Introduction to Idaho’s Health Insurance Exchange

This is the first of periodic updates to help make practical sense of Health Care Reform and the upcoming Health Insurance Exchange (HIX) in the State of Idaho — what it could mean to you, and how you might benefit.  I begin with “short answers” on the bigger questions.  I’ll elaborate on each of those in later posts.  The emphasis here is individual insurance.  If dependent coverage on your group plan is expensive and your employer’s open enrollment is coming up, you’d be wise to get familiar with this.

Please read my Plain Language Disclaimers regarding these commentaries on PPACA.

The HIX will be much like the well known “e” site, except the HIX won’t result in your being bombarded by unsolicited calls from agents in other time zones, nor will it sell your info to other agents who buy “leads.”  However, Uncle Sam is establishing very broad collection and coordination of your personal, health, and financial information.

Will the HIX save you money compared to off the HIX?

No.  Premiums for identical plans must be identical whether sold on or off the HIX.  So the HIX does not necessarily bring you deals that you couldn’t access off the HIX using an independent broker.

However, those making up to 400% of the Federal Poverty Level could be eligible for immediate premium subsidy.  The federal subsidy is only available when purchasing on the HIX.

Will the HIX eliminate your need to use an independent broker?

No.  A broker’s assistance is free to you.  Brokers must be specially trained on the new plans in order to sell via the HIX.  If brokers must endure hours of training, would you be comfortable to just wing it without one?

Must you get new insurance starting January 1, 2014?

No.  You have options.  If the HIX shows you can get better value starting Jan 1, then go for it.  If not, you can wait until your current plan reaches its annual renewal date later in 2014.  At that point, coverage must be with a new plan of the kind sold on the HIX.  Open Enrollment begins October 1.  I recommend letting the dust settle until November before exploring the HIX.

If you simply cannot afford major medical insurance, what can you do?

One option to consider if you are healthy is Short-Term Medical (STM).  You can quickly get covered for up to 10 months.  STM does not cover any pre-existing conditions, nor does it cover maternity.  Consider it a bridge or “just in case” coverage.  STM is relatively inexpensive.

The Idaho legislature will consider expansion of Medicaid to adults some time in 2014.