The American College of Physicians (ACP) has written a brief to explain how health exchanges, or health insurance marketplaces, will work when the Affordable Care Act begins to roll out late this year.
By 2014, most individuals who do not have health insurance will have to acquire health insurance or pay a fine. The marketplaces were created under the ACA with the hope of enabling individuals to objectively compare private health plans that meet the minimum standards set by the government and also meet their budget and health needs.
Legal residents without access to affordable, comprehensive insurance, and business with up to 100 employees can access the marketplaces online, via toll free number, or in person to research and purchase an appropriate health benefits package.
To meet government standards, a health package must have services in 10 benefit categories, including hospitalization, outpatient care, prescription drug coverage, and preventive and wellness and chronic disease management. The goal of marketplace-based coverage is to limit out-of-pocket costs and provide essential health benefits without restricting coverage or varying premiums based on health conditions.
Health Policy Basics: Health Insurance Marketplaces, Ann Intern Med. Published online 24 September 2013, doi:10.7326/0003-4819-159-10-201311190-00724