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A Primer on the Health Benefits Exchange & Action Steps

January 11, 2012 9:31 pm by: Category: Health Care A+ / A-

Are You Sick of SkyRocketing Health Insurance Premiums?
Tell The Virginia General Assembly to Do Something About It!

The creation of a strong Virginia Health Benefits Exchange will control costs and exchange a broken system for a healthier Virginia.


What is an “Exchange”?


Whether you call it a Health Benefits Exchange, Insurance Exchange, or just “Exchange,” beginning January 1, 2014, it will be a new way to improve and purchase health insurance. Exchanges are tools to make health insurance better, more affordable and easier to understand. They are one of the key parts of the Patient Protection and Affordable Care Act enacted in 2010.  Each state can create its own Exchange with its own choices, or let the federal government set up an Exchange for them.


On the surface, the Virginia Exchange will operate as a website where individuals and small businesses can go to compare and enroll in health insurance plans and qualify for subsidies or public plans to make good health care affordable. But behind the computer screen, the Exchange will be defined by important decisions about how to make good health insurance affordable. Many of those decisions are being made right now.


What does it mean for you?


·      If you can’t get health insurance through your job, starting in 2014 you can purchase good, affordable health insurance on the Exchange. 

·      Small businesses may choose to use the Exchange to offer affordable health insurance for their employees.

·      Starting in 2014, many Virginia families will receive financial assistance to make health insurance more affordable. Using the Exchange, individuals can find out if they qualify for “subsidies” to make private insurance cheaper, or for public health care. For example, individuals earning less than about $14,000, or a family of four earning less than about $30,000, will qualify for Medicaid, while those with higher earnings may get a subsidy that limits how much they will have to pay to have good health insurance.

·      No matter where you buy it, all insurance plans will have new higher standards of care. Individuals won’t be denied insurance or overcharged based on a pre-existing condition, and preventive health care will be available without a co-pay. Each state also has the option to create even higher standards for plans on its Exchange.

Moving Forward With a Strong Virginia Exchange


Virginia Organizing and its small business initiative, the Virginia Main Street Alliance, have actively participated in the 18-month process led by the Governor’s Virginia Health Care Reform Initiative (VHRI) and its six working groups. We support most, but not all, of the VHRI recommendations and are encouraged by the initiative’s hard work on this critical need. That is why we were disappointed to  learn that Governor McDonnell does not plan to move forward on health care reform implementation in the 2012 General Assembly. Fortunately, individual legislators are planning to introduce Exchange legislation. We believe that Virginia should create and implement its own Exchange, regardless of how the Supreme Court rules on the individual mandate. We need to control health insurance costs, push for greater transparency and move forward with a very Virginia Health Benefits Exchange.


What should the Virginia Exchange look like?


  •  Virginia Organizing supports the recommendation of the Governor’s Virginia Health Reform Initiative's Advisory Council that voted overwhelmingly to recommend setting up the exchange as a "quasi-public" agency using the successful Virginia Housing Development Authority (VHDA) as a model.


  • Virginia Organizing believes the Exchange should be governed by a diverse board with a variety of expertise (at least two representatives of consumer organizations and a representative from small business) along with a broad advisory committee composed of stakeholders not on the board.


  • Virginia Organizing opposes allowing insurers or other entities with a financial stake in the Exchange on the governance board.


  • Virginia Organizing believes the insurance practice of cherry picking only healthy consumers known as “adverse selection” must be avoided in Virginia’s Exchange.



What can I do about it?

You can help choose which path Virginia goes down. Here are three ways to make a difference:

1.) Share your story. Personal stories are the best way to make our choices clear to elected officials and other decision makers. Click here to share yours.

2.) Connect and Educate. Find ways to get people together, start the discussion, and learn

what’s in the ACA and the Exchange for you.

3.) Take Action Together. Join the Virginia Organizing committee, write a letter to the editor, contact your elected representatives, or attend a meeting or action to support health care reforms that benefit

our communities. Click here to join our health care rapid response team.


For more information about Virginia Organizing’s fight for health reform contact: Brian Johns:


A Primer on the Health Benefits Exchange & Action Steps Reviewed by on . Are You Sick of SkyRocketing Health Insurance Premiums? Tell The Virginia General Assembly to Do Something About It!The creation of a strong Virginia Health Ben Are You Sick of SkyRocketing Health Insurance Premiums? Tell The Virginia General Assembly to Do Something About It!The creation of a strong Virginia Health Ben Rating:
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