[…] You can still get quotes for child-only plans, but the only options that will appear on quote engines that work with major health insurance carriers are Rocky Mountain Health Plans, and Kaiser Permanente for people in the Denver/Boulder area. We wanted to clarify this point in case there is confusion surrounding the open enrollment period. It’s unknown whether the other major carriers will be able to find a way to make child-only coverage a profitable venture as time goes by, but for now, the options are still quite limited in the child-only market in Colorado, regardless of the open enrollment window.
Colorado Bill Would Allow Employers To Reimburse Employee Premiums
The 2011 Colorado legislative session is now underway, and Senate Bill 19 will be particularly interesting to watch. Since 1994, Colorado has had a law that bans employers from reimbursing employees for individual health insurance premiums. If any portion of the premiums for such plans are paid or reimbursed by the employer, the Colorado Division of Insurance considers the employer to have created a small group health insurance plan, and the plan must adhere to small group regulations (this impacts things like underwriting, and also has tax implications for the employer). […]
ACOs 101
Accountable Care Organizations (ACOs) have received a lot of buzz lately as the nation grapples with ways to reign in health care costs. But I think that there’s still a lot of confusion about how they would work. A couple of very informative posts on the topic were included in this week’s Grand Rounds, and I wanted to share them with our readers. […]
Health Care Costs Are The Driving Factor Behind Premium Hikes
I’ve long supported the idea that our health care system was in need of reform that would make care more affordable and accessible to everyone, regardless of their health or financial situation. But I’m starting to feel a bit frustrated by what feels like an over-emphasis on regulation of health insurance carriers and not enough focus on ways to actually control the cost of health care (including over-utilization). If people are thinking of this process as health insurance reform rather than health care reform, it’s doomed to failure. […]
Debating The Individual Mandate
[…] There is no simple solution to the issue of balancing guaranteed issue health insurance, an individual mandate, and personal liberties. It will be interesting to see what 2011 brings in terms of court battles over the constitutionality of the individual mandate, and whether any other options become viable alternatives.
Is A Symbolic Repeal Vote Worth The Time?
[…] Political analysts generally agree that a repeal vote in the House is likely to pass, but much less likely to clear the Senate. If it did, it would be virtually impossible to override a presidential veto. So the vote next week is basically symbolic – which can also be looked at as a waste of congressional time and resources. A more productive solution might be to start looking for ways to significantly reduce the actual cost of health care. […]
Looking For Ulterior Motives
Health care costs are rising at a dizzying pace. For most Americans, this translates into increasing health insurance premiums, which are driven mostly by the cost of health care. Getting health care costs under control is a necessary step, and one that politicians generally say is important. But what is said and what is done are not always in line with each other. This outstanding article on Emergency Physicians Monthly is a perfect example of health care costs run amok. […]
Reviewing Health Insurance Premium Increases
[…] even with the new MLR guidelines and a significant review from the Division of Insurance to make sure this year’s rate increases are appropriate, our average rate increase is still nearly 13% – significantly higher than the 10% threshold that would trigger a review under the proposed federal regulation. […]
Three Years To Iron Out Details For Health Insurance Exchange
For anyone curious about the logistics that will go into setting up the new health insurance exchanges that will become active in 2014, this Denver Post article is an excellent overview. The article notes that the 2011 legislature will have to pass a bill to set up basic guidelines for the exchange, and a governing structure to oversee the process. There will be monthly committee meetings to hash out the details, and once you start to ponder all of the questions that still remain unanswered, it’s clear why it might take a few years to get the exchange up and running. […]
Colorado Receives $13.7 Million Award For Medicaid Program
Colorado was one of 15 states to receive a grant from the federal Centers for Medicare and Medicaid Services this week, thanks to changes that the state made in the enrollment process for Medicaid in order to expand the program. Colorado got $13.7 million, which will be used to help finance the state’s Medicaid system. […]
Double Digit Premium Increases Continue In Colorado
The Colorado Division of Insurance issued a press release on Monday, addressing the fact that health insurance premiums in Colorado are continuing to increase. They reiterated some numbers from earlier this fall, noting that less than 5% of the overall rate increases for next year can be attributed to changes implemented by federal health care reform. The vast majority of the rate hikes that insureds will see in 2011 are due to factors that have been driving health insurance premiums for years, long before federal reform became an issue. As long as the cost of health care continues to rise, the cost of health insurance will rise along with it. […]
Possible Alternatives To The Individual Mandate
[…] While many other aspects of reform are generally popular (like the provision to allow young adults to remain on their parents’ health insurance until age 26, and the requirement that all policies be guaranteed issue starting in 2014), the individual mandate has raised a lot of hackles, with people feeling that the government is infringing on their rights by telling them that they have to buy a product (and in most cases, that product will come from a private company). […]
Colorado Falls To 13th In America’s Health Ranking
America’s Health Rankings released their annual report this month, and Colorado fell from 8th place in 2009 to 13th place in 2010. Overall, Colorado does quite well in terms of current health outcomes, but we fall short in terms of some factors that could lead to lower health outcomes over time (insurance coverage, geographic disparity, and immunization rates). […]
Standardized Language For Health Insurance
[…] In Colorado, all policies have long been required to have a standardized plan description form (separate from the carrier-created marketing brochure), and House Bill 1166 passed earlier this year, requiring that all policy information be written at no more than a 10th grade reading level. But I think that most consumers tend to look at brochures, mailers, online advertising, and other marketing materials designed by each insurance carrier. […]
More Than 200 Waivers Granted By HHS For Limited Benefit Plans
[…] As of last week, the number of waivers granted by HHS has grown to 222, and more than 1.5 million plan enrollees will continue to be covered next year by policies that provide limited benefits, despite the fact that those policies do not conform to the PPACA rules. Some of the exempted plans cover only a few workers, but some have thousands of enrollees. […]
Even Well-Off Americans Face Problems With Health Care Costs
[…] People in the US pay a significantly larger chunk of their income for health care (either through health insurance premiums, or directly to providers) than people in other countries. […] Until we can get our health care costs in line with what other developed countries spend, health insurance premiums will continue to be a financial stretch for many families, and cost will continue to be a barrier standing in the way of health care access for a large number of Americans.
