The website for health care reform is clearly working better. The White House reports that the site can now handle 50,000 visitors at one time. Plus, the success rate is now 90 percent. The site still can have glitches and even if it works well, it still can be a time consuming process. So www.healthcare.govand 1-800-318-2596are the ways to sign up for health insurance in the new Health Insurance Marketplace. Policies purchased before December 23, 2013 will begin coverage on January 1, 2014.

Open enrollment on the Health Insurance Marketplace lasts until March 31, 2014. The penalty for an individual not having insurance kicks in if a person goes without insurance for more than three months of a year. The administration has announced 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 section of the website for small businesses on the Health Insurance Marketplace has now been delayed until next November. This section, called the SHOP, was intended to be a way for small businesses to get better rates on insurance.

As health care reform was planned, Medicaid expansion should have made up about one-half of the total expansion in health insurance coverage. Since the U.S. Supreme Court ruled that expansion is an option, many states (like Virginia) have chosen to delay or decline expansion. Because of the way the law was set up, most of the folks who would have benefitted from Medicaid expansion cannot get a tax credit to purchase health insurance in the Marketplace. These people will continue to be completely without health care coverage. In Virginia, 400,000 could suffer this fate. In addition, expansion of Medicaid would bring $2 billion federal dollars into the state each year, creating an estimated 30,000 jobs. Medicaid expansion will be a major issue in the General Assembly session next year. See http://virginiageneralassembly.gov/for information on the General Assembly, including who your state Delegate or Senator is.

The next meeting of the Medicaid Innovation and Reform Commission (MIRC), the legislative committee that will decide on Medicaid expansion in Virginia, will be on Tuesday, December 17 at 10:00 a.m. in the General Assembly Building.

The Virginia Main Street Alliance, working with allies, will be meeting with many members of the General Assembly this fall. These meetings are before the session gets busy, so they give more time to build a relationship and talk about issues. Contact State Coordinator Bob Becker at 804-937-0752or reply to this email if you are interested in attending one of these meetings in your area.

The federal government has a new website dedicated just to helping businesses understand health care reform. The site http://business.usa.gov/healthcareis part of the federal government’s one stop business website and answers common questions and gives businesses some guidance on how to benefit the most from health care reform.

In addition to the help that anyone under 400 percent of the poverty line will get to buy health insurance, there is also a provision of health care reform that also helps folks under 250 percent of the poverty line with co-pays and other out-of-pocket expenses. This provision is only available on “silver level” plans and is explained more fully on heathcare.gov.