Health Insurance Marketplaces Open for Business

The Affordable Care Act’s health insurance marketplaces launched on October 1, and the nation’s pharmacies are among those helping to inform Americans of their options.

Three and a half years after President Obama signed the Affordable Care Act (ACA) into law, one of its most important provisions goes into effect today, with the launch of online marketplaces where those without employer-based health insurance can shop for a plan. Insurance purchased on the marketplaces will go into effect on January 1, 2014, when most Americans will be required to have health insurance or pay a fine. Prescription drug coverage is one of the essential benefits that must be provided by all insurance plans in the marketplaces, which means that they could help lead to increased business for pharmacies.

The Congressional Budget Office projects that 7 million people who currently lack health insurance will purchase a policy on the marketplaces during the initial 6-month enrollment period, but a recent poll carried out by the Kaiser Family Foundation found limited public awareness of the marketplaces. According to the poll, which surveyed 1503 adults between September 12 and 18, two-thirds of all respondents and three-fourths of those without insurance were unaware that the marketplaces would be open on October 1.

Among those who will be helping to inform Americans about their options on the health insurance marketplaces are the nation’s community pharmacies and pharmacy chains. To help community pharmacy staff address customers’ questions and offer them guidance about the marketplaces, the National Community Pharmacists Association (NCPA) has developed a set of online resources available via the members-only section of its website, www.ncpanet.org.

The NCPA’s online resources include answers to frequently asked questions and a range of material including a comparison between the health insurance marketplaces and the Medicare Part D prescription drug program and information on special requirements exchanges may have for participation in enrollment activities. In a press release announcing the program, NCPA CEO B. Douglas Hoey, RPh, MBA, noted that unlike the Medicare Part D program, in which pharmacists are prohibited from advising seniors to choose a specific plan, pharmacists are free to offer guidance to patients looking for a suitable plan through the marketplaces.

Pharmacy chains that have announced plans to help inform customers about the marketplaces include Rite Aid, CVS Caremark, and Walgreens.

Earlier this month, Rite Aid announced that licensed insurance agents will be stationed in nearly 2000 of its 4600 stores to help the uninsured sign up for health insurance through the marketplaces. The agents will be available 12 hours per week and will meet with customers individually to answer their questions about the ACA, help them find a plan that meets their needs, and enroll them in a plan if they choose. (Agents will not be stationed in stores in states where doing so is prohibited by marketplace regulations, such as Massachusetts, Rhode Island, and Vermont.) Brochures with information on the marketplaces will also be available in Rite Aid stores.

Earlier this year, Walgreens partnered with the Blue Cross Blue Shield Association to inform customers about their options under the ACA. The key element of the campaign is a website, LearnAboutReform.com, that explains how customers are affected by the ACA, provides information on subsidies it makes available to help customers pay for insurance, and offers an introduction to how the health insurance marketplaces will function. In addition, informational brochures will be distributed at almost all Walgreens pharmacies.

CVS Caremark also announced earlier this year that it would reach out to customers to provide them with information on how to select an appropriate insurance plan through the marketplaces. This outreach program will include in-store events held in concert with ongoing programs that offer free cholesterol screenings, glucose testing, and blood pressure measurement. Pharmacists at the chain will target in particular patients who pay for prescriptions in cash and provide them with information about how to get health insurance through the marketplaces. In addition, the chain will distribute informational brochures in its more than 7400 stores and 650 Minute Clinic locations and make information available at http://www.cvs.com/insurance.

Do you think that the launch of health insurance marketplaces will help increase your pharmacy's business? Let us know by voting in our poll.