Setting the Standard: Consumer Protections in New Insurance Marketplaces

You may know that the Affordable Care Act creates new health insurance marketplaces (often referred to as exchanges) that will make it easier to shop for coverage. But did you know that the new marketplaces will also protect you once you have insurance?

The Affordable Care Act sets standards that all insurance plans sold in the new marketplaces must meet. These standards require that:

• Health plans have enough doctors, and the right kinds of doctors, in their provider networks.
• Information about what doctors are in each health plan’s network is easily available and up to date.
• Health plan advertisements and marketing materials honestly and accurately describe the insurance for sale.
• Easy-to-use information about health plan quality is available for consumers.

These are just some of the issues that the new marketplaces will address. The officials in charge of these marketplaces are working now to enact these and other standards to ensure that the health coverage they sell will meet consumers’ needs. In a recent Families USA report, we compiled examples of how nine different states are enacting consumer-friendly health plan standards for their marketplaces (referred to as exchanges in the report). In this report, you can see how states are addressing the issues described above, as well as how to make sure:

•  Consumers aren’t overwhelmed by too many confusing health plan options in the marketplace,
• Consumers who are leaving one type of insurance for another don’t face interruptions in care, and
• People who use tobacco don’t face surcharges on their health insurance that make coverage completely unaffordable for them.

If your own state isn’t featured in the report, you might want to find out why. Ask your elected officials what they are doing to make sure that your marketplace will provide consumers with all the protections they need. Enrollment in marketplace coverage starts in less than eight months, on October 1. Make sure your marketplace is ready!