[…] Some lawmakers have proposed making people pay higher deductibles or doing away with first-dollar coverage on Medigap policies, with the idea being that if people have more of their own money on the table, they would be less likely to over-utilize non-essential healthcare. The problem, of course, is that seniors who are already struggling to pay for healthcare would be more likely to skip necessary care if they had to come up with additional money to pay for it. […]
More On Health Insurance Exchanges
[…] We need exchanges that are easy to navigate, accessible for people who are not fluent in English, and that provide seamless access to the subsidies that the PPACA provides to help people afford health insurance. I’ve already pointed out that we’re going to have to walk a fine line in terms of keeping things fair for both insureds and insurers, in order to attract as many enrollees and high quality insurers as possible to the exchanges. […]
The Challenge Of Creating Unbiased Health Insurance Exchanges
[…] In order to attract high-quality health insurance carriers to the exchanges, we have to make sure that the exchanges represent a business environment that is appealing to carriers. We also have to make their appealing and fair to consumers, in order to attract enough people into the exchanges. To work well, the exchanges will need to have a delicate balance between the interests of consumers, providers, and health insurer carriers, with no one group more heavily favored than another.
HHS Guidelines For Women’s Healthcare
HHS today announced new PPACA guidelines pertaining to women’s health, listing several services that must be covered by health insurance plans with no cost sharing by the insured. In scrolling through healthcare news this morning, I saw numerous headlines stating that birth control and breast pumps must be covered by health insurance with no copays. This is true, but the requirements don’t take effect for another year (August 1, 2012) and will apply to new policies that begin on or after that date. […]
Comparison Shopping For Health Insurance
[…] But in terms of being a comparison-shopping website for health insurance, I’m struck by how much that sounds like the service we’ve been offering our clients for years. The exchanges will function mostly online, which was a transition we made back in 2003 when we established our website and started working with carriers to get online applications for our clients. We realized soon after getting into the health insurance industry that there is no one-size-fits-all when it comes to health insurance, and that it didn’t make sense to only represent one or two carriers. […]
A Good Summary Of The HHS Proposed Regulations For Exchanges
[…] The proposed regulations from HHS for the exchanges come to 244 pages, but Timothy notes that they are “practical, sensible, and functional” and that HHS tried to simplify things wherever possible, rather than complicate them. For anyone who wants to get the gist of the proposed regulations without reading the 244 pages that HHS released this month, I highly recommend that you check out Timothy’s article. […]
Employer Funding of Individual Health Insurance – The Rules Are Changing
[…] Because of the new law, employers can now use wage adjustments to reimburse employees for individual policies (as long as they haven’t had a group policy in the past twelve months), which wasn’t allowed at all in the past. But the use of HRAs to fund individual policies can now only be done if the employer hasn’t had a group policy in the past twelve months, and that restriction wasn’t found in the DOI final agency order regarding HRAs. […]
One Size Does Not Fit All
[…] A person with a set amount of money that can be devoted to life insurance premiums will be able to purchase significantly more face value if she goes with term coverage. But the insurance will be in place for the rest of her life if she goes with permanent coverage (assuming she doesn’t cancel it). There’s no one-size-fits-all answer to whether term or permanent life insurance is a better option, and it depends largely on the person’s budget, face value needs, and long term planning. […]
Grand Rounds – It’s All About Personal Responsibility
[…] Even when people really need a major wake-up call (their life literally depends on it), doctors feel like they have to tread very softly in order to avoid hurting feelings. And there’s also the problem of time: most providers have so many patients to see in a day that they don’t have time to have in-depth conversations about lifestyle choices. The growing shortage of primary care docs (especially after 2014 when millions of previously uninsured Americans will have health insurance and will be looking for a doctor) isn’t likely to help that problem.
Health Insurance Does Not Always Prevent Medical Debt
[…] Chances are, if you have a claim on your home or auto policy, it will be because of a one-time incident like a fire or a car accident. That can be the case with a health claim too, of course, but many times a large claim on a health insurance policy can be the result of a chronic condition or one that will need extensive long-term treatment. A person might have health insurance at the start of the ordeal, but may lose coverage as time goes on […]
Is High Risk Pool Eligibility Guideline Hampering Enrollment?
[…] In terms of underwriting actions for less serious conditions (those that don’t result in a decline), GettingUsCovered only takes people who have been offered a policy with an exclusion rider… which most carriers don’t do anymore. Perhaps this is resulting in GettingUsCovered being comprised mostly of members who have a condition that would result in a decline in the individual market, while CoverColorado has those members as well as members who have less serious conditions that simply result in a higher-priced policy in the individual market.
Tips For Sorting Through Medigap Advertising
[…] I would add that the advertising tactics Trudy mentions also apply to regular health insurance plans too – not just those related to Medicare. Unfortunately, health insurance advertising can sometimes get a bit murky. If in doubt, always ask for more details or get a second opinion… and as with most things, if it sounds too good to be true, it probably is (there’s no such thing as comprehensive individual health insurance for $150/month for a family of four with no deductible and all pre-existing conditions covered).
