Individual Exchange Opens Doors to New Care Opportunities

COVID-19 has drastically shifted health care coverage for many across the nation. Almost overnight, millions of individuals abruptly lost access to employer insurance. Many of these individuals are now weighing their coverage options, including the opportunity to access care through the health insurance marketplace (also referred to as the individual exchange or exchange). In fact, engagement in the health insurance marketplace is accelerating, and this shift could alter health care coverage through COVID-19 and beyond.

Individual exchanges could drastically change care coverage

Despite high unemployment rates and the associated impact on income levels, many newly unemployed individuals do not qualify for Medicaid, driving them to the exchange to access available coverage options. With access to federal subsidies, this product has become an important health care coverage option, attracting many who are managing conditions during the pandemic.

Leading up to this point, the exchanges had slowly been stabilizing. Now, these exchanges are playing an essential role in helping people access coverage that best fits their health needs.

Now, these exchanges are playing an essential role in helping people access coverage that best fits their health needs.

Quality coverage at an affordable price

While health insurance affordability has always been an issue, the exchange is now an option for many, offering quality coverage at an affordable price. Additionally, the increasing stability of the exchanges due to longevity in the delivery system is removing risk factors and encouraging more participation — and competition among health plans.

Because a significant percentage of the population wasn’t familiar with the workings of the health insurance marketplace when it first appeared around 2013, confusion prevented many from taking advantage of the option. And the future of the Accountable Care Act (ACA) created uncertainty that limited participation.

Today, exchanges are more recognizable among consumers. And as we take into account the impact of COVID-19 on health insurance, many individuals are looking to re-enter the workforce as fast as they can and may be looking for interim insurance in the meantime. Even once re-employed, some may experience a lack of access to employer-sponsored coverage or high insurance rates that drive them to look for accessible and more affordable alternatives.

Helping individuals to understand what options are available to them, and what might be the best fit for their health moving forward, will play a crucial role in helping individuals manage their health conditions.

Guiding consumers to the best benefits for their health needs

This shift in health coverage provides an opportunity to help guide individuals to benefits that will best fit their current lifestyle and health needs. Some families may be looking for an alternative to employer-sponsored coverage when they’ve experienced a layoff but don’t qualify for Medicaid. As incomes continue to shift for many, eligibility will continue to shift alongside it, as we have seen happen at an accelerated pace during COVID-19.

As time goes on, we anticipate that delays in preventive care and elective procedures due to COVID-19 will increase the need for care. For some, this means securing health care coverage before they will be able to access the care they need. This makes access to affordable coverage even more essential. And helping individuals to understand what options are available to them, and what might be the best fit for their health moving forward, will play a crucial role in helping individuals manage their health conditions.

COVID-19 will continue to alter the health care landscape. And as political leaders continue to discuss health care coverage options, exchanges will continue to play a larger role in ensuring and maximizing coverage trends cross the country. This will not only provide coverage to more people, but it will improve health outcomes for all populations.  

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