Both Cigna and Anthem Blue Cross of Colorado report no rate increases on new business in Colorado. However, for existing clients on open plans, rates may change due to age attainment and trend. Carriers may adjust rates for closed plans effective January 1, 2013.
Blog
How the Affordable Care Act Affects You
For the first couple years after the Affordable Care Act was signed into law, everything seemed to be a bit up in the air. There was almost constant bickering about the subtle nuances of the legislation, along with uncertainty from both sides of the political spectrum insofar as whether or not the law would stand the test of time. The Supreme Court had to weigh in, and we also had a major election cycle midway between the signing of the law and the enactment of many of its main provisions.
Most of that has settled down now. SCOTUS upheld the law. And there was no election upheaval in Congress to tilt the legislative body towards a crowd that would be likely to repeal it. States – like Colorado – that had been working towards setting up a health benefits exchange can continue to do so without as much worry that their work might be in vain (there had been 
some concern that the law would be tossed after states had invested a lot of time and money in the exchange-creation process). We are just over a year out now from January 2014, when many of the major provisions of the ACA will go into effect; it seems relatively certain at this point that the ACA will continue to move forward now that some of the potential roadblocks are in the rearview mirror.
Several provisions of the Affordable Care Act – ACA have already been implemented over the past two years: Young adults can remain on their parents’ health insurance policy until […]
Individual Health Insurance After Donating A Kidney
This recent AARP article caught my attention last week. My father lost his kidneys in 2001 as a result of Wegener’s Granulomatosis, a rare autoimmune disease. In August, he was the recipient of a kidney generously donated by the family of a young man who had passed away. And this fall, for the first time in 11 years, he’s been able to go about his life without being tethered to a dialysis machine every evening. So I’m drawn to stories about kidney transplants, living donors, or families who choose to donate a deceased loved ones organs.
To sum it up, Radburn Royer is a healthy 57 year old who donated a kidney to his daughter four year ago, after her own had failed as a result of lupus. Prior to donating a kidney, Royer was covered by Blue Cross Blue Shield of Minn. It’s unclear what his health insurance status was in the interim, but last year he reapplied for coverage with them and 
was turned down. He’s appealed several times, but for now he’s covered by his state’s high risk pool (he has to pay $130 more per month for his coverage and has a higher deductible, both of which are common in high risk pools).
Individual health insurance in Colorado is underwritten just as it is in Minn., but underwriting guidelines usually vary from one state to another and from one carrier to another. So we contacted three of the top individual health insurance carriers in Colorado to see how they would underwrite an applicant who had previously donated a kidney. Cigna, Humana and Anthem Blue Cross Blue Shield all said that as long as the donor had been released from medical care and had normal blood pressure and blood lab results, the most likely underwriting outcome would be acceptance with a standard rate.
At first glance, this seems to be at odds with the situation experienced by Royer, but maybe it’s not. The AARP article notes that Royer underwent […]
[…] In the context of kidney donation, it’s important that potential donors not be inadvertently scared off by AARP’s article. Kidney donors are heroes – anyone who had received a transplant will attest to that fact – and they save lives. The study that I linked to above followed donors for 20 – 37 years after their transplants. While some donors did end up having kidney problems, the majority had normal kidney function 20 – 37 years out from surgery, and would likely not have a problem obtaining individual health insurance, even prior to it being guaranteed issue in 2014. Most people who are healthy enough to be accepted as a donor will continue to be healthy after they donate a kidney.
Kaiser Permanente 2013 Rate Increase Announced
Kaiser Permanente announces the average 2013 rate increase for individual/family health insurance in Colorado was 11%.
Election Thoughts – Healthcare Reform And Exchanges
[…] Tim’s article is an excellent primer on the implementation of healthcare reform, specifically in terms of the health benefits exchanges that need to be up and running by October 2013, when enrollment is scheduled to begin (health insurance effective dates wouldn’t start until January 1, 2014, but people should be able to start enrolling next October). That’s less than 11 months away, and there’s still a lot of work to be done. Colorado has been working on its health insurance exchange for some time now, and has made a lot of progress so far. We’re one of the states that has selected a benchmark plan for essential health benefits, and much of the groundwork for Colorado’s exchange has already been done. But in addition to the nitty gritty logistics of setting up the exchanges, there are still plenty of legal and administrative bumps that will need to be ironed out. When the ACA was signed into law in early 2010, the implementation of exchanges and the majority of the law’s “teeth” in 2014 seemed like a long way in the future. That is now just over a year away, with exchange enrollment beginning in less than a year. And there’s still plenty of work to be done, especially in states that haven’t made much progress on their exchange implementation yet. […]
I wish my health insurance _____________?
