Confused By Health Care Marketplaces? Help Is Coming

May 8, 2013 -- Now that the federal government is building health insurance Marketplaces (also called Exchanges) in 34 states, the question is: Will customers come?

The Centers for Medicare and Medicaid Services (CMS), the government division overseeing the roll out of the new Marketplaces, is getting ready. It recently announced that thousands of people will be hired to staff call centers tied to the Marketplaces.

Beginning in June, 7,000 to 9,000 additional people will answer phones through CMS’s "1-800-Medicare" help line, 24 hours a day, 7 days a week. The staff will answer questions about how to apply and enroll in the new insurance plans that will be offered in the states where the federal government is partially or wholly running the Exchange.  

Under the Affordable Care Act, on Oct. 1, 2013, people and small businesses will be able to purchase insurance through a Marketplace. Officials hope it will be as easy to operate as web-based travel shopping sites like Travelocity. In the Exchange, people can look for different insurance options and decide the type of plan they would like to buy. They will also learn if they qualify for tax credits to help pay for insurance or for Medicaid, the health insurance program for people with low incomes. Insurance coverage is set to begin in 2014.

Educating people and small businesses on what insurance to buy may be a big challenge, given that many people still don’t know there is an option to buy health insurance. An April Kaiser Family Foundation poll found that 42% of the public didn’t know the Affordable Care Act had become law. Among that group, 19% thought it had been struck down by the Supreme Court or repealed by Congress.

Of those people with incomes of $40,000 or less -- those most likely to benefit from the law -- about 56% said they didn’t have enough information to know how the law would impact their families.

CMS has been spending money to make the public more aware, including $28.2 million on the call centers. The funding was awarded to Alexandria, Va.-based Vangent (a unit of defense contracting firm General Dynamics), which has been operating the "1-800-Medicare" call centers for about a decade. 

Those centers help people with Medicare with questions about billing, claims, medical records, and expenses. They also help them get Medicare Advantage, the program that provides Medicare coverage through private insurers. This contract builds on the work that Vangent has already been doing for CMS.

“The people who will be answering the phones will be thoroughly educated and well-trained,” says Mark Meudt, vice president of marketing and communications at General Dynamics' Information Technology division.

He says because Vangent has been working with CMS for so long, “we are efficient in staffing up” and expect to have employees in place by June.

Staff will provide services for people with hearing impairments as well as services in Spanish and English. There will also be a separate line to support 150 different languages.

Information will be available by telephone, email, or fax, and there will be a web site where people can find their state information. 

In addition to the call centers, the Obama administration will spend another $54 million to help states hire and train "navigators" that will also help people determine the right insurance to buy.

Sixteen other states are running their own health Exchanges, and some will have their own call centers to help people make decisions.