Washington Insurance Exchanges Open October 2013

The Affordable Healthcare Act continues to move forward and the various states are due to have their Insurance Exchanges open and available by the end of this year. The exchange for Washington is Washington Healthplanfinder. People living in Washington State can begin enrollment October 1, 2013 with coverage taking effect January 1, 2014. For Washington State, the exchange is at http://wahbexchange.org/.

The Affordable Healthcare Act requires each state create an Exchange. Exchanges are a mechanism for organizing the health insurance marketplace to help consumers and small businesses shop for coverage in a way that permits easy comparison of available plan options based on price, benefits, services, and quality.

The tax credits can only be accessed through the Exchanges. Part of the goal of the Affordable Health Care Act is to provide affordable healthcare to individuals and small businesses who can not obtain reasonable insurance policies. This goal is captured in two steps. First, the Exchanges allow for pooling of consumers in order to reduce transaction costs and administrative costs. Second, the Federal Government will provide a tax credit to qualifying individuals.

The exact calculation has been described as “difficult and complicated”. Therefore, information is not easily accessed on how the credit is calculated. The calculation will be done by computer and after submitting an application through the Exchange, the amount of your credit will be identified. The Federal Government will pay the insurance company directly. There is the risk of over payment of credit based on revised income. If that happens, the individual will be responsible to reimburse the credit. The IRS is responsible to collect the over-payment.

The Affordable Care Act requires states to have oversight responsibilities in certifying and monitoring the performance of Qualified Health Plans. Part of certifying and monitoring the performance of Qualified Health Plans is the establishment of Essential Health Benefits (EHB) which each plan must offer. To ensure that all Americans have access to quality, affordable health insurance, the Affordable Care Act ensures that health plans offered in the individual and small group markets inside and outside of health benefit exchanges offer key items and services known as “essential health benefits” (EHB). These health plans will continue to be run by private companies and not the Federal Government.

For Washington State, Acupuncture will be part of the EHB offering with 12 visits offered per year.

Beginning in 2014, most people will have to purchase health insurance or pay a fine. For individuals, the penalty will start at $95 a year, or up to 1 percent of income, and rise to $695, or 2.5 percent of income, by 2016. For families, the penalty will be $2,085 or up to 2.5 percent of household income.
Although only part of the details are available at this time, one key point is that the Washington Exchange will be up and running on October 1, 2013. Applications for insurance can be made at that time, tax credits will be reflected, and coverage will take place on January 1, 2014.

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