators.  But beside that, things were going to be fairly equal.

Well, not so.  The federal website is experiencing all sorts of glitches and delays.  It is unfortunate since those who have been able to create and account and see what their states’ insurance offerings are have been satisfied. We now see evidence that running such a massive online site, with apparently outdated government type computer services, is more problematic than having states put together smaller Exchanges. Check out this article explaining the differences: http://www.nytimes.com/2013/10/09/us/politics/uninsured-find-more-success-via-health-exchanges-run-by-states.html?_r=0

Kansas families who have not been able to register or submit an application to consider a policy being offered in the Kansas Exchange can at least get a glimpse of what the premiums and tax credits might be for them in Kansas by going to insureks.org

There one enters county, household size, income, and ages of family members to be covered and a cost estimator gives expected monthly costs based on premiums and tax credits that are true to the cost of premiums in their region of Kansas.


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