Health

The Road To Idaho's Health Insurance Exchange

Idaho's state-run health insurance exchange is expected to begin enrollment by Oct. 1, 2013 and fully functional by Jan. 1, 2014. The exchange is an online marketplace where Idahoans will be able to shop for and purchase health insurance. The Idaho Legislature approved plans to build the exchange in March 2013, but two years of intense debate preceded the vote.After the U.S. Supreme Court upheld the Obama Administration's federal health care overhaul in 2012, two key decisions rested with states. One, should states expand Medicaid to include more people? Two, should states create their own health insurance exchanges?Gov. C.L. "Butch" Otter chose not to make a snap judgement, instead, he created a work group to study whether Idaho should create it's own health insurance exchange, let the federal government create one for the state, or some combination of the two options.Otter's 14-member panel decided in October 2012 that Idaho should move forward with creating it's own exchange. The governor followed suit, and Gov. Otter issued a statement on Dec. 11, 2012 that Idaho should create a state-based exchange. Two Years Of DebateThe health insurance exchange debate has been ongoing ever since it became clear an exchange would be part of the federal health care reform package which was signed into law in 2010.Because Idaho didn't have the framework set up for a health insurance exchange, it was expected to be one of the biggest debates of the 2012 legislative sessionThe Associated Press held a special discussion of the issue during its January 2012 legislative preview. In a series of interviews that StateImpact conducted in December, legislator after legislator predicted it would be a defining issue of the months ahead.Instead, it was more or less dead on arrival. Not even a plan developed by Sen. Dean Cameron (R-Rupert) and Rep. Fred Wood (R-Burley) for a stripped-down, state-run exchange could muster sufficient support.Health insurance exchanges are a primary component of the Affordable Care Act. By their most basic description, exchanges are organizations — essentially online marketplaces — intended to make health insurance options more clear and, thereby, more competitive.The underlying logic is this: individuals and small businesses don’t have perfect information or a great deal of bargaining power with insurers. A health insurance exchange lays out the private and public health insurance options, explaining plans in terms of benefits and costs.Under the Affordable Care Act, states can create their own exchanges or wait for the federal government to do it for them.Rep. Wood says it was ideological opposition to the health care law that did in the prospects for a state-run exchange. “I think there was a certain number of people that simply didn’t want anything to do with an exchange,” he said. “And they were in a position that they could affect that outcome. In other words: no exchange.”Wood, a retired physician and former director of the Cassia Regional Medical Center, believes state lawmakers are rolling the dice, hoping the federal health care law will be overturned. “They’re betting that the Supreme Court will strike down the entire law,” he said. “And if we bet the wrong way, it could be very costly for the state.”Costly because states creating their own exchanges will have some discretion to set the essential benefits that must be provided by insurers. But states falling under the federal plan likely won’t have that same flexibility. The Idaho Department of Insurance has predicted Idaho employers could expect to pay millions more in health care costs under a federal exchange.

What You Need To Know About Idaho's Health Insurance Exchange

Boise State Public Radio News

Published October 1, 2013 at 7:43 AM MDT

Idahoans who don’t have health insurance can now start to shop for and buy insurance through the state’s online marketplace which launches today.

Nearly 19 percent of Idaho’s population under the age of 65 don’t have health insurance. Up to 200,000 Idahoans could be eligible for the subsidized health insurance or Medicaid through the state exchange.

The Washington Post's Wonkblog has done a fantastic job outlining the basics of this piece of Obamacare. Here is some info to get you started with Idaho's marketplace.

Where do people go to shop for and buy insurance on Idaho’s exchange?

Idaho’s health insurance exchange website is YourHealthIdaho.org. That’s where people can go to research their available options. If you don’t have access to a computer, the phone number to call for assistance is 855-944-3246.

Is anyone without health insurance eligible to buy coverage at YourHealthIdaho.org?

The short answer is yes. If you are uninsured, your employer doesn’t offer health insurance, and you don’t have Medicaid or Medicare – YourHealthIdaho.org is the place to start.

It’s estimated between 100,000 and 200,000 Idahoans will be eligible for subsidized health insurance or Medicaid. Idaho is not expanding Medicaid coverage to more low income Idahoans, but the state knows there are people out there who qualify, but who just haven’t signed up.

What will happen to Idahoans who don’t qualify for Medicaid and who don’t qualify for subsidized health insurance through the exchange?

That’s what’s called the coverage gap. The Kaiser Family Foundation estimates of the 25 states that aren’t expanding Medicaid to more people, about 7 million uninsured adults may fall into this coverage gap. In Idaho, the Department of Health and Welfare estimates 77,000 people aren't poor enough to qualify for Medicaid, but are at 100 percent of the federal poverty level and don't qualify for subsidized health insurance through the exchange.

This is something that will start to shake out overtime as policymakers begin to see where the gaps are.

Open enrollment at YourHealthIdaho.org starts today – how long does that last, and what can people expect at the site?

Open enrollment starts today and goes through March 31. If you choose not to buy insurance, you'll be subject to a $95 penalty in the 2015 tax year. That penalty will increase each year.

Once you're logged on to YourHealthIdaho.org – you’ll find 7 different insurance companies to chose from. They’ll offer 146 different plans that fall under the federal government’s tiered program. The tiers are named Platinum, Gold, Silver and Bronze – with Platinum having the highest premiums with the most robust coverage – and Bronze having the lowest premiums, but you can expect higher out-of-pocket costs in the instance you get sick and need medical care.

The marketplace will ask some basic questions like; your age, where you live, whether you smoke and your annual income. With Obamacare, preexisting conditions will no longer disqualify someone for coverage – and gender is no longer taken into account.

If you already have insurance through your job, Medicare, or the VA – you don’t have to do anything right now?

Right. Idaho's health insurance exchange launch is for people who don’t have insurance and are ready to start shopping for subsidized coverage.

The exchange websites across the country are expected to experience some glitches in the first few days. If you need assistance in Idaho, the phone number to call is 855-944-3246.

What You Need To Know About Idaho's Health Insurance Exchange

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