When the Affordable Care Act (ACA, or Obamacare) was ushered into law, it not only mandated that all U.S. citizens obtain minimum health coverage, but it also provided for a means of obtaining required healthcare insurance. First, federal resources were put into place via Healthcare.gov, a website that all Americans could use to enroll in Obamacare, peruse options and information, and ultimately gain affordable health insurance coverage. However, Obamacare also provided for the creation and facilitation of state-run health insurance exchanges, or more localized health insurance marketplaces designed to better meet the needs of residents on a state-by state basis. In addition, state expansions of Medicare and Medicaid services provide access to affordable services for those most in need.
So why do some states have exchanges and some do not? What are these health insurance exchanges and how do they work? Should you purchase your insurance through the federal marketplace or via your state health insurance exchange? It’s important to understand, first and foremost, that you can start seeking health insurance options via Healthcare.gov whether your state is one of those that has set up an exchange or not. If your state does have an exchange, the Healthcare.gov website will simply redirect you to it when you enter your zip code.
Healthcare.gov is the federal health insurance marketplace, or health insurance exchange. It is designed to help those without health insurance to find affordable options so that they can obtain qualifying coverage (to meet legally required mandatory minimum coverage and avoid penalties). In order to qualify, you need only be a U.S. citizen living in the United States (and you cannot currently be incarcerated). Even if you have other healthcare options, you may apply for enrollment. If you have access to insurance benefits through an employer-sponsored plan, Obamacare may not ultimately be your most affordable option, but you can certainly apply and check out your options.
Generally speaking, Obamacare is going to provide the best options for those that are not able to gain insurance coverage through their place of employment. You can enroll with Healthcare.gov, but if your state has an insurance exchange, you may end up with more options for affordable coverage. The reasons for this have to do with expansions of Medicare and Medicaid programs at the state level, as well as the fact that the large pool of applicants allows the exchanges to negotiate the lowest rates (as opposed to private insurance options).
In order to encourage states to set up their individual healthcare exchanges, federal funds were provided for implementation and expansion of exchanges and related services. States were granted a limited amount of time to take advantage of federal funding for their rollouts, and those states that accepted assistance have generally been able to provide better access to health insurance options and services for their residents. Of course, many states also elected to put state funds into these programs, as well, in an effort to increase access to affordable services for citizens.
State exchanges may be able to provide additional options and savings for residents that apply for health insurance. At the very least, state health exchanges can offer competing options from a variety of health insurance providers, helping residents to find the best coverage at the most affordable cost. However, those that qualify for Medicare and Medicaid through state exchanges may find that they have access to additional services and savings, even beyond what they could expect through the federal health insurance exchange. In other words, it pays to understand what your state offers and explore all available options when determining how Obamacare can be utilized to your best advantage.
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