In a few weeks there are these public databases called exchanges which states were supposed to set up. Ideally, one state, one exchange, handled by that state’s department of insurance. This is what the landing page of the exchange in New Mexico may look like when it’s up and running.
The exchanges are the more visible implementation of the Affordable Care Aact, aka Obamacare, including some of the parts people care most about, like subsidizing and covering everyone of every income level. Obamacare will be handled mostly under the HHS. The exchanges are state-created mega-websites used to educate, compare and enroll residents of that state into healthcare policies found there.
TPM — The refusal of red states to establish their own online insurance marketplaces under Obamacare has impeded the White House’s outreach efforts with a month to go before the marketplaces launch on Oct. 1.
In the most extreme cases, red states with huge uninsured populations will have the same amount of money to spend on outreach as blue states with much smaller segments of uninsured, according to an analysis of grant information by TPM. Take a look at these numbers: Texas, where Gov. Rick Perry steadfastly refused to establish a marketplace, also known as an exchange, has 6.1 million uninsured people. Washington state has less than 1 million. But they will have the same amount of money for Obamacare outreach.
When the Obama administration handed out two sets of grants for exchange outreach and enrollment this month, Texas received a total of $20.8 million, according to the U.S. Department of Health and Human Services. Washington state, on the other hand, which established its own exchange and had therefore access to much more generous federal funding, will spend $20.4 million on its marketing efforts, according to state officials.
Or look at another state: Colorado’s entire population is smaller than Texas’s uninsured population, but Colorado is spending more money (more than $21 million) marketing Obamacare.
From the layperson’s perspective, the exchanges are just a glorified public database with approved venders selling health insurance at regulated rates, maybe links and/or hypothetical rates, out of pocket expense examples, “How To Enroll” steps and FAQs about the ACA, along with the traditional nuts and bolts material you can find on most insurance company websites. The cost of creating and maintaining the exchange in each state is covered under the ACA, but some states still refused to set them up. In which case the federal government and/or possibly other states will create that state’s exchange. This is just one example of many obstacles that will be thrown up and have to be solved, as the hard-right tries to impede access to healthcare in much the same way they are impeding access to voting.
The only thing that gives me some comfort is thinking that Obama and most in his administration are not the crazed idealistic socialists the right has cooked up, they are careful, center left political animals, most of whom now come with a long successful record of public administration. They better keep all those skills polished, the search engines on those sites better work, the servers backed up and chained, the rates quoted better be double checked, the services offered better be spot audited, insurance companies that go out of business removed, etc., because their task is a huge practical undertaking in the face of a purely PR attack, with the lives of millions of Americans held in the balance.