Virginia Health Insurance Exchange

The Federal Government will create the State of Virginia’s Health Insurance Benefits Exchange

Health care reform is sweeping the United States of America. The last time such broad legislation had been passed, in regards to finding solutions for the ailing health care situation that our nation experiences was in 1965, with the creation of Social Security. Since then, health care costs have risen and access to affordable health insurance has diminished. Approximately 55% of the United States has employer-sponsored health insurance coverage. However, for the remainder of the United States, the only option has been purchasing health insurance on the open, private market, or going without it altogether. In the private market, health insurance can be prohibitively expensive, and even unavailable depending on your health and medical record. Virginia has one of the lowest percentages of uninsured residents nationwide. Nonetheless, in Virginia, 14% of its residents lack health insurance. This amounts to nearly 1.1 million individuals who do not have any type of assistance with their medical expenses.

In March of 2010, President of the United States Barack Obama passed the Patient Protection and Affordable Care Act, often referred to as the ACA.  This law included several provisions, mandates and requirements that all states would need to adhere to. One of the primary requirements, which was accompanied with a pretty tight deadline, is the need for each state to create and operate a Health Insurance Benefits Exchange for their residents. A Health Insurance Benefits Exchange is a marketplace where consumers are not only able to review available insurance plans from private insurance companies, but are also able to compare these policies in several key areas, including: cost, qualities, types of coverage, usage statistics, member satisfaction and member complaints based on actual actuarial data.

To be allowed to be included in the listings, private insurance companies also had to adjust some of their policies. No longer can these companies deny coverage due to preexisting conditions. They also have to allow adult children to stay on their parents’ policies until the age of twenty-six. They also are not allowed to drop members for being unhealthy. They also are banned from instituting lifetime caps on coverage. These changes alone provide coverage for a lot more Americans who presently go without.

In response to this legislation, in April of 2011, Virginia Governor Bob McDonnell signed HB2434 into law. This bill expressed the state of Virginia’s intent to create its own health insurance exchange. However, even after a gubernatorial advisory council made recommendations, which were provided to the governor in November of 2011, the state of Virginia has not proceeded with the implementation of this exchange. Virginia received a $1 million planning grant to conduct studies on best practices and feasibility to establish and administer the exchange. Any state that does not submit a declaration letter and blueprint by the deadline, which has just been moved from November of 2012 to January of 2013, the federal government will establish the exchange and partner with a non-profit organization to administer it on behalf of the state’s residents. If Virginia decides to operate their own exchange in the future, it will require twelve months’ notice to the U.S. Department of Health and Human Services.