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Why ACA Compliant Plan Premiums Will Vary Significantly In 2014

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David Williams did an excellent job with the most recent edition of the Health Wonk Review – be sure to check it out.  One post that everyone should read comes from Health Affairs Blog, and was written by Joel Ario, Adam Block and Ian Spatz.  They dig into the details of Silver plan premiums in four major US cities, finding lots of variation in pricing in some areas, and surprisingly little variation in others.  As premiums have been slowly publicized over the last several weeks, I’ve seen numerous articles describing rates for ACA-compliant plans and how they vary from one Why ACA Compliant Plan Premiums Will Vary Significantly In 2014plan to another within the same metal designation.  But the Health Affairs article is the most thorough and helpful that I’ve read.  The authors not only explain the details, but they also provide five very well-reasoned explanations for rate variation.  If you’re confused about premiums for ACA-compliant plans, this article is a must-read.  It’s also helpful in terms of helping people understand how plans can differ – even at the same metal level – beyond the basic deductible/copay amounts.

Wide variation in health insurance rates is nothing new.  When I run current quotes (not yet 2014 ACA-compliant) for my own family, I get 11 pages of results, with prices ranging from $238/month to $1889/month.  Much of that is explained by the vast differences in deductibles ($10,000 for the lowest priced plan, $500 for the highest), but even if I focus on plans that all have the same deductible ($5000, just to pick a middle-of-the-road number), I still get rates that range from $325/month to $924/month.  Plan designs can vary greatly from one carrier to another, and provider networks make a big difference in terms of explaining premium variation from one area to another within a state (as an example here in Colorado, the carriers that offer the best rates in the Denver metro area and along the front range are typically not the same carriers that offer the best rates in the mountains or even in nearby Boulder, and much of the variation has to do with provider networks).

So it’s not at all surprising that rates will be significantly different from one carrier to another next year, both in and out of the exchanges.  In most states […]

Removing An Exclusion Rider On Our Policy

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[…] It’s a lot of hoops to jump through, but if you have an individual health insurance policy in a state like Colorado that allows pre-existing condition exclusion riders, you might want to double check to see if your rider can be re-evaluated. Most carriers in Colorado require that the condition be resolved for at least a year before you can request a review of the rider. […]

Colorado House Kills Oral Chemotherapy Bill

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The Colorado House killed a bill today that would have required Colorado health insurance companies to cover oral chemotherapy pills. Diane Primavera (D-Broomfield), sponsored Senate Bill 250 in the House, and had support from patient advocate groups and the pharmaceutical industry. But the House Health and Human Services Committee voted 7 – 4 to kill the bill. […]

The Art And Science Of Choosing Providers

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[…] Provider quality rankings are a piece of the puzzle for sure, but they’re not the only piece. I do think they will get more popular if health insurance carriers start actively encouraging patients to select from among the highest ranking providers. But there are other factors that go into choosing a provider that can’t be quantified on a spreadsheet or a graph.

Where The Uninsureds Live

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[…] In Colorado, there are 12 counties with at least 29.7% of their population with no health insurance. I think this micro-analysis of the uninsured population is long overdue, and I’m hopeful that it will help lawmakers and health insurance carriers target the hardest hit areas when new policy designs and future government health care subsidies are introduced.

Drugs In Our Water

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[…] The problem of drugs in our water supply in Colorado and throughout the US is scary and formidable. Drug companies should be required to implement safe systems for re-distribution of unused medications. Health insurance carriers should put pressure on pharmaceutical companies in this regard, since drugs that are getting flushed down the toilet aren’t free.

Uninsured Patients Not Causing ER Overcrowding

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and thus three emergency rooms – are within 20 minutes of our home in Broomfield Colorado (and if we were to go a few miles down the road to Denver, there are several more). But I don’t know the location of any urgent care facilities near our home. So in the event of a serious illness or injury, my first reaction would probably be to head for an emergency room […]

Bad Timing

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A proposal to offer health insurance to about 180,000 Colorado children who lack coverage got bipartisan support Wednesday in a Senate committee. Senate Bill 211 would raise the income limits for kids to receive coverage under the Medicaid and Children’s Basic Health Plan programs. It also would fund a team of state workers to find… Read more about Bad Timing

Vaccine Required on Colorado Health Insurance?

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As Colorado lawmakers consider one proposal to promote the vaccination of young girls against cervical cancer, they’re also looking at another measure that would require all health insurance companies to pay for shots for their patients. The measure from Reps. Bernie Buescher and Dianne Primavera, D-Broomfield, would also set aside $1.5 million from the state’s… Read more about Vaccine Required on Colorado Health Insurance?