The health care reform feature that likely will affect the greatest number of Americans — and hospitals — is state-run health insurance exchanges. As mandated by the Patient Protection and Affordable Care Act, every state must establish and launch its own exchange by Jan. 1, 2014, or default to a national fallback program. (States that cannot meet the 2014 deadline still can set up their own exchanges later as long as they give the federal government a year's notice to transition from a federally administered exchange.)
Health insurance exchanges will have a profound effect on how individuals and employers select and buy their health care. There will be an online, one-stop shopping mall where consumers, employers, insurance brokers and still-to-be-defined "navigators" easily will view competing health plans — comparing benefits, costs, provider networks and other features. Exchanges also will enable individuals to access subsidies and employers to access tax credits.
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