Praying you don't get sick isn't much of a health care plan. But for many Nebraskans, that's been the default option for too long.

The Legislature got its first look at a better option Aug. 15, when the Department of Insurance unveiled a first look at what a Nebraska Health Insurance Exchange might look like as part of the Affordable Care Act.

The manner in which the exchange is set up and implemented is crucial to Nebraskans finding affordable health care. Even though it seems to be a political football nowadays, affordable health care continues to be the number one issue facing families in Nebraska and across the country.

The problems with the old health care system have been long known -- a recent study by the nonpartisan Kaiser Family Foundation showed that the average annual cost of a family health plan was nearly $14,000.

And for Nebraska farmers or workers who may have to purchase health care on their own, the costs can be higher and the coverage less.

Information issued by DOI showed some of the benefits of reform -- an exchange that helps foster one-stop shopping, standardized plans, requires insurance companies to issue coverage in rural and urban Nebraska alike, increased competition and most of all -- lower costs.

According to the presentation, a Nebraska family making $55,000 with two children would have their insurance premiums capped at 8 percent of their income under an exchange -- just $370 per month, with lower premiums available depending on the level of coverage selected.

Many decisions still need to be made, such as whether the state creates an exchange or whether the state opts to have it operated by the federal government. However, the law requires that it be up and running by January 1, 2014.

The DOI's presentation was a concrete example of how health care reform can help everyday Nebraskans, thousands of whom either have no coverage or have been forced to make tough choices after years of spiraling costs.

So far, there is reason for optimism that with careful decision making by the Legislature and the DOI Nebraska will have access to more competitive and affordable health care coverage.

Social workers support an "exchange" that will provide low and middle income Nebraskans and small businesses an efficient, cost competitive method of accessing high quality health coverage.

Terry Werner is executive director of the Nebraska Chapter National Association of Social Workers.

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