Beginning in 2014, as part of the Affordable Care Act (ACA), health insurance coverage for individuals and small businesses will become available through new state health insurance exchanges (also called "marketplaces"). Most importantly, the key tax credits (e.g. the small business healthcare tax credits) and tax subsidies (e.g. individual health insurance tax subsidies) will only be available for coverage purchased through a state health insurance exchanges.
All states have three options for setting up a state health insurance exchange for 2014:
Build a State-Based Exchange
Enter into a State-Federal Partnership Exchange
Default to a Federally-Facilitated Exchange
Alabama will default to a federally-facilitated health insurance exchange. The Alabama Health Insurance Exchange will open October 1, 2013, with coverage beginning January 1, 2014.
Alabama Health Insurance Exchange - History
Alabama Governor Robert Bentley announced in November 2012 that the state would default to a federally-run Exchange, however initially Alabama supported developing a state-based exchange.
In June 2011, Governor Bentley created the Alabama Health Insurance Exchange Study Commission to recommend how Alabama should establish a Health Insurance Exchange (via Executive Order 17). In November 2011 the Commission endorsed the establishment of the “Alabama Health Insurance Marketplace.” In May 2012 a bill establishing a state exchange passed in the House, however the bill failed to pass the Senate and the bill died at the end of the 2012 legislative session. Therefore, Alabama will default to the federally-run Exchange.
Alabama Health Insurance Exchange - What is It?
The Alabama Health Insurance Exchange will be operated through a federally-run Health Insurance Exchange called the "Health Insurance Marketplace." According to healthcare.gov, starting in October 2013 Alabama residents will be able to access information about insurance plans available through the Marketplace. The SHOP Exchange will be available to small businesses in Alabama for businesses with 100 or fewer employees. Coverage starts January 1, 2014.
According to an estimate by healthcare.gov, 642,738 or 16% of Alabama’s non-elderly residents are uninsured. Through the Exchange, Alabama residents can shop for and compare insurance plans, access insurance premium tax credits, and be screened for eligibility in public assistance programs such as Medicaid and CHIP. More information on the federally-run Health Insurance Marketplace can be found here.
Alabama Health Insurance Exchange - What Plans will be Available?
All plans offered through the Alabama Health Insurance Exchange will meet the federal ACA definition of a Qualified Health Plan (QHP). The plans will be offered by level of coverage for essential health benefits (EHB), to allow consumers to compare plans on an "apples to apples" basis. The four "metal" levels are: Bronze (plan pays 60%), Silver (plan pays 70%), Gold (plan pays 80%) and Platinum (plan pays 90%). More information on the types of plans that will be available, and the carriers offering plans in Alabama, is expected by late summer 2013.
Alabama Health Insurance Exchange - Role of Insurance Professionals & Navigators
The Alabama Health Insurance Exchange will follow federal guidelines for insurance professionals selling policies through the Exchange, and for Navigators assisting consumers and small businesses.
Insurance professionals will be able to register with the Alabama Health Insurance Exchange and receive commissions directly from the carriers (using their Exchange ID number and NPN to track sales). For more information see: Role of Agents in Health Insurance Marketplaces.
The Alabama Health Insurance Exchange Navigator program will assist consumers in making choices about their health care options and accessing their new health care coverage, including access to premium tax credits for some consumers. The Federal government will run the Navigator program in Alabama.