More than 100 people gathered Tuesday at the Hartford Public Library to quiz Health Insurance Exchange officials about what they’re doing to make health insurance more affordable and accessible.

The exchange will be the virtual marketplace where consumers will be able to shop for insurance starting in Jan. 2014. It is expected that one in 10 Connecticut residents will purchase coverage through the state’s insurance exchange once it’s up and running.

“With all due respect, I still think we’re focusing on the wrong thing,” Gretchen Vivier told Kevin Counihan, CEO of Connecticut’s Health Insurance Exchange. “Getting everybody insurance is not the same thing as getting everybody health care.”

Counihan didn’t disagree, but he said they’re related.

“Most people actually get health care by having health insurance,” he said. “Research actually shows people who are insured get different care than people who are uninsured.”

“What are you doing to try and encourage getting something more like a public option?” Vivier asked.

As for the public option, which was included in first iteration of the Affordable Care Act, Counihan said they’re not doing anything about it.

“That’s just not our charge,” he said. “Our job is to implement the Affordable Care Act and I can tell you that’s challenging enough right now.”

Advocates haven’t given up on creating a public option for Connecticut, but Gov. Dannel P. Malloy squashed the idea during his first year as he sought to close a $3.6 billion budget deficit. Over the next two years the state will face an estimated $2.13 billion deficit.

Without a public option, consumers who attended the meeting Tuesday were concerned about exactly how affordable health insurance will be under this new construct.

Two subcommittees of the Health Insurance Exchange Board so far have been unable to reach agreement about whether the state should negotiate with the health plans coming into the exchange.

Healthcare advocates are encouraging the state to negotiate with insurers coming into the exchange, while state officials aren’t convinced they have enough information about the population that will participate to force the companies to negotiate.

If negotiations for benefits occur they will focus on both rate setting and prices.

Alta Lash, executive director of United Connecticut Action for Neighbors and a member of one of the subcommittees, said she thinks it’s wholly unacceptable to ask the consumer to bear the responsibility of figuring out pricing of specific medical services.

“The pricing system is so complicated that everyone including the exchange has to weigh in on this issue,” Lash said.

“You can’t just say it’s up to the consumer now to be more price conscious.”

Counihan said he doesn’t disagree, but he’s just trying to look at how change occurs and sometimes change occurs at the grassroots level when people demand it. He said the exchange will help drive change.

At the moment, health care providers often don’t know how much it costs to render certain services.

A federal grant will help the state set up an all-payer claims database where consumers will be able to see the pricing for certain procedures.

As far as affordability is concerned, one woman in the audience said health insurance currently costs her 17 percent of her income and next year it will be 20 percent of her income at the same time she will be receiving fewer benefits.

Counihan said the Affordable Care Act tries to address that by capping the amount consumers pay based on their income and family size.

A family of four making $92,000 a year will be capped at $692 per month under the legislation, which is 9 percent of income.

“What the Affordable Care Act tries to do is ameliorate some of that with some subsidies,” Counihan said.

Also the legislation allows small businesses with fewer than 50 employees to get a tax credit of up to 50 percent of the premiums, if they decide to offer their employees health insurance.

Businesses with more than 50 employees will have to pay a penalty of $2,000 per employee, per year if they decide not to provide coverage.

Counihan, who was working in Massachusetts in 2006 when that state mandated insurance coverage for its citizens, said the number of employers offering insurance increased from 70 to 77 percent in the first year.

“While I don’t think anyone can predict how employers will act in our state or anywhere else, I just give that as some background,” he said.

The conversation Tuesday at the Hartford Public Library was the first of seven that will occur throughout the state.

The next meeting will take place Thursday at Waterbury City Hall. Conversations also are scheduled to take place in New London, New Haven, New Britain, Stamford, and Bridgeport.

Click here for a list of dates and locations.