You must use healthcare.gov if you are a legal US resident who qualifies for a subsidy and who wishes to buy a health policy rather than pay a tax. The subsidy is realized only as a tax credit and is available only by buying insurance via a government-run marketplace.
For those not qualifying for a subsidy Healthcare.gov serves only as a data collector and a place where you can see a list of policies available in your locale. While you will be able (some day) to purchase a policy directly on healthcare.gov you can also go to insurance company web sites to get information about available plans and buy a policy.
The idea that Obamacare offers a health insurance "marketplace" is a complete fraud. The term is used to give the impression of a free market where you can compare competitively priced health plans that meet your needs. The reality is that the "marketplace" simply lists the pricing of plans that meet Obamacare requirements (NOT your needs). Minimum requirement plans from "competing" insurance companies are all priced close to each other and differ only in minor ways such as different levels of co-pays for various services. The insurance companies then increase premiums for plans that offer lower deductibles and lower copays. (A rational customer would only purchase these higher priced (Silver, Gold, and Platinum) plans if they expected to incur medical costs above the lower deductibles sufficient to compensate for the higher premium. In other words, only people who are already really sick should be willing to pay for more than a Bronze Obamacare plan.)
I have been self employed and use an Aetna policy to cover myself and my family. My Aetna policy has been outlawed effective December 15, 2014 (I am one of the fortunate few who get a year's reprieve.). I do not qualify for a subsidy.
I compared my current pre-Obamacare policy for 2014 with Obamacare policies. Here are the premiums and out of pocket costs for my family of four, non smokers, ages 64, 59, 23, and 21 assuming we use only providers in the insurance company networks (the lowest cost alternative):
Current Health Plan:
Aetna Open Access POS 2014 premium: $7,632. In network out of pocket max per person $10,000 - per family $20,000.
Two Obamacare Bronze Plan Alternatives:
Aetna Advantage 6350 PD 2014 premium: $19,668. In network out of pocket max per person $6,350 - per family $12,700.
Florida Blue Everyday Health 1449 2014 premium: $19,044. In network out of pocket max per person $6,250 - per family $12,500.
Looking back a few years, the four of us average a total of about $4,000 per year in health care expenses that apply against the deductible/out of pocket max in the policy. So, our total annual cost if we stay relatively healthy is about $12,000 per year ($7,632 premium plus $4,000 in expenses). Under the Aetna Obamacare policy given our history we will have total annual costs of $23,668 ($19,668 premium plus $4,000 in expenses). Obamacare thus imposes almost $12,000 on our family in additional annual costs assuming we all stay relatively healthy.
Under our current policy, the total annual exposure is the premium plus the out of pocket max, together totaling $27,632 if we experience severe medical problems.
Under the Aetna Obamacare policy, the worst case annual cost in premium and out of pocket totals $32,368 ($19,668 premium plus $12,700 out of pocket max). Obamacare thus imposes $5,000 on our family in additional annual costs assuming we experience severe medical problems.
The end result of Obamacare is that everyone who does not get a subsidy gets punished while everyone who would previously go the emergency room for care can still go to the emergency room for care and either pay a tax of up to a couple hundred dollars or buy a subsidized health policy that has an out of pocket max they likely won't be able to pay anyway.
Those receiving subsidies under Obamacare could have been helped with direct tax credits that would cost far less than cost increases imposed on hard working Americans by this horrid and grossly unfair law.
The disaster continues...
Regards, Pete Weldon