In Our View: Health Care Changes Near

State close to rolling out benefitexchange for those without insurance

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ike it or not — and we acknowledge that there are many Americans who don’t like it — the Patient Protection and Affordable Care Act is coming. Colloquially known as Obamacare, the vast change in the United States’ health care system is closing in on a couple of deadlines.

Another reminder of that was delivered last week, when the Washington Health Benefit Exchange granted final approval for 35 insurance plans that will be sold at the state-based online marketplace. In Clark County, a total of 18 plans from three insurers — Kaiser Permanente, Community Health Plan of Washington, and LifeWise Health Plan of Washington — will be available. Late negotiations with Kaiser and Community Health Plan increased Clark County’s options from eight plans to 18, but that still is the smallest number of any county in the state.

The online health exchange will open for business on Oct. 1 for people who don’t have access to health coverage through their employers; the 125 million Americans with job-based coverage will not be affected by the changes. Then, come Jan. 1, nearly everyone in the United States will be required to carry health insurance or be subject to fines that start at $95 in 2014 and could be as much as $695 for an individual in 2016. Insurance companies, meanwhile, will be prohibited from turning away people who are in poor health.

While the marketplace won’t be open for a couple of weeks, some selling is already underway. The Obama administration rolled out a $700 million national advertising campaign this summer to inform the public about the changes to the health care law. According to The Associated Press: “About 16 percent of Americans are uninsured, but despite years of political debate and media attention, more than three-quarters of them still know little about the law known as ‘Obamacare,’ according to recent surveys.” That requires a special kind of sales pitch. As one advertising executive told AP, “It’s not sugar cereal, beer and detergent.”

The success of the advertising campaign will be crucial to the effectiveness of the Affordable Care Act. If only the most sickly among the uninsured sign up through the state-run exchanges, their health care needs could prove too costly and overwhelm the system. If an adequate number of relatively healthy people sign up, their premium payments will be able to subsidize care for those who require it. That’s not unique to Obamacare; that’s the way insurance works. Yet there’s no telling how it will turn out in this case, especially with different states taking different approaches to their exchanges.

Obamacare long has been a journey into the great unknown. It has survived a challenge that reached the Supreme Court; it has survived 40-some votes in the U.S. House of Representatives designed to overturn the law; it has survived the administration’s decision this year to postpone until 2015 a mandate that businesses provide employees with insurance. Obama cited concerns from business owners in deciding to alter the schedule, but the legality of the administration’s unilaterally changing a portion of the law has been questioned by many.

In Washington, meanwhile, the state appears ready to help its roughly 960,000 uninsured residents figure out what they need to know. Information about the Washington Health Benefit Exchange can be found at http://wahbexchange.org. Obamacare is right around the corner — like it or not.