It might not be Black Friday, the day after Thanksgiving, but Oct. 1 should be a shopping day to remember.
For the first time, millions of uninsured Americans will be able to go online to compare health insurance plans, find out if they are eligible for federal help in paying the premiums and buy coverage.
That, at least, is the way things are supposed to work when the online health insurance marketplaces, the centerpiece of the 2010 Affordable Care Act, open for business. If there are computer or other glitches, all bets are off.
Theinitial open enrollment period for these marketplaces, which operate as interactive Web sites, runs from Oct. 1 through March 31. Under the law, most Americans are required to have insurance by Jan. 1, 2014, or face a fine, but officials have said those who are insured by April 1 won’t be penalized. Insurance bought by mid-December will take effect Jan. 1; coverage bought by mid-March is effective April 1.
Insurers must meet new requirements. For the first time, for example, they’ll be barred from rejecting people with preexisting conditions or charging them more.
Each state will have its own online marketplace, or exchange, and offer in-person help. The District and some states, including Maryland, will run their own marketplaces. The federal government will run others, including Virginia’s. A federal Web site, www.healthcare.gov, will direct people to the right marketplace.
The marketplaces will tell people if they are eligible for Medicaid, which many states are expanding, or if they should sign up for private plans. If someone doesn’t qualify but earns less than four times the federal poverty rate — $45,960 for an individual and $94,200 for a family of four — that person may qualify for subsidies to reduce the cost of the premiums. Small businesses will also be able to sign up their employees for policies on the marketplaces in many states.
Individual policies will be organized into four tiers — bronze, silver, gold and platinum — depending on their coverage and costs. (For more details, see accompanying story.)
People with employer-sponsored coverage generally won’t buy on the exchanges, nor will those on Medicare, Tricare or other veterans health-care plans.
How to buy insurance under Obamacare if you live in DC
The District will have one of the country’s smallest marketplaces — a distinction it shares with Vermont. It has among the fewest uninsured residents. The rollout of the District’s marketplace, DC Health Link, has been controversial at times because the D.C. Council voted in June to require that all small businesses buying policies in 2015 must go through the exchange. That was an effort to make the insurance pool as large as possible.
At least three categories of people will be targeted for enrollment. An estimated 42,000 people, or 7 percent of the District’s population, are uninsured. Nearly three-fourths live in Wards 1, 4, 5 and 7, according to the Urban Institute. Almost two-thirds are men and more than half are African American. A majority are younger than 35; most describe themselves as in good, very good or excellent health,
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