Howard Koh, HHS assistant secretary for health

Dr. Howard Koh, assistant secretary for health at the U.S. Department of Health and Human Services. Photo by HHS

The passing of the Affordable Care Act in 2010 revolutionized the U.S. health system, containing provisions that will expand health coverage for 30 million Americans. One of the foremost changes in the law is the inception of the nationwide Health Insurance Marketplace, a new way for Americans and small businesses to find and access health coverage that fits their needs. Every U.S. state must have its own marketplace, or “exchange,” by Oct. 1.

To explain the finer details of the exchanges, Public Health Newswire chatted with Howard Koh, assistant secretary for health for the U.S. Department of Health and Human Services. The agency’s objective is simple, according to Koh.

“The more Americans we can reach out to and get signed up, the healthier this country will be,” he said.

Q: The Health Insurance Marketplace will open in every state Oct. 1. In short, how will these “exchanges” create greater health equity for all Americans?

The more Americans we can reach out to and get signed up, the healthier this country will be. When kids get good coverage, they are more likely to get the vaccinations they need. When adults get good coverage, they have a greater opportunity to get the preventive care — like mammograms and colonoscopies — that will keep them healthy. When families get good coverage, the results ripple through all of our communities.

We want everyone to have the chance to reach their full potential for health.

Q: offers instructions for Americans and small businesses in every state to shop, and apply, for health coverage. What strategies are being implemented to educate the public before different coverages take effect nationwide on Jan. 1, 2014?

We are building on best practices in terms of commercial shopping experiences that many consumers are familiar with. We are engaging industry experts and seeking advice and feedback from consumer groups and the best in the field of consumer marketing and online applications.

As we plan for the outreach work ahead, additionally HHS is taking lessons learned from its experience launching other major initiatives such as Medicare Part D and the Children’s Health Insurance Program. In these efforts, the importance of coordinating across federal agencies, fostering private-sector partnerships and reaching into communities to find individuals where they lived, worked, played and prayed was critical to success.

Key outreach and education includes:

  • a re-launched version of that has detailed consumer information and educational materials;
  • outreach efforts coordinated with outside  partners and federal agencies;
  • TV and online commercials and paid media;
  • social media;
  • a 24/7 call center that consumers can call now to speak with a trained customer service representative 24 hours a day, seven days a week. Representatives will be available in English and Spanish, and there will be a language line to assist callers in over 150 additional languages.  The number is 1-800-318-2596.
  • accounts that let consumers sign up, begin entering information and complete the online application, and see available plans; and
  • in-person assisters that include certified counselors, agents, brokers and others who will help consumers complete their form and analyze their coverage options.

Q: The Affordable Care Act expands Medicaid and Children’s Health Insurance Program, or CHIP, benefits to millions of Americans. What are these improvements and how will the Marketplace make it easier for Americans to access them?

Beginning in 2014, 41.3 million uninsured Americans will have new opportunities for coverage. The Marketplace will make it easy to compare qualified health plans, get answers to questions, find out if you are eligible for lower costs for private insurance or health programs like Medicaid and the Children’s Health Insurance Program, and enroll in health coverage that meets your needs.

Consumers will be able to fill out one application to see if they qualify for a range of health coverage options — including plans in the Marketplace, Medicaid and CHIP — or lower costs on monthly premiums based on their income.  For many, the three-page application for individual market Marketplace coverage can be completed, on average, in just 10 minutes, which is much shorter than the industry standard today. You can fill out the application online, in person, over the phone or via mail.

Consumers will have access to a number of resources to learn about the Marketplace and navigate their coverage options. They can get in-person assistance from Navigators, non-Navigator assistance personnel, certified application counselors, and/or agents and brokers.

The newly remodeled is the destination for consumers to prepare for open enrollment and ultimately sign up for health coverage. It includes a 24/7 live chat function, and the newly launched Marketplace call center is open 24 hours a day, seven days a week (1-800-318-2596 toll free, or 1-855-889-4325 for the hearing impaired). Spanish-speaking consumers can go to

Whatever state a consumer lives in, he or she will be able to shop seamlessly for coverage through the Marketplace.

Q: One of the major themes of Healthy People 2020 is improving communication — specifically, how to make health care easily understood and accessible to Americans of all social and cultural backgrounds. How does the Marketplace promote health literacy?

Patient engagement is vital to breaking the cycle of crisis care and moving us toward more proactive, preventive care. But patient engagement must be informed engagement – which, according to the Affordable Care Act’s definition of health literacy, means patients have the capacity to obtain, communicate, process and understand basic health information and services needed to make appropriate health decisions.

Coverage for millions of Americans will begin Jan. 1, 2014. Many of these Americans will have had little to no experience in the health care system. One of the first health decisions people will face is choosing a health care insurance plan. Every American needs to know every plan will cover them with comprehensive benefits, from visits to the doctor or the hospital, to prescriptions, vaccinations, to screenings for cancer and other conditions.

We have an unprecedented opportunity to apply health literacy and patient education principles.  Millions of Americans can become consumers of health care for the first time. They will be able to obtain, communicate, process and understand health information and make appropriate, well-informed and engaged health decisions.

Educating the public is critical. But now more than ever we have to encourage organizations to adopt health literate systems of care. Through the Affordable Care Act’s infrastructure supporting informed patient engagement I believe more Americans will:

  • have meaningful access to coverage and health care services;
  • use preventive, emergency and hospital services appropriately;
  • manage their chronic conditions successfully;
  • be more accurately diagnosed; and
  • be healthier and enjoy a health care system that helps them stay that way.