Grand Rounds Vol. 7 No. 40
Welcome to Grand Rounds! It’s the third time we’ve hosted Grand Rounds at the Colorado Health Insurance Insider and we’re honored to be hosting again. It was a pleasure to read so many great articles for this edition. Since our blog tends to focus on health care policy and reform, I’m starting things off with the posts that pertain to that topic. Enjoy!
PVHS and UCH Begin Process Of Creating A Joint Hospital System
[…] The merger is expected to provide numerous benefits for both hospital systems, and will presumably make for lower total operating/administrative costs than they would have if they weren’t working together. As health care costs continue to climb, this should help both hospitals continue to provide quality care to their patients. It’s also reasonable to assume that the merger will be beneficial for UCH and PVHS patients, since access to both hospital system’s strengths will likely be available to patients in both Denver and Northern Colorado. […]
Support For Hospital Fees Varies From One State To Another
[…] This is a good example of how similar legislation does not necessarily have the same support or outcomes in different states. That’s not to say that the Health Care Affordability Act is universally supported in Colorado – it’s not. But it’s working relatively well as a vehicle to fund Medicaid here and to support Colorado hospitals that treat a large number of uninsured patients.
Call For Grand Rounds Submissions
We’re honored to be hosting Grand Rounds next week, on June 28th. Please send me your medical/health care posts by 8pm mountain time on Sunday, the 26th. No theme this week – just pick your favorite recent post. Submissions can be emailed to me at louisen78 [at] gmail [dot] com. I look forward to reading your articles!
Biased Language In Employer Health Insurance Survey
[…] Overall, the survey is very thorough, the questions are mostly objective, and the data obtained from 1300 employers is no doubt a useful barometer of current employer attitudes towards health care reform. But I imagine that if the sentence about assuming that exchanges will make individual health insurance easy and affordable had not been included, the number of employers who said that they plan to drop their group plans might not have been so high. Time will tell.
Rate Review Process Does Not Keep Premiums Artificially Low
[…] If the rates are justified, they’ll likely be approved – even if the amount of the increase is distastefully large. The DOI is not trying to keep premiums artificially low or force carriers to cut out legitimate claims expenses. Having rates approved by the DOI does not mean that the people of Colorado get smaller-than-average premium increases. Rather, it means that although our rate increases are sometimes substantial, we know that those rates are justified as a reflection of increasing claims costs.
Aetna Purchasing Genworth’s Medigap Business
The first of the Baby Boomers turn 65 this year, and health insurance carriers are paying attention. Aetna has agreed to purchase Genworth’s Medicare supplement business for $290 million. Going forward, Aetna expects to post yearly gains from the Medicare supplement (also known as Medigap) business. This makes sense given that the Baby Boomers will be flooding into the Medicare (and Medicare supplement) system over the next two decades. […]
Expanding Eligibility For Federally Administered High Risk Pool Coverage
[…] The 27 states (including Colorado) that administer their own PCIPs have been notified by HHS that they can modify their programs in a similar manner. As of this morning, the GettingUSCovered website still has the same eligibility guidelines that it has always had: a letter from a private carrier stating that the applicant has been declined, or approved with an exclusion on a pre-existing condition. […]
Surprising Effect Of More PCPs On Healthcare Costs
[…] The Dartmouth study results might seem counter-intuitive, since we often assume that as long as people are getting regular care by a PCP, they will be more able to avoid expensive hospitalizations. That appears to be true, but the lower cost office visits and outpatient treatments add up faster than one might expect, and would actually exceed the cost of the hospitalizations that they would prevent. […]
Governor Hickenlooper Vetoes Bill To Charge Premiums For CHP+
[…] Even if parents with kids in CHP+ do smoke and buy lottery tickets at a higher rate than parents with private health insurance, what’s to make us think that they would all of a sudden stop spending money on those things and instead pay premiums for CHP+? Is our goal to punish those parents for what better-off families view as poor choices, or is the goal to make sure that as many kids as possible have health insurance? If it’s the latter, then the point made by Senator Brophy is irrelevant.
Medicare Trustees Report Not So Gloomy
[…] One way or another, we need to seek solutions that will enable Medicare to pay the 10% shortfall that is currently predicted for a decade from now. That can be accomplished by cutting costs, increasing revenues, or both. But we don’t need to start from scratch and overhaul the entire system, especially with the improvements that the PPACA has already created.
Medicare and Prescription Coverage
[…] If the government can tell the health insurance carriers that no more than 15 – 20% of premium dollars can be spent on administrative expenses, including profits, why can’t similar guidelines be enacted for the pharmaceutical industry? Perhaps then we wouldn’t need to worry as much about who is going to pay the cost of prescription drugs for seniors. And maybe individual health insurance policies could start covering prescriptions with basic copays again.
Health Care Reform In The 2011 Colorado Legislative Session
The Colorado legislative session that wrapped up this month was a busy one for Colorado-specific health care reform. Despite a few bumps in the road, SB200 passed, which means that Colorado is now on its way to creating a health insurance exchange that will address the particular needs of individuals and small businesses in the state. Although this bill was controversial simply because the whole idea of exchanges is too closely tied with the PPACA […]