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What Could Be More Important than October 1, Right?

September 20, 2013

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October 1, 2013—the date’s been circled on our calendars for months. We’ve talked about it in podcasts and spilled ink over it on our blog. October 1, 2013, is opening day for health insurance marketplaces, which are online destinations that will allow consumers to shop for and compare insurance under our reformed health care system.

Sounds great, right? Of course, it does! It brings choices to consumers and theoretically gives more people access to affordable, quality health insurance. For years, the AIDS Foundation of Chicago (AFC) has been advocating for a more just health care system for people living with HIV/AIDS – and anyone in need of health care – and this is a gigantic step forward.

Perhaps that’s why there’s so much frustration.

October 1 is less than two weeks away, and most states—including Illinois—still haven’t launched their marketplaces or finished training in-person counselors, who are people designated to help individuals navigate insurance options online.

To gain a nuanced perspective on the coming marketplaces, Inside Story sat down with John Bouman, president of the Sargent Shriver National Center on Poverty Law, a national organization that advances laws and policies that secure justice to improve the lives and opportunities of people living in poverty.

Inside Story: A lot of people contact AFC about Illinois’ insurance marketplace, asking, “When will the site go live? Where can I find the web address?” The only answer we have is, “We don’t know,” which leaves people frustrated. Many know that marketplaces can’t sell insurance until October 1, but they still want to see the site in order to formulate questions for in-person counselors and to have reassurance that they’ll have health insurance in 2014.

John Bouman: We have to keep the national picture in mind. People will want to use the frustrations and advocacy around the implementation to fuel the effort to de-fund and undo the whole ACA. We have to be careful that our legitimate advocacy around implementation issues is not used for that purpose. This means strong advocacy with the system but careful handling of the big public message—don't forget the thousands who do enroll and don't have problems.

IS: What happens if October 1 comes and goes, and our marketplace system isn’t functioning smoothly or even worse, isn’t live yet?

JB: October 1 is the opening date for enrollment. Coverage doesn't start until January 1, and people can enroll until March 31 and still be covered in 2014. So, the long-awaited October 1 live date for the website and enrollment is not paramount. January is. In the interest of paying attention to my previous point, we can have some patience with the start-up delays and inevitable glitches, mistakes, and other issues.

Moreover, we have to contribute to an over-arching message that implementing something of this size inevitably has some start-up problems. This is normal stuff, and we're working on it. But it does not mean that the underlying policies are wrong or not worth their funding. Illinois authorities have also done their best to plan ahead, but more importantly they have been paying close attention to feedback from communities and acting quickly to correct mistakes or unanticipated issues.

IS: Is there anything we, as general consumers, can do to make sure health care reform can make the greatest, positive impact?

JB: Yes, for sure, we have to push hard to identify all the problems in this new system, so that we can pressure the state to fix them. If somebody discovers an issue, please contact Molly McAndrew, Program Manager for AFC's In-Person Counselor Program, at MMcAndrew@aidschicago.org.

John Bouman, president of the Shriver Center, is widely recognized as one of the most effective and thoughtful public-benefit advocates in the country. He was a leader in the design and implementation of positive aspects of Illinois’ new welfare law in 1997, and he spearheaded the statewide efforts in Illinois to create both the FamilyCare program, which provides health care insurance for up to up to 400,000 working poor parents of minor children, and All Kids, the first state plan to extend health coverage to every child. Click here to read his full bio.

Categorized under Inside Story.

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