Consumer Reports Health Insurance Rankings
I recently picked up a copy of the November issue of Consumer Reports, which included a section about health insurance. The article featured an interview with President Obama, and a good overview of how the changes included in the PPACA will impact consumers. In addition, Consumer Reports published a ranking of 227 HMO and POS (point-of-service) plans (you have to subscribe to Consumer Reports Health in order to be able to see the details online), according to data compiled by the National Committee for Quality Assurance (NCQA). […]
The Value Of Preventive Care
[…] I found this article by Dr. Lucy Hornstein to be particularly interesting. Dr. Hornstein takes the view that preventive care does not save money in the long run, and wonders if the provision in the PPACA to provide preventive care to everyone – with no copays or deductibles – is a wise idea. The discussion is made even more interesting with a comment from Maggie Mahar (who was referenced in the article) noting that some preventive care is more worthwhile than others. […]
Most Employers Have Not Enrolled In Early Retiree Reinsurance Program
[…] a Robert Wood Johnson Foundation report indicates that the majority of employers who offer retiree health insurance benefits have not yet signed up for the program, scheduled to last until the end of 2013. The RWJF study notes that in addition to the many small employers who offer retiree health insurance benefits, there are also about 24,000 large employers who do so. Obviously, most employers have not enrolled in the early retiree reinsurance program yet, and it’s unclear whether they plan to do so or not. […]
The Future Of Employer Based Health Insurance
[…] I can’t imagine huge numbers of people simply opting to be uninsured if employers stop offering coverage, especially once individual health insurance is guaranteed issue and pre-existing conditions are no longer an issue. I would guess that in 2014 we will see at least some shift away from employer-sponsored coverage in favor of individual health insurance, but I imagine that plenty of employers will continue to offer at least some level of coverage as a way to attract and retain quality employees.
Thoughts On The Postponed Medicare Payment Cuts
[…] While these changes might not have been warmly welcomed, they will ultimately help to make the system sustainable in the long term. The same could be said for the rest of the health care industry if similar cuts are implemented in other areas. Although the physician reimbursement cuts are unpopular with most doctors, they may be the only way to keep Medicare as a viable payer for seniors’ health care needs. And ultimately, it’s in the best interest of both doctors and seniors to keep Medicare around.
Grand Rounds Vol. 7 No. 10
Welcome to Grand Rounds. As we get ba ck into the work week routine after the Thanksgiving weekend, we have a great collection of health care articles for you to browse through. Enjoy! […]
Most Americans Do Not Get To Make Their Own Health Insurance Choices
This article is not the first I’ve seen that calls into question whether Obama was being truthful when he said that health care reform would be structure so that people would still be able to keep their existing health insurance if they wanted to. And it would seem that his statements did amount to a bit of over-promising. But even before the PPACA came up for a vote, many Americans weren’t in control of whether or not they got to keep their existing health insurance. […]
Capping Profits And Admin Costs Across The Healthcare Industry
[…] Time will tell, but it seems that as long as doctors, hospitals, medical device makers, and pharmaceutical companies are exempt from any rules concerning profits and administrative costs, the MLR rules might not have much long term impact on the actual cost of health insurance. Premiums will keep rising (at a pace similar to what we’ve seen over the last several years) as long as the cost of healthcare continues to climb at the same rate it has for the last decade or so.
How US Healthcare Compares With Other Developed Countries
[…] While many studies comparing health care around the world tend to look at generalized data like life expectancies and total cost of healthcare, this one was more focused on how healthcare in each country impacts individual people, and whether people are satisfied with their health insurance, personal medical costs, and access to care. […]