[…] Over the last several years, most of the major health insurance carriers in Colorado have increased the out of pocket portion that an insured has to pay for prescriptions. Most individual policies now have prescription deductibles, and a lot of carriers have designated very expensive drugs as a separate tier that requires a percentage copay from the insured, rather than a flat amount. And of course, premiums continue to climb. The Makena story is an example of why this happens, and it has nothing to do with health insurance carrier profits. When insureds see their health insurance premiums skyrocket again, where do you think they will point their finger?
Does Colorado’s New Maternity Law Impact Underwriting?
[…] The language in the Division of Insurance FAQ page does seem to create some confusion on the issue. Stating that “A person who is already pregnant may obtain insurance at this time” could be interpreted in various ways… some might see it as saying that the person may obtain insurance if the carrier allows it (which none of them currently do), while others might see it as stating that the DOI interpretation of the law requires carriers to treat a current pregnancy as a specific exclusion rather than cause for an outright decline. […]
Maternity Coverage On Renewing Individual Policies
Since January 1, 2011, all new individual health insurance policies issued in Colorado have included maternity coverage as required by a new state law. The text of the bill was quite clear in stating that its provisions would apply to all “policies issued or renewed on or after the applicable effective date of this act.” (see the top of page 3 of the text). But until now, there was still some confusion around maternity coverage and policy renewals, and inconsistencies in how the law was being applied. […]
Using HRA Funds To Purchase Individual Health Insurance
[…] However, it appears that the Colorado Division of Insurance has repealed its 2009 order regarding the use of HRA funds to purchase individual health insurance. Final Agency Order O-11-064 details the questions involved (including issues regarding eligibility for CoverColorado) and concludes that “Self-funded employee benefit plans sponsored by a private company such as an HRA, are employee benefit plans under ERISA and are not subject to the jurisdiction of the Commissioner.” […]
Mandatory Health Insurance Does Not Prevent Medical Bankruptcies
[…] The study’s authors note that implementing mandatory health insurance rules is not likely to result in a significant decline in the number of medical bankruptcies nationwide unless we also focus on improving the level of coverage that people have (to reduce out of pocket exposure), and on expanding access to disability insurance that can help provide income to people who are unable to work because of a major illness or injury. […]
HHS Proposes Waivers To Allow States Flexibility In Healthcare Regulation
[…] Colorado has been taking an active role in reforming healthcare for some time now. And our legislators are obviously still focusing on healthcare reform at a state level, from several different angles. Based on the initiative the state has shown over the last few years, I’m guessing that if the state waivers are available from HHS as of 2014, Colorado will likely take advantage of the opportunity to craft at least some aspects of our own healthcare regulation.
A Bill To Extend And Enhance The Regulation Of Midwifery In Colorado
I often write about bills in the Colorado legislature that pertain to healthcare, but Senate Bill 088 is one that is particularly important to me on a personal level. The law in Colorado regarding the regulation of direct-entry midwives is up for review this year. SB 088 renews the existing regulations, and would also allow direct-entry midwives in Colorado to provide some additional services, such as sutures and the administration of Vitamin K to newborns and RhoGAM to Rh- mothers. […]
Colorado Bill Would Allow State To Opt Out Of Federal Healthcare Laws
The Healthcare Opportunity and Patient Empowerment (HOPE) Act (HB 1273) was introduced in the Colorado House of Representatives this week, with primary House sponsorship from Reps Nikkel and Stephens (the House majority leader), and primary Senate sponsorship from Senator Kopp. The idea behind HB1273 is to allow Colorado to legally opt out of the PPACA – not just the individual mandate portion, but the entire law. […]
The Complexities Of Tort Reform
Tort reform has long been a contentious topic in the healthcare reform debate. Many Republican lawmakers – on both a state and federal level – have proposed tort reform as one of the major platforms of their alternative healthcare reform proposals. It’s the sort of issue that people tend to see as black and white, but is really many shades of grey. […]
New Study Finds Healthcare Reform Will Benefit Colorado Economy
The New America Foundation (NAF) and the University of Denver’s Center for Colorado’s Economic Future recently published a new study in conjunction with The Colorado Trust and The Colorado Health Foundation. The study was designed to look at the projected economic outcomes for the state of Colorado with and without health care reform. For the reform scenario, the researchers concentrated on the recommendations created by the Colorado Blue Ribbon Commission (208 Commission) a few years ago. They compared that data with the projected outcomes if we do nothing and simply maintain the current system with regards to health care. […]
Interesting Data Regarding Pay For Performance Studies
[…] There has been much debate recently about what is the most efficient and cost-effective method of reimbursing doctors and hospitals. While most providers now are paid on a fee-for-service model, there’s concern that such a model tends to encourage over-utilization. ACOs might pose a possible solution, although their designers would be wise to ponder the data regarding pay-for-performance, since much of the success of ACOs could hinge on providers’ ability to “perform” in terms of keeping their patients healthy and avoiding costly hospitalizations.
