The website of the Health Insurance Marketplace continues to have technical problems. The phone number, 1-800-318-2596, seems to be working fine. You can also find information about health care reform and paper application forms at http://marketplace.cms.gov/. Many of the technical problems on the website are related to heavy usage. About 10 million people visited a Marketplace website on October 1, and usage continues to be heavy. Interestingly, several of the state-based Marketplaces seem to be operating much more smoothly than the federal Marketplace. 

Open enrollment on the Health Insurance Marketplace lasts until March 31, 2014. No plans purchased on the Marketplace will begin actual coverage until January 1, 2014. Any plan purchased on the Marketplace before December 15 will start coverage on January 1, 2014.  The “change” announced last night is simply a clarification. The penalty for not having insurance kicks in if a person goes without insurance for more than three months of a year.  Last night’s announcement just clarified that if folks have purchased insurance by March 31, and keep it all year, they will not be fined even though their coverage might not begin until April 15.  

The Health Insurance Marketplace has two sections, one for individuals and one for small businesses (the SHOP). While tax credits are available on both sections, they are not the same tax credits or valued the same. Some small businesses may benefit the most from the SHOP, while others may benefit the most from helping employees buy their own health insurance on the individual section of the Marketplace. It is worth it for small businesses (those wishing to help provide health insurance for their employees) to explore both the individual and the small business sections of the Health Insurance Marketplace, although a small business and its employees cannot benefit from the tax credits on both sections of the Marketplace.

A review of a website the Richmond Times-Dispatch provided shows some information about the costs of health plans in the new Marketplace. These costs are pre-subsidy. Anyone between 100 percent and 400 percent of the poverty level will get some level of subsidy.  In the three major urban areas of the state, the least expensive “bronze level” plan seems to be Coventry Care plan in Richmond that costs $139 a month for a 27 year old, $238 for a 50 year old and $471 for a family, all pre-subsidy costs.  

The website enroll-virginia.com is a great source of help in dealing with the new Health Insurance Marketplace. It has an interactive map to let you find people who can help you with the application process. 1-888-392-5132 is the statewide phone number.

Medicaid expansion is a major part of health care reform. Virginia is still discussing whether to expand Medicaid. The legislative committee set up to consider expansion (the Medicaid Innovation and Reform Commission, or MIRC) held a public hearing last week on the issue.  Both in person and online comments in favor of expansion greatly outnumbered those opposed. The MIRC will meet once or twice more this year and may vote on expansion at some point. However, it is possible that the entire Virginia General Assembly will decide the issue when they meet again starting in January.  

A study by the Virginia Hospital Association found that Medicaid expansion will cover close to 400,000 Virginians and create 30,000 new jobs. The study also found that the cost to Virginia of expanding Medicaid was actually less than the cost of not expanding it.

Virginia state elections will be held on Tuesday, November 5. The Governor, Lieutenant Governor, Attorney General and the entire House of Delegates will be on the ballot, as well as local elections in some areas. 

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