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Delaware set for new health insurance exchange

Randall Chase, Associated Press

DOVER, Del. (AP) -- Delaware officials say they're ready for open enrollment to begin in the state's new health insurance exchange but acknowledge that glitches are likely as a key component of the federal health reform law is launched.

Among other things, not all of the 68 marketplace guides being hired to help people learn about and enroll in the health care exchange will be in place when open enrollment begins Tuesday.

"That's still a work in progress," said Health and Social Service Secretary Rita Landgraf, who noted that people have until Dec. 15 to enroll for coverage starting Jan. 1, and that the enrollment period runs through the end of March.

"This is going to be a rollout enrollment period," Landgraf said. "We don't want everybody to stand in line Oct. 1 like they did with that new iPhone."

In fact, Landgraf said she would be concerned if a lot of people chose to enroll on the first day because there is so much information to consider.

Delaware received $12.9 million in federal grants to implement the marketplace.

Among other things, the money was used to award contracts to Delmarva Foundation for Medical Care Inc. of Easton, Md.; Brandywine Women's Health Associates of Wilmington; Westside Family Healthcare of Wilmington; and Christiana Care Health Services of Newark to help guide people through the new health insurance marketplace.

But Michael Gould, director of consumer services for Delaware's Department of Insurance, said some applicants for training and certification as marketplace guides have taken other jobs, while others failed criminal background checks.

State officials have been working with the marketplace guides and hired consultants in recent weeks to reach out to the estimated 90,000 people in the state who currently don't have health insurance.

Officials hope to enroll as many as 35,000 state residents through the health insurance exchange. The exchange includes subsidies for those with incomes up to 400 percent of the federal poverty level — about $46,000 a year for an individual or about $94,000 for a family of four.

They also say up to 30,000 residents will be eligible for expanded Medicaid under the Affordable Care Act, which will cover those with incomes up to 138 percent of the federal poverty level.

Of the remaining 25,000 people without insurance, some are illegal immigrants not eligible for the exchange, and others will decide to pay the penalty for not having insurance, which starts at $95 or 1 percent of taxable income for an individual in 2014 but climbs to $695 or 2.5 percent of taxable income in 2016.

People will be able to enroll in the new exchange online or on the phone. Marketplace guides armed with laptops will be fanning out to churches, community centers and other venues across the state to offer information and help in enrolling.

"We are working closely with the marketplace organizations to make sure they have all the information we can possibly give them," said Linda Nemes, assistant director of market regulation for the Delaware Department of Insurance.

Nemes said implementation of the Affordable Care Act, which puts new restrictions and coverage mandates on private insurers, is expected to result in an average increase of about 11 percent for private insurance plans in Delaware.

A key goal for officials overseeing the plan is enrolling enough young, healthy people to make the system work. Options for those young people include low-premium, high-deductible catastrophic plans to cover accidents and injuries.

"In order to make it affordable, you need to get that economy of scale that includes people who are healthy," Landgraf said.