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Colorado Premiums Rising Faster Than National Average

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Across the US, employers will see a 9% increase in health insurance premiums next year. But in Colorado, the increase will be an average of 11.8%. The Lockton Group has released its 2010 Colorado Employer Benefits Survey Report, and it indicates that Colorado will see bigger premium increases than the country as a whole. This puts Colorado businesses at a disadvantage in terms of direct operating expenses, as health insurance makes up a large portion of business overhead. It also makes it harder for Colorado businesses to compete for the best employees, since premium increases are being passed along to employees in the form of higher premiums and fewer benefits. Not surprisingly, Colorado businesses are much less likely to offer pricey HMOs than they were a decade ago (32% now, versus 89% in 2000), and far more of them are offering HSA qualified, high deductible health insurance policies (which have lower premiums) for their employees (27% now, versus only 3% in 2003).

Colorado residents tend to be healthier than the average American. We’re thinner, and have lower incidence of hypertension and diabetes than most of the rest of the country. So why would health insurance rates be rising faster here than in the rest of the country? My guess is that it has something to do our higher-than-average percentage of the population without health insurance. 17.2% of Colorado residents are uninsured, compared with national numbers that tend to be in the 15 – 16% range. When uninsured patients are treated by our health care providers (emergency rooms are a good example of this), the providers have to recoup their losses somehow. This usually translates into higher reimbursement rates being negotiated with health insurance companies. The insurance companies pass on their higher costs to customers in the form of higher premiums and/or reduced benefits. […]

Health Insurance Premiums And The Public Option

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David Williams has written an insightful article about how big business concerns about a public health insurance option might be overly dramatic. I do understand the concerns that business owners have, since they believe that a public option will lead to costs being pushed onto private health insurance carriers, who in turn would charge higher premiums. There is no doubt that businesses have felt the sting of rising health insurance premiums for years now. In Colorado, employer-sponsored health insurance premiums rose by almost 87% between 2000 and 2009, while wages increased by only 20.5% over those years. Employees are increasingly seeing higher premiums deducted from their pay, combined with higher deductibles and copays. But employers still pay the lion’s share of many employees’ health insurance premiums, and the prospect of even higher premiums isn’t likely to sit well with them […]

Women And The House Health Care Reform Bill

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Not surprisingly, House Democrats are going after the female vote by including several provisions in the current draft of their health care reform bill that are designed to expand coverage and reduce premiums for women. For starters, the bill includes a ban on using gender as a factor in setting premiums. This will result in lower premiums for women, but higher premiums for men. In Colorado, men are currently more likely than women to be uninsured. Raising their rates to compensate for lowered rates for women might result in more men being uninsured. But in terms of overall fairness, it does make sense to charge the same rates for men and women.

Specifically forbidding the practice of denying coverage to domestic violence victims is also part of the House bill, and will likely receive widespread support from both women and men alike. But in the eight years since we started selling medically underwritten health insurance, I can’t remember a single time that an applicant was declined for being a victim of domestic violence, nor have I ever seen a question on any application asking if the applicant has been abused. So while this provision makes sense, and will no doubt be beneficial for a few people, I imagine its strongest impact will be in helping to rid us of “blaming the victim” mentality […]

Health Insurance Premiums And Age

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How much should age play a part in determining health insurance premiums? That’s a question that lawmakers are debating, and one that might require an answer that is more strategic than it is fair. In general, older people have higher health care bills than younger people. Because of their lower claims, younger people currently pay much lower premiums for health insurance than older people. But they continue to be the most uninsured segment of our population.

In 2007, the Lewin Group released a report for the Colorado Blue Ribbon Commission for Health Reform. It showed that 38.7% of Colorado residents age 19 – 24 were uninsured. This was far more than the next highest category (27.1% of people age 25 – 34 were uninsured). Several factors contribute to the high percentage of young people who are uninsured. They tend to be healthy, and thus aren’t as likely to see the value in health insurance. They tend to work in entry-level jobs that aren’t as likely to provide health insurance benefits. And they usually have lower incomes than older workers, making health insurance – even if it is cheaper for them – harder to afford […]

Imaging And Primary Care Doctors

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[…] When Jay hurt his knee a couple years ago, an MRI was done prior to surgery. We have an HSA qualified health insurance policy, and at the time our deductible was $3000. So we paid for the MRI ourselves, and it amounted to more than a third of the deductible. And that was after Humana reduced the bill to the network negotiated amount. MRIs have helped to make medicine a much more exact science, but they are not cheap.

It seems that any system that pays physicians – directly or indirectly – to order additional testing will end up with excessive testing, adding to the overall cost of health care. Even doctors with the best of intentions are likely to be swayed by the knowledge that they can boost their paychecks by adding a few MRIs here and there.

I believe that the number of tests a doctors orders should not impact his or her income. And it seems that adding more medical imaging facilities in primary care offices will only increase our already burgeoning health care costs […]

How The Pharmaceutical Industry Drives Health Care Costs

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My father has been on dialysis for eight years. He has Wegener’s Granulomatosis, a rare autoimmune disease, and it destroyed his kidneys very suddenly in 2001. His illness came out of the blue, following a lifetime of good health, and has given my parents an up-close look at our health care system. Because he has kidney failure, my father qualified for Medicare. But until the advent of Medicare Part D in January 2006, my parents had to pay for all of his medications out of pocket.