SB 168 Introduced With Goal Of Creating Colorado Health Care Cooperative
In a continuation of the string of healthcare-related legislation we’ve seen recently, Colorado Senate Bill 168 was introduced earlier this week. SB 168 would create a nonprofit healthcare cooperative to act as the benefits administrator and payer for health care services in Colorado. Similar to several other healthcare bills we’ve seen over the years, this one would implement change in a multi-step process: first by creating a proposed Colorado Health Care Authority, which would design the cooperative and take it to the legislature and then voters for approval. […]
Student Health Insurance And The PPACA
[…] Today, HHS has proposed additional regulations specifically aimed at student health insurance policies, in order to make sure that those plans meet the guidelines created in the PPACA. In essence, it would define student health plans as “individual health insurance coverage” and would eventually obligate student health plans to meet the same requirements as any other individual policy. […]
Repealing The Mandate – Some Simple Math
[…] As I’ve mentioned before, health care costs are what drive health insurance premiums. And until we figure out how to reduce the amount we spend on health care, health insurance premiums will continue to rise. But they will rise even faster if we require health insurance carriers to accept all applicants without imposing some sort of system that eliminates the possibility for people to wait until they are sick to purchase coverage.
When The Media Recommends Over-Consumption Of Healthcare
[…] We seem to be caught up in a wave of screening test excitement lately, with new advanced testing available for every disease under the sun. Rather than focusing on things that can truly prevent health problems (the old, and decidedly low-tech diet and exercise ideas…), we are fixated on developing newer and better screening tests. This exacerbates the problem of over-consumption of health care and rising health care costs.
EHR Transition Process Not A Simple One
[…] But like any big project, nobody said this will be an easy transition. The government has created an incentive program to help providers with the financial aspect of transitioning from paper records to EHR, but of course there are hoops to jump through. It’s not as simple as just setting up the first EHR system you come across and then getting money from the government to help pay for it. In order to qualify for the incentive program, EHR systems must meet meaningful use criteria as laid out by the Centers for Medicare and Medicaid Services last year. […]
Smart Medicine
[…] We cannot continue to tackle the health care mess by focusing on health insurance reform. That has been a large part of the focus of debate over the last couple years, mainly because health insurance is the point at which most people interact with the financial aspects of their health care. But health care costs are what drive health insurance premiums, and there’s no getting around that. It’s refreshing to hear the President of the Colorado Medical Society talking about the need for evidence-based medicine and a general scaling back of what we spend on health care. […]
Peace Of Mind With Automated Payment Of Health Insurance Premiums
[…] If you sign up for automated payments, there’s nothing to remember. You don’t have to worry about your health insurance lapsing because a bill didn’t arrive, or because you forgot to send in a check. You don’t have to worry about making a typo or accidentally sending an underpayment. And in a lot of cases it’s less expensive to have automated payments set up too – some carriers charge an additional fee if you opt to receive a bill and mail a check for your premium.
Consumer Protections And The PPACA
I doubt that regulators will simply throw out the existing rules and allow ACOs to operate without consumer protections to place to guard against fraud and abuse. Instead, I see them coming up with new regulations that take into account the changing landscape of health care delivery, including ACOs. But either way, the creation of new consumer protections while suspending others does make for an interesting discussion. […]
Is Colorado Representative’s Information Based On Email FWD?
Last week, the House of Representatives voted to repeal the PPACA. One of the Representatives voting for repeal was Scott Tipton, a Republican from Colorado’s 3rd congressional district. Obviously each Representative had to vote according to his or her own conscience and the general consensus from constituents, but one would also hope that prior to voting, each Representative would clearly understand the facts surrounding the various issues within the law. […]
Colorado Senator Introducing Legislation To Study Health Care
Colorado Senator Irene Aguilar, a Democrat from Denver, will be introducing legislation next month to address the fact that there are still 700,000 people in Colorado without health insurance. Although Colorado has made strides recently in areas like the expansion of Medicaid, we didn’t even come close to fulfilling former Governor Bill Ritter’s hopes for health insurance for all Colorado citizens by the end of 2010. […]
Comparing US Healthcare Costs With Other Countries
[…] But is having to wait to see a specialist for a non-emergency situation really that much of a drawback, when we consider that this sort of “rationing” might be what we need to bring our healthcare costs down to a reasonable level (and thus make healthcare more available to more Americans)? Maybe we don’t need MRI machines to be as conveniently-located as ATMs… Our current costs (and the rate at which they are increasing) aren’t really sustainable long-term, and the Healthcare Technology News article is a good reminder of how we stack up against the rest of the world.
Removing HSA Contribution Cap Does Not Solve Any Health Care Problems
[…] People who already max out their HSA contributions and still have money left over to contribute more would likely appreciate the removal of the HSA contribution cap. But those are not the people who are struggling to afford health insurance or pay for medical care. They are not the people our elected representatives should be focusing on when coming up with solutions for health care reform. Although I like our HSA and the flexibility it gives us to save for future medical expenses, I acknowledge that HSAs are not a panacea for what ails our health care system. […]
An Honest Look At End Of Life Care
[…] But Amy’s story is particularly important when we look at end-of-life scenarios, where doctors and hospitals will often take the approach of sustaining life at all costs, simply because it’s what we’re used to. I’m not advocating the rationing of health care in people who are terminally ill; patients should be given choices regardless of their prognosis. But honest discussions about end-of-life care and a genuine focus on quality of life might help to not only make life better for patients facing terminal illnesses, they could also result in lower health care costs.
Colorado House Bill 1025 Would Repeal Health Care Affordability Act
[…] HB 1025, introduced by Colorado Springs Republican Rep Janak Joshi, would repeal the Health Care Affordability Act of 2009 (HB 1293). That Act introduced the Hospital Provider Fee system to generate about $600 million annually in funds for the expansion of Medicaid, the Colorado Indigent Care Program (CICP) and Child Health Plan Plus (CHP+). Those funds are supplemented with federal matching of an additional $600 million for the expansion of those programs in Colorado. The Health Care Affordability Act was widely supported by hospital and medical groups in the state. […]