|By The Associated Press|
This fall, new insurance markets called exchanges will open in each state, marking the long-awaited and much-debated debut of President
The goal is quality coverage for millions of uninsured people in the U.S. What the reality will look like is anybody's guess - from bureaucracy, confusion and indifference to seamless service and satisfied customers.
Exchanges will offer individuals and their families a choice of private health plans resembling what workers at major companies already get. The government will help many middle-class households pay their premiums, while low-income people will be referred to safety-net programs they might qualify for.
Most people will go online to pick a plan when open enrollment starts
When you pick a plan, you'll no longer have to worry about getting turned down or charged more because of a medical problem. If you're a woman, you can't be charged a higher premium because of gender. Middle-aged people and those nearing retirement will get a price break: They can't be charged more than three times what younger customers pay, compared with six times or seven times today.
If all this sounds too good to be true, remember that nothing in life is free and change isn't easy.
Obama's law is called the Affordable Care Act, but some people in the new markets might experience sticker shock over their premiums. Smokers will face a financial penalty. Younger, well-to-do people who haven't seen the need for health insurance might not be eligible for income-based assistance with their premiums.
Many people, even if they get government help, will find that health insurance still doesn't come cheaply. Monthly premiums will be less than the mortgage or rent, but maybe more than a car loan. The coverage, however, will be more robust than most individual plans currently sold.
Consider a hypothetical family of four making
A lower-income family would get a better deal from the government's sliding-scale subsidies.
Consider a similar four-person family making
4 percent of their income, or about
The figures come from the nonpartisan
Obama's law is the biggest thing that's happened to health care since
Yet exchanges are coming to every state, even those led by staunch
But what's starting to dawn on Obama administration officials in the health care industry is that the lack of consumer involvement, unless reversed, could turn the big launch into a dud. What if Obama cut the ribbon and nobody cared?
"The people who stand to benefit the most are the least aware of the changes that are coming," said
Polls underscore the concerns. A national survey last October found that only 37 percent of the uninsured said they would personally be better off because of the health care law. Twenty- three percent said they would be worse off in the Kaiser poll, while 31 percent said it would make no difference to them.
Only one state,
"It's being portrayed by opponents as being socialistic," Schultz said. "It is only socialistic in the sense of making sure that everybody in society is covered, because the cost of making sure everybody is covered in advance is much less than the cost of putting out fires."
The Connector's executive director,
"There is no backing away from all the challenges associated with expanding coverage," Shor said. "We are proud in
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