Exchange dynamics will dictate consumers' experiences, costs

Health law advocates frequently say health insurance will cost less as a result of the health law, but news outlets report that a downside could be less choice.

The Wall Street Journal: Health-Law Implementation To Vary By State
There is just one federal health law, but the way Americans experience the debut of its main provisions on Oct. 1 will vary widely depending on where they live. Every state, whether it supports the law or not, will have a health insurance exchange where people will shop for coverage-;the health overhaul's centerpiece (Schatz and Radnofsky, 9/22).

The New York Times: Lower Health Insurance Premiums To Come At Cost Of Fewer Choices
Federal officials often say that health insurance will cost consumers less than expected under President Obama's health care law. But they rarely mention one big reason: many insurers are significantly limiting the choices of doctors and hospitals available to consumers (Pear, 9/22).

Meanwhile, CQ HealthBeat offers an update on federal exchange software issues -

CQ HealthBeat: CMS Downplays Reported Premium Errors Calculated By Federal Exchange Software
A Centers for Medicare and Medicaid Services spokesman Friday downplayed reported difficulties the government is having debugging software that calculates how much people will pay for the health coverage scheduled to be offered starting Oct. 1 by exchanges in the 36 states operated by the federal government (Reichard, 9/20).

Also, some reports from states -

The Star Tribune: MNsure Shows Growing Pains, Fewer Than Two Weeks To Launch
Botched grants, an unnerving data security breach involving more than 1,000 Social Security numbers, and ridicule from some quarters over a multimillion dollar advertising campaign have left officials for MNsure scrambling to restore public confidence less than two weeks before a closely watched launch of the only state-run health exchange in the Midwest (Crosby and Brooks, 9/22).

California Healthline: Exchange Announces Its Enrollment Goals
Yesterday, Covered California, the state's health insurance exchange, announced its projection of success -- the target number of Californians it wants to enroll in the first phase of the exchange. "Our goal is to have 500,000 to 700,000 subsidy-eligible Californians enrolled in the exchange by April 1, [2014]," Peter Lee, executive director of Covered California, said. Lee spoke at yesterday's board meeting of Covered California, which will begin enrollment Oct. 1. Coverage for early enrollees would not start until Jan. 1, 2014. The end of the first insurance enrollment period for the exchange will be April 1, 2014 (Gorn, 9/20).

And then, of course, there's the latest on private exchanges as well as how Medicare beneficiaries should steer clear of the new marketplaces -

Reuters: Analysis: Benefit Firms Create Tremors For Insurers In U.S. Healthcare Shakeup
American companies are sending shockwaves through the healthcare industry by moving a rapidly growing number of employees onto privately run online exchanges for their medical coverage. In a business already bracing for major change because of President Barack Obama's healthcare reforms, the decisions are threatening to shift more power in the market to the benefit consulting firms opening many of the exchanges (Humer and Krauskopf, 9/20).

Kaiser Health News: FAQ: Seniors On Medicare Don't Need To Apply To The Health Law Marketplaces
Nearly 50 million Americans are enrolled in Medicare, the federal health insurance program for the elderly and disabled. The 2010 health care law, known as the Affordable Care Act, will make some changes to the program. Here are some answers to frequently asked questions about Medicare and the health law (Carey, 9/23).