Health Insurance Exchanges are now Online (Affordable Care Act) | Hacker News Reader

Health Insurance Exchanges are now Online (Affordable Care Act)

healthcare.gov

19 pointsyapcguy31 comments

This neatly coincides with my need to purchase my own health insurance: I just accepted an offer with a startup that does not yet have a company plan in place, but they are giving me a a monthly allowance to purchase my own.

May I solicit any recommendations from the other hackers and entrepreneurs out there? Where have you bought insurance from? What private equivalents to the Health Insurance Marketplace are out there?

Right now I'm running through the application on eHealthInsurance.com and it's looking like I can get some pretty sweet PPO health insurance + dental + vision for about $212 per month.

Are those for the 2014 calendar year? Everything changes then. As of last night, I was seeing 'good deals' on insurance from multiple places, but it was all 2013 numbers.

My understanding is that you need to have an 'ACA-compatible' plan, and in my state (NC) there are precious few, and effectively only one provider. HSAs are effectively gone (at least for me in NC - it looks like for others in NC as well) and my premium doubled for 2014.

Why are HSA's gone?

There's conflicting information out there. eHealthInsurance asks if this is for 2014 (or now), giving this reason for the question:

> With the introduction of the Affordable Care Act (Obamacare), plans in 2014 may be different from those offered now. You can no longer be denied coverage for pre-existing conditions, but you may incur higher premiums and find more limited offerings. Many insurance companies are allowing you to purchase plans now that can automatically be extended through 2014, meaning you will be able to keep your plan (and doctor) without worrying about the tax penalty in 2014.

According to HealthCare.gov, any plans instated after March 23, 2010 will need to change to comply with the new laws when you have to renew your plan in 2014. At least I think that's how it's working. See https://www.healthcare.gov/what-if-my-current-individual-pla...

Even more confusing is when I may or may not enroll for health insurance, inside or outside of the government marketplace. It looks like if you don't renew your plan within 30 days, you're not allowed to enroll anywhere (and I bet they'll even fine you for it! How nice!)

The lack of HSAs in NC is troubling - can you provide more details?

I called coventry, and they said they have an ACA-compatible HSA, but they had no info yet - getting a call on monday.

I'm pretty confused about this. I thought the ACA plans through the exchanges don't take effect until January (or later?). So do you need to buy a plan now on the exchange? And then buy a separate plan to cover you until then?

I guess that's how it would need to be. So, it's not perfectly neat. But I would probably be able to purchase COBRA to hold me off until 2014.

Still, individuals making more than roughly $45k (at current numbers) don't qualify for any subsidization. So purchasing through the government marketplace seems to be a moot point.

Is that the only benefit of the marketplace? Subsidies?

I was thinking they would have cheaper/better plans?

Yes. Cheaper/better plans == subsidies.

There are cheaper and better plans available, but ONLY if you make the income cutoff (~$45k for individuals with no dependents).

Whether you buy in or out of the marketplace has no bearing on the rules that healthcare plans have to follow. All healthcare plans must cover rules outlined by the act, or you will be fined.

What about paperwork? More or less?

Also the plans on ehealthinsurance can't require preexisting conditions ?

Haha, well, I'm having to figure out more government mandates, procedures, etc. to abide by now, so as it stands currently, more.

For California, the website looks okay, but might not really be ready.

https://www.coveredca.com/coverage-basics/plans.html

Click 'Health insurance companies for 2014' and you get a 404. Ouch.

https://www.coveredca.com/PDFs/English/booklets/CC%20health%...

Does anybody know if things like this are developed internally or outsourced to contractors?

It could just be that they are not prepared for the amount of traffic they are getting, for part of the morning the New York website had a warning that they were getting a lot of traffic and to try again later in the day if you are unable to apply.

It depends on the state. Most states are actually using the federal system. Some states did their own. For those, most were outsourced to contractors, as the business rules are extremely complex and state governments tend to not have much experience with high-volume consumer transactional websites.

A lot of the projects were handicapped by short schedules, due to political interference. They weren't really free to work full strength until after the 2012 election was done.

In every case I know of, contractors.

Worked yesterday. They are probably getting slammed today.

Seems like they work about as well as any other major launch.

http://twitchy.com/2013/10/01/surprise-obamacare-health-insu...

Problem is, some people will spin this as a government failure and as more ammo stating the government can't do health care.

I feel they should have made it more clear that no plans will take effect until Jan 1st, so there is no need to rush to sign up.

While many of the dates where the provisions for ACA could have been clearer, it is important to remember it has been delayed over and over pushing out the implementation dates many times over.

So again, much like any other major roll out or release.

No rush to sign up specifically, but at least some states have had a blackout on all pricing info, and people do need to start at least budgeting for next year, and without knowing how much you'll need to pay, it's hard to do that.

Will it matter if I find out today or tomorrow? Probably not. It would have been nice to have had a better functioning website, given that they've known about this for a while and should have an effectively unlimited budget.

Please change the title to "Health Insurance Exchanges are now OFFLINE".. as most of them are not working :)

For some bizarre reason, the Federal site will not allow usernames that are all letters.

Also, when I got to the security questions page, there were no questions in the dropdown boxes. It let me continue anyway after I put BS "answers" in the relevant boxes.

...and then I get a message about my account not being created because the system is unavailable. Guess I'll have to wait until the initial rush dies down.

Overall, though, what I have seen so far looks much better than I expected from a Federal government product.

Georgia dropped the ball in general, so I'm still waiting for the federal site to let me log in.

Why are they even called 'exchanges'?

Are quotes coming in live from the healthcare providers?

Can we get a feed to the data to chart price changes over time?

At the moment it looks like the websites are fairly static and all we're getting a look at is a menu of prices.

You're thinking of a stock exchange. This is a marketplace. As in one person has a set of goods and services, and someone has a need for those goods or services. They exchange goods and services for other goods and services--or money--on the marketplace.

I honestly can't tell whether you're trolling or genuinely confused.

Both words 'marketplace' and 'exchange' are being used so that might confuse people.

Obviously I don't expect it to look like a stock exchange with bid/ask but one of the ideas of having the marketplace was that competing healthcare providers would (maybe) lower premiums.

That means there must be a mechanism for updated prices appearing on the websites. Are prices updated on a daily, weekly, monthly or quarterly schedule?

It would be interesting after a year to see whether prices really do fluctuate or not, and what the variance from the mean is. Is this a free market where health providers really do compete on price, or is this a stitch-up like e-book prices?

Our anonymous title-fixing vigilante is asleep on the job. The actual page title uses marketplace.

www.healthcare.gov 's Backbone site is busted. Should have used knockout. 500 on https://www.healthcare.gov/ee-rest/ffe/en_US/MyAccountEIDMUn... and they didn't handle the error.

So The Republicans really have no excuse for not showing us how they would do it better?

We already had an election in which the Republican alternative was showcased. The American people determined "get rich or die trying" was not a viable option.

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