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Lesson from CO-OP failures: low premiums aren’t sustainable unless we reduce healthcare costs

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Healthcare accounts for 17.4% of the US GDP. And yet most of us can’t or won’t include a healthcare line-item in our budget that accounts for 17.4% of our annual spending. Whenever health insurance carriers raise their rates – particularly if it’s a significant increase – there tends to be a public outcry, with the carriers… Read more about Lesson from CO-OP failures: low premiums aren’t sustainable unless we reduce healthcare costs

Why is Colorado Health OP shutting down?

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UPDATE, 10/20/15: On October 19, Colorado Health OP filed a lawsuit in Denver District Court, seeking an injunction and temporary restraining order to allow the carrier to continue to sell policies – and participate in the 2016 open enrollment period – while working for the next few weeks to secure funding from one of the… Read more about Why is Colorado Health OP shutting down?

A harvest cornucopia of health wonkery

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Joe Paduda did an excellent job with this week’s Health Wonk Review. If you’re looking for some good weekend reading material, look no further. I highly recommend Roy Poses’ article highlighting yet another case of the industry-government revolving door, and Max Horowitz’s summary of House v. Burwell and its implications for the ACA’s cost-sharing subsidies. And… Read more about A harvest cornucopia of health wonkery

Colorado Health OP risk corridor payment shortfall

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EDIT 10/7/15: Updated information from Colorado Health OP added at the end of this post. EDIT 10/17/15: Updated with more details about the budget-neutrality of the risk corridor program.  EDIT 10/20/15: On October 19, Colorado Health OP filed a lawsuit in Denver District Court, seeking an injunction and temporary restraining order to allow them to participate in the… Read more about Colorado Health OP risk corridor payment shortfall

IRS 2016 HSA contribution limits and out-of-pocket maximums

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Open enrollment is just around the corner, and it’s time to start thinking about the health insurance plan you want in 2016. HSA-qualified high deductible health plans (HDHPs) have remained a popular choice among consumers, with enrollment climbing every year for more than a decade. And while there used to be concerns that the ACA’s… Read more about IRS 2016 HSA contribution limits and out-of-pocket maximums

Potential legislation could change how health insurance works in Colorado

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The Colorado Health Insurance Exchange Oversight Committee (a group of five Senators and five Representatives) met last week to discuss possible legislative ideas that could alter the health insurance system in Colorado.  The committee “passed” four bill ideas, which means they’ll be drafted by the Legislative Council this week and discussed in more detail at another… Read more about Potential legislation could change how health insurance works in Colorado

Health Wonks and Selfies

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Steve Anderson did a great job with the selfies edition of the Health Wonk Review, hosted at MedicareResources.org this week.  There’s plenty of great reading material in this edition, so be sure to check it out.  Some of my favorites: Wendell Potter’s article about prescription drugs, Medicare, lawmakers, and pharmaceutical lobbying is a must-read.  The… Read more about Health Wonks and Selfies

Access to healthcare in Colorado: A new day, but there’s still work to be done

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Colorado Uninsured Rate Down 53% Every other year since 2009, the Colorado Health Access survey has been conducted by interviewing at least 10,000 Colorado households on a variety of health-related metrics.  The 2015 report was released on September 1, and is aptly titled “A New Day in Colorado.”  One of the biggest headline grabbers in the latest… Read more about Access to healthcare in Colorado: A new day, but there’s still work to be done

Universal healthcare in Colorado – does one size really fit all?

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Universal healthcare coverage could be a reality in Colorado a few years from now, although it admittedly has some significant hurdles to overcome in the meantime.  Supporters need to gather 99,000 signatures in order to get the ColoradoCare initiative on the 2016 ballot.  And then voters would need to approve the measure in order to… Read more about Universal healthcare in Colorado – does one size really fit all?

A petition to make pregnancy a qualifying event in Colorado – but something doesn’t add up

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Last month, Broomfield resident Sean Jenks created a Change.org petition asking Colorado lawmakers to allow a special enrollment period for women who become pregnant.  It’s picked up considerably steam in the last 24 hours, and now has more than 13,000 supporters. Jenks points out that New York and California have taken steps to make pregnancy… Read more about A petition to make pregnancy a qualifying event in Colorado – but something doesn’t add up

Broker participation in Connect for Health Colorado

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As of the end of June, Connect for Health Colorado had 134,200 people with effectuated individual private plan enrollments for 2015.  Of those, 62,146 had help from a broker, and 9,509 had help from a health coverage guide (Colorado’s version of navigators).  According to the Connect for Health Colorado 2015 enrollment report, just 1% of… Read more about Broker participation in Connect for Health Colorado

Connect for Health Colorado board meeting – Jay’s proposals

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Earlier this month, Representative Hullinghorst, the Speaker of the Colorado House of Representatives, appointed Jay to the Connect for Health Colorado board of directors.  Jay and I have always worked as a team, and we’re honored and excited to have the opportunity to help guide the exchange going forward.  We welcome feedback from the rest… Read more about Connect for Health Colorado board meeting – Jay’s proposals

Proposed rate increases in Colorado: CO-OP up 21%, Kaiser up 2%

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The back-story Last September, when we wrote about the fact that the average individual rates increase in Colorado was less than one percent for 2015, we noted that the overall rate increase was astoundingly low – far lower than anything we’d seen during our time in this industry. And although it will be several more weeks… Read more about Proposed rate increases in Colorado: CO-OP up 21%, Kaiser up 2%

Health wonk reading for the Memorial Day weekend

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Julie Ferguson did an outstanding job with this week’s Health Wonk Review, and it’s full of great articles from our favorite health wonks. A must-read is Charles Gaba’s excellent run-down on what you need to know about rate increase filings.  Gaba’s is the wizard behind ACAsignups.net, and he does an outstanding job of crunching up… Read more about Health wonk reading for the Memorial Day weekend

The Luis Lang story – an update and my own thoughts

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Last week, Ann Doss Helms wrote an article for the Charlotte Observer about Luis Lang, a SC man with diabetes who will go blind if he doesn’t get eye surgery in the near future.  In a nutshell, Luis Lang is a Republican who opted to ignore the ACA’s individual mandate in 2014, and he also… Read more about The Luis Lang story – an update and my own thoughts

Health Wonkery – replacing Obamacare, covering undocumented immigrants, and much more

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Joe Paduda did an excellent job with the latest edition of the Health Wonk Review over at Managed Care Matters.  My favorite post in the HWR comes from Tim Jost, writing at Health Affairs.  His article, about what would replace the ACA if it were repealed, is an excellent read.  Jost digs deep into the… Read more about Health Wonkery – replacing Obamacare, covering undocumented immigrants, and much more

A new job is not a qualifying event for a SEP

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Now that open enrollment is over, the only way people can enroll in individual health plans is with a qualifying event.  This applies both on and off the exchange. Outside of open enrollment, individual/family health insurance is only for sale if you’ve got a special enrollment period triggered by a qualifying event. So what constitutes… Read more about A new job is not a qualifying event for a SEP

What if your coverage gap spans two calendar years?

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Last week, I wrote a post detailing exactly how the ACA’s “short coverage gap” exemption works.  In a nutshell, as long as your gap in coverage is less than three months long and you maintain coverage for the rest of the year, you don’t have to pay a penalty for being without coverage. In that… Read more about What if your coverage gap spans two calendar years?