Health Insurance Marketplace

Between November 1, 2016, and January 31, 2017, millions of Americans—individuals, families, and small businesses—will be able to find health insurance that fits their budgets and meets their needs, with less hassle, at the Health Insurance Marketplace. Consumers will be able to go to one place to search for health coverage options; to get accurate information in easy to understand language on different plans; and to make apples-to-apples comparisons of private insurance plans. They’ll be able to get comprehensive information about benefits and quality, side by side with facts about price, before they have to make a choice.

No matter where they live, consumers will only need to fill out a single application on the Marketplace to choose from the health plans available in their area, to learn if they qualify for programs like Medicaid or the Children’s Health Insurance Program, or to find out if they qualify for lower costs on monthly premiums or out-of-pocket costs.

Coverage starts as soon as January 1, 2017.

Coverage Can Improve Population Health

All health plans offered on the Marketplace must cover a comprehensive set of benefits, including physician visits, preventive care, hospital stays, and prescriptions. Plans must also treat everyone fairly; discrimination against pre-existing conditions will be banned.

Most health plans must cover certain preventive services for children, women, and adults without a copayment, co-insurance, or deductible. Just a few of the covered preventive services include:

• Screenings
• Counseling
• Routine vaccinations against flu, pneumonia, HPV, measles, polio, meningitis, and many other diseases
• Blood pressure, diabetes, and cholesterol tests
• Regular well-woman, well-baby, and well-child visits
• Care to ensure healthy pregnancies

Find out which preventive services are appropriate for you and your family by consulting the CDC Prevention Checklist.

Already we are seeing that access to coverage increases the use of preventive care and improves reported physical and mental health. A recent report from Oregon found extending coverage resulted in:

• More than 50% improvement in cholesterol screening rates
• Greater than 30% improvement in cervical cancer screening rates
• 100% improvement in mammography rates

(Citation: Baicker K, Taubman SL, Allen HL, et al. The Oregon experiment — Effects of Medicaid on clinical outcomes. N Engl J Med 2013;368:1713-1722)

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To Help Encourage Enrollment You Can:

• Post videos on your websites and social media sites.
• Include content in your newsletters, listservs and social media channels.
• Share information through conversations, presentations, speeches, and interviews.
• Educate and train staff on what they can do in their roles as family members, friends, and professionals.