What to know about the new healthcare marketplace

By Matt Porter

October 1, 2013 Updated Oct 2, 2013 at 10:07 AM EDT

(WBNG Binghamton) Three years after Congress passed the largest comprehensive health insurance law of its kind, the major part of the Affordable Care Act is finally open.

New online health insurance exchanges opened across the country where an expected 14 million uninsured people are expected to sign up for a new healthcare plan.

New York Assemblywoman Donna Lupardo, D-Endwell, said Tuesday marks the first time there will be an affordable option for millions of uninsured New Yorkers and there will be multiple choices.

"We're lowering healthcare costs and improving access," Lupardo said. "But we're also creating a marketplace where people can look at various options."

The New York healthcare exchange, NY State of Health, opened with more than 10 million web visits.

People will be able to create an account using their personal information, and then input their income information to determine if they are eligible for a federal subsidy to pay for insurance.

The site will offer visitors a choice of private plans of different levels, bronze through platinum.

High levels will cost more in premiums, but provide lower deductibles and extra coverage.

Premiums will be based on age and income, but not on preexisting conditions or gender.

There is also a "catastrophic" insurance plan available for people younger than 30 years old.

All plans will be mandated to provide a basic level of coverage including doctor's appointments, prescription coverage, maternity care and mental health.

Krys Cail, of the town of Ulysses, said she is self-employed and plans to shop the exchange for herself and her unemployed husband.

She said many in her family have been waiting for the chance to sign up.

"A family member has a needed surgery coming up and we definitely do need to have insurance in place at that time," Cail said.

The state has brought in 50 community organizations as "navigators" to help people sign up for their new plans.

In the Southern Tier, Mothers and Babies Perinatal Network and the Southern Tier Independence Center will act as navigators.

Mothers and Babies Executive Director Sharon Chesna said they are ready to handle the expected demand.

"Our role will be working with individuals one on one, face to face, helping them through the process," Chesna said. "And even those for whom it doesn't go really easily, we'll be there for them as well."

Although this is the largest change as a result of the healthcare law, most American won't have to do a thing.

Americans who already have insurance through their employer, Medicare or Medicaid, do not have to do anything they don't already do.

Despite the new exchanges, there is an estimated 25-30 million people who will remain uninsured.

Part of that is due to the Supreme Court decision allowing states to opt-out of the Medicaid expansion.

Only 26 states have signed on to expand their Medicaid program, which will be paid for by the federal government.

New York has signed on to the Medicaid expansion.

Individuals who choose not to sign on to a plan will have to pay a $95 penalty.

Individuals who can't afford a plan, even with federal help, can obtain a waiver to the mandate.

Individuals must choose a health plan by March 31, 2014.