Health care reform requires states to set up health insurance marketplaces, also called exchanges, where people can see their options for health insurance and compare costs and benefits. The exchanges are set to launch Oct. 1.

Will the new way of buying health insurance lower premiums and make health insurance more accessible?

The answer depends on your perspective.

Doctors surveyed by LocumTenens.com of Alpharetta, Ga., don't believe the exchanges will be ready by the Oct. 1 deadline and aren't sure whether they will see new patients because of greater access to health insurance.

Meanwhile, U.S. Health and Human Services Secretary Kathleen Sebelius said that the new exchanges would spur competition, which will lower premiums by about 20 percent in 2014. When the cost is lower, more people will be able to afford coverage, she said in a new report on the Affordable Care Act.

Doctors unsure how exchanges will work

The survey of independent doctors in June by LocumTenens, a staffing agency for all physician specialties, found that 56 percent of doctors were unsure how policies bought through the exchanges would impact their practices. Also, 70 percent said they were unfamiliar with how the claims process would work, and 67 percent said they didn't know how terms, such as grace periods, would impact how much they are reimbursed.

Fifty-five percent of the physicians surveyed also said they expected bad debt from patients unable to pay would increase under health care reform.

"This is a patient population who, in many cases, hasn't had access to insurance and isn't familiar with how it works and what it covers," Shane Jackson, president and chief operating officer of LocumTenens, said in a press release. Doctors will have to play a major role in educating their patients who never had access to insurance, he said.

HHS: Exchanges to increase access at lower cost

When Sebelius released her report in July, 11 states (including the District of Columbia) made information available for individuals buying health insurance through exchanges, and six states made information available for the small group market. Overall, she said, it appears that premiums will be almost 20 percent lower in 2014 than previously expected.

Actual premiums may be even lower by the time health plans are offered through the exchanges in the fall, Sebelius said.

Sebelius said she was optimistic that the Affordable Care Act will mean consumers not only will have better access to coverage but also at a better value in 2014.

The report also noted that data shows the average premiums for employer-sponsored health insurance plans increased 3 percent from 2011 to 2012. That's the lowest rate of increase seen since the Medical Expenditure Panel Insurance Component started keeping such data in 1996.