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What is not being emphasized enough is that with or without Medicaid expansion, the PPACA seeks to increase health care enrollment across the entire nation. Besides this, the ACA wants to make healthcare more quality conscious, more affordable and rid the system of traditional challenges that have kept the costs high.The idea is to create a system where healthcare premiums are prevented from climbing. It is not as if the current healthcare system does not provide the basic inputs for providing quality medical care. The nation boasts of good physicians, hospitals, research facilities and medical schools but it is held down by rising administrative costs. As a result, nearly 40 million folks are uninsured at the time and the healthcare service industry is highly fragmented. The equation becomes even more confusing with variable costs and no standards to control the outcome of care.While the household income averages have struggled to surge, the premiums have been rising steadily, often beyond the projections made by industry analysts.Coverage for the poor and the underprivileged has not risen at the same rate with Medicare health care enrollment still struggling to provide coverage to seniors fighting with rising drug prices and inflated cost of healthcare. However, profits made by the primary care physicians have continued to soar in the last decade. Some of the states even witnessed Medicaid cuts.By spreading healthcare and by making it more affordable outside the ambit of the private exchanges, the PPACA has been designed in such a manner that costs are limited while coverage is available in a more streamlined and transparent manner.An interesting aspect of the exchange ecosystem is the subsidies on offer for small business owners who have traditionally struggled to gain adequate insurance.Different mechanisms have been proposed to distribute the subsidies across different states. Some have chosen to disperse them at the time of filing the tax returns while some have chosen a monthly system. The actual picture will become clear only in October when the exchanges take a more clear shape. Some states are expected to distribute the subsidies every month, from January 2014 onwards. Tax credits for employers have already been put into effect in states like Colorado where tax credits are calculated at the time of filing tax returns.The private health exchange marketplace has been trying to compete with the state exchanges by adopting state-of-the-art insurance company software solutions. Here, different enrollment modules are created for different employees. The log-in capabilities can be shared between the employees and the employer. After choosing a health plan, people are guided towards the health care enrollment process. Since this functionality provides a dedicated employer portal, employee data like date of birth and address is preloaded. The entire layout is very intuitive, providing a step-by-step process for buying the most appropriate health plan. The process reduces manual data entry and allows employers to save critical time with automated functionalities.One such group insurance health plan capability is offered by hCentive, called the WebInsure Group.

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