Dialysis does not remove phosphate, so my father has to be on a drug that prevents phosphate from building up in his blood. In 2002, he was on PhosLo, a brand name drug, because the generic wasn’t available. At that time, a three month supply cost $108.25. Now, seven years later, he takes the generic version (calcium acetate) and a three month supply is $528.29 (a 488% increase in price). Humana, his Medicare D carrier, picks up the tab, but we all know that claims […]

What Guaranteed Issue Without A Mandate Looks Like

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[…] Yes, companies like Wellpoint are in business to make a profit. But that doesn’t mean that everything they say in the health care reform debate should be dismissed. If we don’t make sure that everyone becomes part of the health insurance pool, we’ll likely be looking at fewer health insurance companies and far higher premiums after a few years of guaranteed issue policies.

How Current Reform Proposals Would Impact Colorado Premiums

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[…] Wellpoint actuaries have crunched the numbers and come up with their best estimates as to how premiums would be impacted in the 14 states where Wellpoint operates. Colorado is one of those states, and for the first time we’re able to see a detailed analysis of what would likely happen to premiums for people here. […]

Conflicts Of Interest In Health Care

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[…] Hospitals are in business to make money, just like most of the other players in the health care industry. And hospitals have boards of directors. We know this, but do we know what they do, or who they are? Dr. Roy Poses of Health Care Renewal has written an article about hospital boards that might make your blood pressure rise a notch or two. […]

Increased Cost Sharing Reveals The True Cost Of Health Care

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[…] There’s no doubt that a co-insurance based system would make people more aware of what health care actually costs. Nobody should have to devote their life to trying to obtain coverage for a serious medical problem, but on the other end of the spectrum, perhaps nobody should be paying only $15 to see a doctor, and a deductible of a couple hundred dollars a year. […]

Obesity As A Pre-Existing Condition

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[…] I can see the benefit to making sure that everyone gets accepted for health insurance, as it’s counterproductive for society as a whole to have people who are uninsured. But I believe that it makes sense for obese applicants, and tobacco users, to pay more for their health insurance in order to offset the higher claims they are statistically likely to have. […]

Expanding Access To Cover Colorado

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I have often wondered about the feasibility of Cover Colorado expanding their eligibility to attract healthier applicants and perhaps improve their loss ratio. The state high risk pool health insurance policy – has claims expenses that far exceed premiums collected. Fees on private health insurance companies and a grant from Medicare help to make up the difference. […]

Reducing Demand For Health Care

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Dr. William Foster has written a very thoughtful editorial about the state of our health care system, and it’s well worth reading. He points out that as a society, we’re always looking for the latest and greatest in health care, but at the same time we want it to be more affordable. We run more tests and perform more procedures than ever before – and our health care costs reflect this. […]

John Mackey And Health Care Reform

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[…] But with any commodity in the marketplace, there will always be people who can’t afford it. The life or death nature of access to health care makes it too important to place it on the same shelf as cars and jeans and high-end organic potato chips. It people can’t afford (and thus don’t purchase) those things, they will still be ok. The same can’t really be said for health care.

Playing With Fire

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I just read this article from NPR and Kaiser Health News about Lyn Robinson, a 52 year old woman who has chosen to be uninsured. Lyn is very healthy. She leads an active life and takes good care of herself. She pays out of pocket for alternative health care like acupuncture and chiropractic care – things that often aren’t covered by health insurance policies anyway. […]

Setting Minimum Standards For Health Insurance Policies

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[…]In Colorado, we have the health plan description form that is standardized and makes comparing plans somewhat simple. But it tends to get buried in marketing materials, and is often overlooked by consumers. I would take this a step further and make sure that all plans – regardless of where they are sold – clearly state the important details up front.[…]

We Are What We Eat

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[…] no matter how comprehensive or affordable our health insurance is, we won’t be healthy without a good deal of personal commitment. But it’s unrealistic to expect people to purchase fruits and vegetables over less expensive grain products. As long as we continue to subsidize the grain products, they will continue to be less expensive and more widely available.

Personal And Government Responsibility For Health Care

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[…] So while we need to do a better job of stressing personal responsibility in health care, we also need to make sure that everyone has access to quality health care and a good catastrophic health insurance policy. The health care problems that we’re facing aren’t going to be solved by government alone, but they also aren’t going to be solved without any government action at all.

Fines Are Not The Same Thing As Taxes

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[…] Most people without health insurance aren’t uninsured by choice, and don’t need the threat of a fine to motivate them to try to get coverage. The fines are to motivate people who can afford health insurance but would otherwise choose to go without (potentially transferring the cost of a significant emergency room bill onto the population that does pay for health insurance). […]

Colorado Senator Morgan Carroll On Health Insurance

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Colorado state senator Morgan Carroll has written a very persuasive article about why we should end gender-based pricing in the individual health insurance market. I agree that it makes more sense to average premiums across the entire population, but I also understand that doing so would mean a rate increase for men to offset the rate decrease for women. […]

Why Mandatory Health Insurance Makes Sense

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[…] no matter how careful we are, we never really know what is around the bend when it comes to our health. Accidents can happen to even the healthiest people. Freak illnesses can strike otherwise healthy people. And when these situations arise for people who are uninsured, the cost is eventually borne by those who have health insurance.