I understand the trade off we got when we switched to a really inexpensive high deductible plan when even our high deductible HSA qualified plan was too rich and expensive. So I wish my health insurance had a monthly credit card billing option. Our current health insurance company, Anthem Blue Cross of Colorado used to have it, like most health insurance companies did. But then, like most other companies also did, they stopped offering that as an option about a year ago.
What would you change about your health insurance company or plan? It could be the coverage, billing, customer service, anything…
Going Without Health Insurance
You may already be familiar with the blog Zen Habits. It’s a very popular site with hundreds of thousands of readers. It’s written by Leo Babauta, who has authored numerous ebooks and paper books and has over a hundred thousand followers on Twitter (he’s following three people – all those followers he has are just interested in what he has to say). When he writes something, it gets read and shared and talked about. I’ve been reading – and enjoying – his site for a few years, and I usually find myself nodding in agreement with whatever he’s written.
But his most recent post threw me for a bit of a loop. He explains his rationale for not having health insurance for his family (he and his wife and six kids), and goes into a detailed description of how you, too, can make health insurance a bad bet.
I have no idea what his full financial situation looks like. He often writes about being a minimalist, so I know he’s not spending lots of money on material stuff. They do like to travel and recently spent several weeks in Europe – that doesn’t come cheap, but it’s a great experience for adults and children alike. He has a very successful blog and several books, so I have to imagine he’s not poor. And yet Leo Babauta considers going without health insurance to be a reasonable risk.
To be fair, I agree wholeheartedly with the tips he gives for “making health insurance a bad bet“. Things like eating well, exercising, avoiding excess alcohol, not smoking, driving safely […]
2012 Obamacare Premium Rebates (Infographic)
Did you receive a health insurance premium rebate this year? If so, how much was it? We created a simple visualization of how the PPACA (Obamacare) health insurance premium rebates break down between the individual/family, small group and large group markets and how Colorado’s rebates compared to the national average.
Electronic Medical Records And Data Security
[…] As David pointed out, we really don’t need to be too worried about our medical data being stolen. Medical identity theft is increasingly a problem, but that generally happens when someone attempts to steal an insured’s identity in order to receive healthcare under the victim’s health insurance policy. Again, no theft of sensitive medical records, but a significant problem. Data security absolutely needs to be a priority as we transition to electronic medical records. But for the most part, the problems are not what people think of first (sensitive medical data being compromised), but rather, theft of credit card numbers and social security numbers, as well as people who try to fraudulently use another person’s health insurance coverage.
No 2013 CoverColorado Assessment
CoverColorado announced that there will be no assessment in 2013 on Colorado health insurance carriers. The 2012 assessment was roughly $3.79/month/contract for individual/family insureds.
Anthem Blue Cross of Colorado has also announced that their membership this year was higher than expected this year. They were making up for a shortfall by charging $4.36/month/contract in 2012. Due to the higher enrollment, Anthem BCBS has enough funding to satisfy December without billing subscribers a CoverColorado assessment.
Patients Want More Electronic Communication With Doctors
For the past few years, healthcare information technology has been one of the major players in healthcare reform efforts. All six hospitals in Northern Colorado are now linked with a medical information sharing program, and medical offices all over the country are getting on board with electronic medical records. The rise of electronic media in healthcare is not without controversy, but I think that we can all agree that it was – and is – inevitable. Each year brings newer and better technology, and people (patients and healthcare providers alike) have ever-increasing expectations in terms of the availability of information and communication.
Thus it’s no surprise that a recent survey found that patients want more digital interaction with their doctors. Half of respondents in the study felt that a past medical problem could have been avoided if their doctor had sent text messages or emails with encouragement, tips and reminders. Of course, whether electronic communication with doctors would actually have averted the problem is unknown. What’s important however, are the patients’ perceptions. 68% of the survey respondents said […]
Healthcare Affordability And Quality: Two Perspectives
[…] He notes that the problem of access to care has been well addressed: 30 million additional Americans will soon have health insurance coverage (although we have to bear in mind that health insurance coverage and actual access to care are not necessarily the same thing, especially if the health insurance in question is Medicaid or another public plan). But he goes on to point out that affordability and quality are areas with some wrinkles that still need to be ironed out.
