Just around the corner, a big change in coverage

Fifty-one days.

That’s the time left until enrollment starts on the health insurance exchange.

“The clock is ticking,’’ said Sandy Praeger, the Kansas insurance commissioner, during a health care panel Sunday at the legislative summit for the National Conference of State Legislatures, which opened in Atlanta.

“The reality is going to be here before we know it,’’ Praeger added.

Signing up for insurance in the exchange, also known as a marketplace, will be more difficult than the often-used comparison with Travelocity, said Praeger, a Republican. Many people have compared the online exchanges to the ease of picking the best deal on the familiar travel website.

“Consumer outreach is going to be critically important’’ to the rollout of the exchange, Praeger said.

The federal call center is already hearing from consumers who have questions, said Chiquita Brooks-LaSure of the Centers for Medicare and Medicaid Services.

The “exchange’’ is actually a number of exchanges. There’s one for each state, and they differ significantly. Some states will be running their own exchanges, but about half the states, including Georgia, are having the federal government run theirs.

Georgia’s insurance commissioner, Ralph Hudgens, recently approved insurers’ filings for exchange premiums in the state, though he said they contained “massive rate hikes.’’

Hudgens, a Republican, said he approved the premiums because he was facing a deadline and had no choice. He has called for repeal or delay of the Affordable Care Act (ACA), the health care law that requires the exchanges.

There’s much concern about exchange rate shock for young and healthy consumers, Praeger noted Sunday, though she added that many of them will be eligible for substantial subsidies.

How the marketplace rates will affect people will depend on age, location and other factors, said Karen Ignagni, president and CEO of America’s Health Insurance Plans, an industry trade group. While California rates are competitive, she said, those in the northern part of the state are higher because of hospital consolidation.

The “elephant in the room,’’ Ignagni said, is the continued “deep partisan divide about the law.’’

The ACA, which was passed in early 2010 and is not yet fully implemented, has survived challenges in court and repeal efforts in Congress. Many Republicans remain committed to scrapping or delaying the law.

The law implements many insurance reforms, including prohibiting insurance rate discrimination based on pre-existing health conditions, noted Timothy Jost, a health law expert at the Washington and Lee University School of Law.

That particular provision can’t take effect soon enough for Keisha Kuma of Snellville.

Kuma, 41, a mother of three, is covered under a policy offered by her husband’s new employer. But it does not cover Kuma’s multiple sclerosis, which she says was diagnosed in 2010 and is considered a pre-existing condition under his health plan.

Kuma said she had a recent treatment that cost $800, and medications can cost up to $300. That leads to fears of what could happen if a serious medical event happened.

“It’s scary for a mom with three kids,’’ she said. “I’m looking forward to a health care system that cares for your health.’’

Keisha Kuma with her husband and two of her children.
Keisha Kuma with her husband and two of her children.