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Rebecca Farley

Director, Policy & Advocacy, National Council for Behavioral Health

Health Insurance Marketplaces Open for Business as Federal Government Shuts Down

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Federal Shutdown Won’t Stop Rollout of Key Obamacare Provision

Today, the state-based health insurance marketplaces began accepting applications for enrollment, even as the federal government shut down amid a political battle over defunding the very law that established them.

The health insurance marketplaces are one of several coverage expansions included in the 2010 Affordable Care Act and are a critical pathway to coverage for uninsured Americans who do not qualify for Medicaid. October 1 is the start of a 6-month open enrollment period during which consumers can sign up for health insurance coverage through the marketplaces. These online portals provide a one-stop shop for individuals seeking to purchase health insurance. Health plans participating in the marketplaces must meet a minimum coverage standard that ensures access to essential health benefits. Consumers can use the online marketplaces to easily compare plans and sign up for coverage; they can also learn whether they qualify for the federal tax subsidies that are available to individuals with incomes under 400% of poverty. The marketplaces will also offer a route to Medicaid enrollment for individuals who are eligible for Medicaid under current rules or under the Medicaid expansion that takes effect January 1.

Individuals in every state have access to a marketplace. In some states, the marketplace is state-operated, while in others it is operated by the federal government or as a federal-state partnership. Health coverage under the exchanges becomes effective on January 1, 2014. To learn more and enroll in coverage, visit You’ll find an enrollment timeline, resources in multiple languages, and links to find application assistance.

The Department of Health and Human Services has made clear that enrollment in the marketplaces will not be affected by the federal government shutdown that occurred at midnight, when funding for government operations expired. The House and Senate remained at an impasse Tuesday over how to fund the government for the 2014 fiscal year, which began today. The House Republican leadership expressed its determination to use the budget as a bargaining chip in efforts to undermine or delay the ACA, while Senate Democrats and President Obama insisted that the 2014 funding measure must be “clean” – that is, free of policy riders related to the health law. Because much of the funding needed for the operation of the federally-facilitated marketplaces was already appropriated in the prior fiscal year, the marketplaces can remain operational during the shutdown. This means that the online marketplace will continue to function and consumers will still have access to a 24-hour call center for technical assistance.

The National Council strongly encourages behavioral health providers to help eligible consumers enroll in health coverage. Data from Massachusetts’ early experiments with health reform suggest that individuals with addiction or mental illness will make up a disproportionate share of individuals who are eligible for coverage but remain. A concerted enrollment push is needed to make sure that these individuals gain access to the health coverage for which they are eligible. The Substance Abuse and Mental Health Services Administration has created a toolkit to help providers educate consumers about their coverage options and get them enrolled. The toolkit has been developed in six slightly different 30-minute, interactive formats, each of which can be accessed and viewed online:

For more information about enrollment, stay tuned to Capitol Connector and the Public Policy Update.