Come 2014, you may get your health insurance through a health insurance exchange. Health insurance exchanges will be set up by states or the federal government as part of the Obama administration's health care reform. The exchanges will offer a choice of different health plans and provide information to help consumers understand their options.

A survey of health plan business leaders found they're likely to participate. The poll was conducted by KPMG, the U.S. audit, tax and advisory services firm, in September.

More than two-thirds of the health plan business leaders who participated in the webcast poll say they had already developed a plan to be exchange ready or had begun implementing changes so that they could meet the October 2013 open enrollment deadline to participate.

Initially exchanges will be for individuals who must buy their own health insurance and for small businesses with fewer than 100 employees though states may add larger employers in the future.

Second survey finds less enthusiasm for exchanges

However, a survey of employers by Eastbridge Consulting Group Inc. of Avon, Conn., released in November finds they may not send their employees to the new health care exchanges once they are available.

Of the more than 700 employers surveyed nationwide, 37 percent say there was "little or no" chance they would send employees to the exchanges. A quarter of the respondents (25 percent) say they "don't know" while 20 percent say they expected to send their employees to the exchanges for health, dental and other types of coverages.

The size of the employers surveyed ranged from 10 to thousands of employees and the responses were not representative of any particular employer size.

Exchange participants will choose plans based on cost

If you are sent to an exchange for your health insurance, you will likely make your choice based on cost, yet another survey by the global management consulting firm Accenture of Arlington, Va., has found.

According to the Accenture survey, 72 percent of U.S. consumers who plan to join insurance exchanges say affordability will be the top driver of their health-care decisions. However, less than a third of those surveyed say they are willing to change doctors or hospitals to lower their costs.

The survey of 3,209 people also finds:

  • Less than half (43 percent) would be willing to switch to generic prescriptions or see a nurse practitioner rather than a doctor for routine visits (41 percent) to save money.
  • A majority (81 percent) say they want guidance to improve their health but less than half (40 percent) say going to the doctor for regular checkups was a priority.

Whatever happens with exchanges, the Eastbridge survey finds that most employers (63 percent) feel "very much informed" about the requirements of the health reform law. More than a third say they monitor the law and keep abreast of any changes.