The writer, of Omaha, is a state senator representing District 7 in the Nebraska Legislature. He is a former chairman of the Health Committee of the National Conference of State Legislatures.
When the Affordable Care Act (ACA) was signed into law in 2010, it carried with it a promise of expanding access to good-quality, affordable health coverage for millions of American families and small businesses.
We have a historic opportunity, beginning Oct. 1 of this year, to make private health insurance more accessible and affordable for hundreds of thousands of Nebraskans through the new Health Insurance Marketplace, turning the ACA’s promise into a reality here in our state.
Important positive changes have already been made to our health care system as a result of the ACA. Children with pre- existing conditions can no longer be denied coverage. Young adults can stay on their parents’ private insurance until age 26. Insurers are now required to spend at least 80 percent of our premium dollars on medical care. If they don’t meet that threshold, they have to provide a rebate to their customers. It is now illegal for health insurance companies to arbitrarily cancel your coverage just because you get sick. Lifetime limits are a thing of the past, and annual limits will go away in 2014.
One of the most significant steps toward the promise of quality, affordable coverage begins on Oct. 1, when Nebraskans will have a whole new way to shop for private health insurance on the Marketplace. For the first time in the history of the private insurance market, consumers will be able to go to one place to check out their coverage options, get accurate information in easy-to-understand language and make apples-to-apples comparisons of plans before they make their decisions.
All plans in the Marketplace will be required to cover a comprehensive set of benefits, including physician visits, preventive care, hospital stays and prescriptions. Discrimination based on gender or pre-existing conditions will be banned. And many families and small businesses will qualify for a break on their monthly premiums. According to Nebraska Department of Insurance estimates, more than 90 percent of people who enroll in coverage in the Marketplace will receive some sort of financial assistance to make that coverage more affordable.
Right now, families and small-business owners can visit HealthCare.gov to get ready for open enrollment on Oct. 1. For Spanish speaking consumers, CuidadoDeSalud.gov has been updated in preparation for the Marketplace. There is also a toll-free consumer call center at 1-800-318-2596 that will be open 24 hours a day, seven days a week to help answer questions about the Marketplace. There are trained individuals, called navigators, available in local communities across the state — through the local Community Action Agencies or through the Ponca Tribe — who can help people enroll in coverage in the Marketplace.
Whether consumers seek help through the call center, through the website’s live chat feature or through trained professionals who will be working in their communities, they’ll have access to support that is personal, unaffiliated with the insurance industry and available to help in more than 150 languages.
The promise of the Affordable Care Act is within our grasp. But to make this promise a reality, we need all those who care about getting more people covered to do their part. Elected officials at all levels — community organizations, churches, human service providers, neighborhood associations, friends, family and neighbors who understand the value of getting people covered in private insurance — can all play a role in sharing information about the Marketplace. We need organizations, community leaders and human service providers to help spread the word that “now’s the time to get ready.” We need them to engage their networks and their community. And we need them to help ensure that no one who is eligible is left out, left behind or left on the sidelines of the Marketplace.
Open enrollment on the Marketplace starts Oct. 1. Coverage starts as soon as Jan. 1, 2014. To fulfill the promise of affordable, high-quality coverage for all, I encourage individuals, families and small businesses in Nebraska to shop around on the Marketplace and learn what options might be available to best meet their health needs and budgets.
Let’s not miss this opportunity to help more Nebraskans access private health insurance and to make our health care system stronger, more cost-effective and more sustainable into the future. Let’s ensure that everyone can successfully navigate this new Health Insurance Marketplace to ensure better options and better health.