The Affordable Care Act (ACA) creates new state-based health insurance exchanges in 2014 to help individuals and small businesses compare and enroll in health coverage. Individuals and small employers will be allowed to select from a range of health plans offered through exchanges. If a state chooses not to set up an exchange, the federal government is required by law to set up a federal exchange in their place. An up to date profile of each state’s exchange provided by the Kaiser Family Foundation can be found here.

The Federal Government and the states that have chosen to run their own exchanges are busy preparing for open enrollment. On October 1, 2013, the enrollment period will open, allowing individuals to begin shopping, selecting and purchasing insurance through the new health insurance exchanges (also known as marketplaces). This open enrollment period will last for six month, ending on March 31, 2014.

These online exchanges will have tools to help individuals calculate their monthly premiums and determine if they will qualify for financial subsidies from the Federal Government. These subsidies will help individuals pay for their health insurance premiums. If an individual purchases coverage through the exchanges prior to December 15, 2013, their coverage will start on January 1, 2014.

In 2014, the vast majority of exchange have adopted the “competitive” market-based models that provides consumers a broad choice of health plans, while a handful of exchanges have chosen an “active purchaser" exchange model that will limit what health plans are available to consumers.

BCBSA believes that consumers are best served by market-based exchanges, and the U.S. Department of Health and Human Service’s rules should continue to support this approach and also continue to give states maximum flexibility to develop exchanges that best meet local needs.