Short Takes On News & Events

Dick And Jane Sign Up For The Exchange

By Jenny Gold

March 13th, 2013, 2:33 PM

Signing up for health insurance is intimidating — even if you know you might get some help paying for it.

The federal government is trying hard to come up with a way to make the process a bit more palatable — about as simple as, say, doing your taxes online.

The Centers for Medicare and Medicaid Services (CMS) recently released draft versions of online and paper applications which consumers will fill out to buy policies in the new health insurance marketplaces, which are slated to begin enrolling people in October.  Those applications will function as a single, streamlined entry point for  consumers, telling them what sorts of assistance they might qualify for, including Medicaid, CHIP and tax credits to help them afford private insurance in the online marketplaces.  The goal is to make enrollment as easy as possible, because the marketplaces are the chief way that as many as 27 million people are expected to get coverage under the health law.

The 21-page written application is printed in a fetching orange color. CMS estimates it will take 45 minutes to complete. Although critics worry it may be overwhelming to consumers, in the simplest case, single applicants are required to fill out only six pages. It’s also important to remember that this is the government’s first stab at simplifying a notoriously complicated process.

CMS has solicited comments, critiques and suggestions for a second draft.

The online application looks a bit more user-friendly. In fact, it looks almost exactly like the online tax-filing program TurboTax. CMS released two videos explaining the online application. The first video runs through the process with a family of three: wife Jane Doe, husband John Doe and baby Sam.

The second video goes through the same process for an individual, William Doe, who seems to be a stand-in for one of the “young invincibles” — young, healthy people who feel they don’t need health insurance — whom CMS hopes will sign up.

9 Responses to “Dick And Jane Sign Up For The Exchange”

  1. I would like more information about whether a retired person who did not choose to take the employer sponsored health insurance (and is no longer eligible to sign up for the same) is considered to be eligible for use of the exchange under these rules. Can someone explain that to me? Thanks.

  2. luke says:

    if you have questions about coverageand selecting a plan or options pleasefeel free to email: or call 815-793-2046 for Free Information for your state.

  3. Brian says:

    Rebecca: Yes, you can buy a policy on the exchange. A related question is whether you will qualify for the APTC (the tax credit commonly mislabeled “subsidy”) which will probably reduce your monthly insurance cost. Here is a short decision tree that will work for most people:

    —Are you eligible for a government insurance program? (Medicare, Medicaid, Tri-Care, etc)? If “yes”, you are not eligible for the tax credit.
    —Are you eligible for an employer group insurance plan? If “no”, you may be eligible for a tax credit. If “yes”, go to Q3.
    —If the answer to #2 is “yes”, then Q3: Is that plan “good enough” and “cheap enough”? If “yes”, then you are not eligible for the tax credit. If “no” you may be eligible for the tax credit.

    If you’ve gotten this far, then you need to know your Adjusted Gross Income. If that amount is less than 4 times the Federal Poverty Level–about $45,000 for a single–then you will qualify for the tax credit. The lower your income, the greater the tax help and the lower your total monthly insurance cost. (if your income is toward the lower end of the range, there are additional subsidies which will reduce your out-of-pocket expenses as well.)

    Sorry for the long reply but this really is the “short answer’ to the question. The new system WILL let you buy a policy and that will be great news for a lot of people. What that policy looks like and what it will cost you are still completely unknown. The exchange process appears cumbersome right now, but i expect it will get smoother over time.

    Hope this helps.

  4. Ray says:


    Pending the final rules and guidelines, you should be eligible. Exchanges are designed to cover those who do not have employee sponsored health care, and those who can not afford it. If you are eligible for other government provided options (Medicare, Medicaid, etc) you will end up in one of those plans, even if you go through the exchange. It’s designed to put you in the right place, or inform you of your options if you are ineligible.

    The subsidy you receive, if any, is dependent on your income. The prices and plan options will be dependent on your location (home zip code).

    Sit back with the rest of us and wait for the exchanges to open. The rules, regulations, and guidelines change on a near daily basis. We won’t know anything for sure until we’re actually able to enroll.

  5. Contrarian says:

    When the federal and/or state gov’t starts making projections and then organizations such as Kaiser, AARP, Heritage Foundation, etc. my skepticism turns into outright fear the opposite is about to happen. If everything we citizens have heard from our representatives and federal agency employees were factual our nation would not be Trillion’s of dollars in debt, Social Security would me financially sound, Medicare/Medicaid would not be going broke, yadadadada…

    I am willing to bet anyone on the Kaiser staff a nice DQ Blizzard that 27 million more insureds will not be added by the year 2017 and that the projected cost of “O” care will have doubled by 2017.

  6. Michael Pisula says:

    What is the link to the CMS online application referred to in this article? I cannot find this.

  7. gposner says:

    The “Navigator” idea gives me pause for concern. Unless these are licensed professionals who are bonded or carry E & O liability coverage, applicants will have little if any legal recourse when things go wrong. Higher premiums (anticipated) due to benefits being forced on shoppers (like maternity for a couple in their late 50s) will not be recieved well.

  8. What possible motivation would navigators have to force inappropriate benefits onto shoppers? If the exchange navigators are like the patient navigators I know, they are intelligent, culturally-competent and service-oriented.

  9. Ginny says:

    As if the new Healthcare law weren’t as mandatory enough, you add insult to the citizenry’s injury by referring to them/us a “Dick and Jane”. Too bad this administration and president aren’t as clear-cut and honest as the real Dick & Jane.