What makes this post especially interesting is Maggie’s equally well-though-out response that she included in the HWR. Be sure to read what both of them have to say. Maggie references a couple of her previous posts and provides plenty of evidence to back up her premise that affordability and quality of care are both being addressed and that the solutions are working (or will be soon). Definitely an interesting collection of views from two of our favorite healthcare writers.
Snow in Colorado Last Night, But Not Very Much
We just got a little bit of wet, sticky snow in Colorado last night; just enough for a little snowman in the morning. Matt made the snowman all by himself! Most of the snow in the yard has melted this evening, but not the snowman!
Healthcare Overutilization And General Physical Exams
[…] perhaps we need to consider at least some general physical exams to be overutilization of care. I know – that sounds blasphemous and counter-intuitive. But sometimes we have to abandon our preconceived ideas and look at what the evidence is telling us rather than just accepting what we assume we know to be true. I would say that further and more extensive studies need to be conducted before we make any radical changes as far as general physical exams and well-checks. But we definitely need to be taking a much closer look at healthcare over-utilization. Maybe that’s where we can do our “rationing”, and end up with a win-win for everyone: lower healthcare spending and better patient outcomes.
Health Insurance Premiums And The ACA
[…] We wrote a couple years ago about the Colorado Division of Insurance bulletin that laid out the reasons for rate increases in 2010 – almost all of them were the same factors that had been driving health insurance premiums for the previous decade; only 5% of the total premiums could be attributed to the ACA. […] The predicted long-term cost savings from the ACA are definitely not a sure thing. But we need to keep in mind that many of the substantial changes included in the law have not yet taken effect. And many of the changes that have been implemented are those that tend to increase short-term costs and/or utilization of care. […]
Individual Health Insurance Mandate From A Perspective Of Compassion
[…] I’ve usually addressed the issue of the individual health insurance mandate in terms of how guaranteed issue health insurance would impact premiums in the absence of an individual mandate. The mandate – regardless of its popularity – just seems like the most practical way to go if we’re in agreement that individual health insurance should be guaranteed issue.
Maybe we should also be looking at the individual health insurance mandate from a more compassionate, human angle too. There has long been a bit of a harsh undertone in the healthcare reform discussions when it comes to people who are […]
ACA Electronic Medical Records – Opposing Views
[…]Dr. Plested believes that the ACA will lead to rationing (it’s hard to say with certainty that this isn’t true, but Dr. Plested believes with certainty that it is true) and that the Obama Administration wants doctors to adopt the ACA electronic medical records so that treatment specifics can be sent to the Internal Revenue Service and federal health officials. He believes that doctors will then be instructed to pursue a treatment plan “that is preferred by the government.”
Dr. Bender notes that in his own practice, computerized medical records have alerted his office to the fact that less than half of their diabetic patients were being tested at least once every three months (standard of care, and a good way to lower costs since it reduces the number of patients with complications stemming from uncontrolled diabetes), Prior to the introduction of electronic medical records he had no idea that the number was so low. It’s now up to 85%. As far as records being transmitted to the IRS and other government officials, Dr. Bender notes that the IRS would need a subpoena to get his patients medical records, which are locked securely behind several firewalls. […]
Healthy Weekend Fun – Mocha Chip Banana Soft Serve
The idea of freezing bananas and then blending them into “ice cream” is not my own. I discovered it online a few years ago, and it has since become so popular that I’ve noticed bananas in the grocery store with little stickers on them letting people know that they can be blended into soft-serve style desserts. But the recipe I’m sharing here is my own creation that came about when I started tinkering with the basic blended bananas idea.
It’s quick, easy, and the sweetness in it comes almost entirely from the bananas. What’s not to love?!
