One of the biggest changes is something called the exchange. It's an online web portal that allows people to research, compare, and buy health plans. The only requirements to participate in the exchange are the following: You must be a u-s citizen, not be incarcerated, and be a resident of the state that established the exchange. Starting in 2014 people and small businesses with up to 100 employees can buy health care coverage through the exchange. Eve Van de Wal of Excellus Blue Cross Blue Shield says the new system puts more responsibility on the individual.
"So for small employer groups the employee will actually choose so the small employer will choose what level of coverage they want to offer and that's where we get into the metals; there are different metals-there's bronze silver gold and platinum 9:46:05 but then the employee of that employer group now have the option to choose. So they will go in again a web based portal think Expedia; they're going to plug in their zip code, demographic, and up will pop a variety of health plans they can participate in."
And she says we may have even more options to choose from than we do now. The employer will pick the level - the employee will pick the carrier. In 2016 the definition of "small employer groups" or small businesses, will increase to over one hundred people. And if you're not part of that small group, you can go on the exchange and buy insurance as well.
"It depends on the individual's needs, as to what they're going to cover," says Van de Wal, "All of them have to cover the basic essential benefits and depending on what level you choose you will get richer benefits as you go up the later."
Another qualification for the health plan - it must cover 60% of health costs. Large companies will not participate in the exchange - but will face penalties if they don't offer their employees insurance. Overall, the plan is supposed to be affordable for everyone.
"Under the model the intent is to expand coverage and to make it affordable no matter what your income is so if you can't afford it assistance will be there for you. And if you can that's when your forced to purchase it being the mandate or pay the penalty."
Eve says she thinks what we'll see is more small businesses not offering insurance because it's too costly, but they know their employees can go on the exchange and still be covered.