SEATTLE — Until now, it's all been talk. Starting Tuesday, health care reform will move from speculation to reality when insurance exchanges in Washington state and across the nation open for business.
People without health insurance or those who buy insurance as an individual will find out how much the Affordable Care Act will add, or subtract, to their cost of living in 2014. And everyone who plans to engage the new system is about to discover if it's harder or easier than filing federal income taxes to purchase health insurance through the new marketplace.
Some like Seattle entrepreneur Aaron Brethorst expect to pay more for health insurance. Brethorst, 31, has been buying catastrophic insurance — with a high deductible for health emergencies — and his new insurance will be more comprehensive but also more expensive.
Young adults will have an option of a catastrophic plan that covers prevention, some primary care and would have a high deductible kick in in case of a major illness or accident.
Some Washington residents are about to get a happy surprise. About 325,000 more people in the state will find they are eligible for Medicaid. New state rules set the bar for free health insurance at 138 percent of the federal poverty level as of Jan. 1, which equals an income of just over $15,000 for an individual.
Some who make more money will get a government subsidy to help pay their insurance costs. Those subsidies are available on a sliding scale, depending on a person's income and the cost of their insurance plan. Those subsidies generally top out at incomes of $46,000 a year for an individual or $94,200 for a family of four.
If you're young and single, but earn at least a middle-class income, you're not likely to get any help from the federal government in paying your insurance premiums. Those premiums could cost you about $3,000 a year if you're 21 and earning $34,000 or more.
The cost of premiums and the limits of deductibles will be determined by which plan you choose, how old you are, how many people you are buying insurance for, which company you buy insurance from and which county you live in. Premiums for a mid-range benchmark plan are expected to average $328 a month nationally for individuals.
Searching for and choosing a plan probably will be more complicated than buying shoes online, but the people who work at Washington's Healthplanfinder are trying to make it as painless as possible, by offering help online, on the phone and in person.
Part of the complexity of the site may be a benefit to some who will appreciate being able to search in sophisticated ways, such as narrowing their choices to plans their own doctor will accept or by coverage for a particular medical service.
If you speak a language other than English, as nearly half a million Washington citizens do, then you may find the new system more of a challenge. The Healthplanfinder will be available online in both English and Spanish and is scheduled to offer information in six other languages eventually.
Those who call the exchange will be able to either talk to someone who speaks their language or get a call back from someone who does. Healthplanfinder also is working with local organizations across Washington that are working as "navigators" to reach out to their communities, share information in their own language and help people navigate the new system.
Printed information about the exchange will be distributed in eight languages.
Michael Marchand, spokesman for the Washington Healthplanfinder, said the site and the program will continue to evolve in the future.
If you want to check out the program without signing up or sharing personal information, you can browse anonymously or just provide some basic information such as zip code and estimated income to get detailed pricing for your area of the state.
Washington residents who don't already have health insurance through their employer, a spouse's employer or the individual market will have until March 31, 2014 to buy insurance or they can expect to pay a fine on their 2014 federal tax return they will file in early 2015.