Mocha Chip Banana Soft Serve
Ingredients:
2 cups frozen banana chunks
3 Tbsp cocoa
1 scoop chocolate protein powder (try to stick with a brand that doesn’t […]
ACA Alternative Has Some Logistical Limitations
[…] But if we’re looking at an ACA alternative, I would say that the major issue that causes health insurance to be dramatically more expensive in some states has more to do with health insurance being guaranteed issue (without a mandate that everyone purchase health insurance) and less to do with specific laws regarding coverage details. I’ve written in the past about some of the problems that could go along with selling health insurance across state lines, but Bob and Joe’s point about no state having truly affordable health insurance is really the crux of the issue. In order to make health insurance more affordable, we have to get a handle on the cost of care, since that’s what drives health insurance […]
How To Better Serve Emergency Room “Frequent Flyers”
The American College of Emergency Physicians had their annual meeting in Denver, Colorado this week, and presentations involved several new studies pertaining to people who are the most frequent users of emergency room care. I found that article to be fascinating, in part because it dispels so many myths about emergency room “frequent flyers.” We’ve written before about the fact that most emergency room patients do have health insurance and that emergency room overcrowding cannot be blamed on uninsured patients (as is often cited in casual conversation). Although most emergency room visitors do have health insurance, many of them have public health insurance via Medicare or Medicaid. And since the Medicaid rolls are expected to grow significantly over the next several years, it’s likely that ER overcrowding will grow to become more of a problem as some of those Medicaid patients are unable to access primary care outside the emergency room. […]
Healthcare Fact Checking the Presidential Debate in Denver
I think that political debates would be a lot more fun (and educational) to watch if non-partisan fact checkers were allowed to sit off to the side and hold up “pants on fire” signs when appropriate. But the next best option is the plethora of online fact-checkers who can help us sift through the statements. It’s generally been acknowledged that there were more than a few half-truths and outright lies in last night’s 1st Presidential debate here in Colorado at the University of Denver.
Specifically regarding healthcare and health insurance reform, there are a couple of PPACA-related points that need further comment. First, we have the comment from Romney regarding the “unelected board, appointed board, who are going to decide what kind of treatment you ought to have.” He’s referring to the Independent Payments Advisory Board (IPAB), whose job is to oversee general Medicare spending. They are allowed to reduce Medicare payments to hospitals with high re-admission rates and recommend ways to reduce wasteful Medicare spending through new innovations. But they cannot restrict benefits, alter Medicare eligibility, or make any decisions regarding treatment options. […]
CORHIO Continues To Make Progress On Colorado Health Information Exchange
There are 110 hospitals in Colorado, and so far CORHIO has connected 27 of them to the health information exchange, and they are actively working on connecting two more. They are also currently working to add 800 more medical offices to the health information exchange, to join the 290 who are already connected.
Health IT has been a major talking point throughout the healthcare reform process, and the steps that CORHIO is taking will no doubt make for a more efficient healthcare system throughout Colorado once the entire state is linked through the HIE. Patients who see multiple doctors or who are treated at more than one hospital […]
Colorado Health Exchange Gets $43 Million Federal Grant
Throughout the entire healthcare reform process, Colorado has been one of the states working hardest to make healthcare for everyone a priority. Even before healthcare reform became a national issue, the Colorado Blue Ribbon Commission was actively working on the problem (and many of the recommendations that the Blue Ribbon Commission recommended ended up being quite similar to reforms that subsequently were included in the PPACA). So it’s not surprising that the Colorado health exchange is moving ahead on schedule to meet the target of being able to start enrolling people and small businesses in the exchange as of October 2013 (January 2014[…]
How Does Health Care Reform Impact HDHPs and HSAs?
Will HSA qualified health insurance plans and Health Savings Accounts (HSA) still exist after the majority of the remaining PPACA changes are implemented in 2014? That’s a question that we often hear from Colorado health insurance clients who are concerned about their existing HSA qualified high deductible health plan (HDHP)/HSA, as well as people who are considering an HDHP but uncertain about the future of that type of health insurance.
In terms of direct impact, the PPACA changes very little about HDHPs and HSAs. There are only two […]
Playoff Health Wonk Review, And The Other Side Of The ACO Coin
An excellent baseball-playoff themed edition of the Health Wonk Review is at Wing of Zock, hosted by Jennifer Salopek – be sure to head over and check it out. This article by Jason Shafrin should be of interest to anyone who has been paying attention to all the talk about ACOs lately. I have been generally impressed with what I’ve read regarding the potential cost savings and improved efficiency that ACOs will hopefully provide. However, although health care reform has focused quite a bit of energy on the creation of ACOs, it is far […]