Bloglander

Back in 2010, one of the key talked-up provisions of the Affordable Care Act, aka Obamacare, was the creation of state-by-state “exchanges.” The idea was to help consumers buy health insurance coverage — not an easy thing to do, if you’ve ever tried it — by making it easier to compare plans and get tax credits to offset the cost. But this was always kind of confusing — is it a real place? A website? Like a shopping center where you actually buy stuff? More like a clearinghouse info center?

As states start to roll out their sites ahead of the Oct. 1 deadline, it’s becoming much easier to understand. Much of the language on the sites is the same: a “marketplace” to make “apples-to-apples” comparisons between plans. Other important parts aren’t yet clear, like the prices.

The deadline to submit a plan for a state exchange was last February. Plenty of states had already declared they had no intention of creating one, which means the federal government will run one for their citizens through HealthCare.gov. Half the states either failed or refused to set up their own exchanges. (The Kaiser Family Foundation lists state-by-state progress, and the National Conference of State Legislatures has a map and summary as of February. Here’s a map of states’ progress a year ago.)

While Washington state enthusiastically went about setting up its exchange from the get-go, Idaho went into the process much more begrudgingly. When Gov. C.L. “Butch” Otter announced the state’s exchange last December, it was very clear he considered it a decision between the lesser of two evils: “Our options have come down to this: Do nothing and be at the federal government’s mercy in how that exchange is designed and run, or take a seat at the table and play the cards we’ve been dealt. I cannot willingly surrender a role for Idaho in determining the impact on our own citizens and businesses.”

Legislators didn’t approve the exchange until March. The message from Otter on the new exchange site has the same emphasis, but with a different tone:

“The implementation of this state-based health insurance exchange has required the collaboration and energy of multiple outstanding Idahoans. I commend the efforts of all those involved in the development of Your Health Idaho for building a consumer-friendly exchange run by Idahoans for Idahoans.”

There’s been some confusion about whether Idaho’s site will be ready in time, and it will be — with a little help from the feds. Idaho will rely on the federal mega-site for secure data storage and entry for the next year or so.

The open enrollment period begins Oct. 1 and ends March 31, 2014. Coverage starts as soon as Jan. 1, 2014.