Pulse on Health: Question marks surround Affordable Care Act

We will not know how the Affordable Care Act works until the uninsured get policies.

The giant preventive-health experiment might actually take years.

Will annual health checks catch illness earlier, make it easier to treat, and decrease risk of death? Time will reveal the answer.

Potential problems with the law are cropping up, such asuninsured persons' home addresses.

A federal "exchange" — a marketplace where insurance companies offer plans (and where the feds note what kind of subsidies are available) — will be used by 26 states, while the other 24 created their own.


Price differences exist at the national, state and even local level .

Southeast Minnesota, for example, has among the highest rates on the state's exchange. But Minnesota's rates, overall, are cheaper than elsewhere in the U.S.

If you already have insurance, you won't need to do much.

But if you have no health insurance, federal law (backed by a Supreme Court ruling) requires that you get it within the open-enrollment period that starts Oct. 1, 2013 and continues through March 31, 2014 for policies that take effect Jan. 1 (or once your check clears the bank — whichever comes first).

A tax penalty gets assessed if you do not get health insurance by the end of open enrollment.

Don't assume you can skip health insurance until you get sick or hurt (and then buy a policy that covers pre-existing conditions). The policy won't take effect until Jan. 1 after you buy it. Crashing your car before that, without insurance, means you'll pay out-of-pocket for health care — plus the tax penalty.

About 100 companies applied to offer policies on the federal exchange, says consumer-information site .

An American Medical Association study, it says, shows a single insurance company controlled at least 30 percent of the market in "nearly 90 percent of U.S. markets."


For the time being, if you live in Texas, your options might be limited to a few federal-exchange companies. But, the consumer site says, multi-state plans will be available in all states by 2017.

"Multi-state plans were created through the Affordable Care Act to address the lack of competition in the individual health-insurance market," it notes.

Seems southeast Minnesota's health-insurance marketplace , in particular, could use a dose of that competition.

Pulse on Health is a weekly column by health reporter Jeff Hansel (285-7615). Follow him on Twitter @JeffHansel.

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