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Will I be able to buy health insurance through one of the future exchanges if my employer offers group health coverage? I think I pay too much for the group plan.

No, only small businesses with fewer than 100 employees and individuals without access to affordable employer-sponsored group health insurance will be able to purchase coverage through exchanges when they open in 2014.

Under health reform, states must establish exchanges by 2014, or, if they fail to act, the federal government will set up the exchanges. Before 2016, states can limit exchanges to businesses with fewer than 50 employees, and starting in 2017, they can open exchanges to employers with 100 or more workers. The Congressional Budget Office projects that by 2019, 24 million people will purchase health insurance through exchanges, along with another 5 million people whose employers allow them to buy coverage through exchanges, according to the Kaiser Family Foundation.

The insurance exchanges will feature several types of plans, which will have to meet certain benefit and cost standards. They also will include information for consumers to help them understand and compare health insurance options.

Individuals who aren't receiving medical insurance coverage through an employer, Medicare or Medicaid and whose incomes fall within 133 percent to 400 percent of the federal poverty level will qualify for subsidies through the exchanges to help them afford premiums. The premium subsidy is available only to those who enter the exchanges as individuals.

Of course, much could change over the next few years as Republicans challenge health reform in Congress as well as in the courts. More than half the states are suing the federal government over health care reform, challenging the constitutionality of the so-called individual mandate, which will require virtually everyone to purchase health insurance starting in 2014 if they don't already have it through an employer or government program. Those cases are expected to wind up at the U.S. Supreme Court.

For more, see how health insurance exchanges will work.

Last updated: Feb. 23, 2011
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