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Many consumers in the dark about health insurance exchanges Posted: June 4th, 2012

By Maryalene LaPonsie

Maryalene LaPonsie has been writing professionally for more than a decade on topics including education, insurance and personal finance. She holds a Bachelor's Degree in Political Science from Western Michigan University.

The majority of people expected to be eligible for government health insurance subsidies in 2014 are not familiar with health care exchanges where consumers will be able to shop for medical coverage. According to research issued by CVS Caremark, 78 percent of those who are eligible for subsidies have never heard of state-based health care exchanges.

Affordable health insurance is goal of exchanges

The exchanges are mandated by the Patient Protection and Affordable Care Act, which makes reforms to the U.S. health care system. In 2014, virtually every U.S. resident will be required to maintain health insurance coverage. State-based health care exchanges are being established to help households find low-cost health insurance to meet the coverage requirement.

Households with incomes up to 400 percent of the federal poverty level will be able to receive government subsidies to offset the cost of health insurance coverage purchased through an exchange. However, as CVS Caremark learned, the vast majority of eligible residents are not informed about the exchanges.

"Despite all the news coverage about health care reform, these survey results clearly show that consumers are confused about the potential changes to our health care system," said Helena Foulkes, CVS Caremark executive vice president and chief health care strategy and marketing officer, in a statement.

In addition, 60 percent of survey respondents indicate they anticipate needing help to understand medical insurance terms and descriptions when it comes time to make a purchase. Doctors, pharmacists, nurse practitioners and independent insurance consultants were the professionals most often cited by individuals as reliable sources of information.

Federal grants fund exchanges

To help states prepare for the 2014 mandates, the federal government is offering grants to fund the development and creation of state-based exchanges. In May, the Department of Health and Human Services (HHS) awarded a total of $181 million to six states:

  • Illinois
  • Nevada
  • Oregon
  • South Dakota
  • Tennessee
  • Washington

Including these awards, federal funding for exchange-related grants has topped $1 billion during the last two years.

The HHS also has issued a document intended to help states demonstrate how they will provide affordable health insurance options to their residents. Every state can choose whether to create its own health care exchange. For states that opt out of the program, a federal health care exchange will be made available to residents instead.