Today is the first day of open enrollment for New York state’s health-insurance exchange, and one word best describes the situation from the perspective of citizens: confusion.
The exchanges were created as part of the Health Care Affordability Act, better known as Obamacare. That law requires that every American have some kind of health insurance by Jan. 1, 2014, or pay a penalty.
We don’t plan to argue the merits or disadvantages of the law, which is complicated and tied up in a web of politics. But we will offer this thought: Obamacare is now law, and there is no alternative in place at this time.
So the reality is that everyone — individuals, businesses, insurance companies and governmental bodies — has to deal with what is on the books.
The North Country Chamber of Commerce held a session to help local people know what to expect from the insurance exchanges. Officials stressed that help is available in wading through the requirements and options. On Monday, private insurance companies, such as Blue Shield, were sending out news releases emphasizing that they were “reform ready” and available to help consumers.
Here is a comforting thought: Most people in the North Country will experience no change in the way they receive health insurance. If you are covered by your employer or under a family member’s policy or by Medicare or Medicaid, that will continue.
Other people will need to find insurance, and the state health-insurance exchange is an option to do that. But you aren’t being thrown out on your own on this.
By today, employers have to tell their workers about their insurance options, including the state marketplace, though no penalty is planned for those who don’t comply. We hope businesses do so out of a sense of responsibility and empathy for their employees, who likely are even more lost on this issue than employers are.
The New York State of Health portal is a way for individuals and small-business owners to get insurance, check eligibility, calculate monthly costs, compare plans and receive personal assistance. Find out more at nystateofhealth.ny.gov and adirondackhealthinstitute.org.
Insurers have to offer at least 10 essential benefits, according to the chamber workshop: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental-health and substance-use treatment, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive/wellness services and chronic-pain management, and pediatric services.
New York offers plans on four levels — bronze, silver, gold and platinum — with different levels of benefits and consumer contributions.
If you are already insured, just carry on as always. If you aren’t, you have a little homework to do. But you have help and a few months to figure it out, so don’t panic.