The ACA's health insurance exchanges are scheduled to be open for enrollment on October 1, 2013. Every state will have its own exchange, although many states' exchanges will be operated by the federal government. All exchanges will sell plans covering the essential health benefits, which include rehabilitative and habilitative services. In virtually all cases, occupational therapy will be a covered service. The Congressional Budget Office estimates 7 million people will be enrolled in exchange health plans next year. That's a lot of new potential consumers of occupational therapy services.

Everyone is likely to hear a lot about the successes and failures of the exchanges in the coming weeks and months. Some of the government contractors responsible for creating key components of the information technology infrastructure that will allow the exchanges to function testified before Congress last week that they'll be ready on time. However, even proponents of the ACA in many states admit that bumps in the road are to be expected when launching new programs like this. Keep in mind that while the exchanges open for enrollment next month, the coverage they're selling doesn't kick in until January 1, 2014 at the earliest, and people will be able to enroll in exchange coverage through March of next year. It will take a while to determine the real successes and failures of the exchanges, and there is likely to be significant variation from state to state. AOTA will be monitoring the impact of the exchanges on occupational therapy practitioners and consumers and advocating for improvements that will benefit the profession.