[…] The language in the Division of Insurance FAQ page does seem to create some confusion on the issue. Stating that “A person who is already pregnant may obtain insurance at this time” could be interpreted in various ways… some might see it as saying that the person may obtain insurance if the carrier allows it (which none of them currently do), while others might see it as stating that the DOI interpretation of the law requires carriers to treat a current pregnancy as a specific exclusion rather than cause for an outright decline. […]
Health Insurance Reform
Maternity Coverage On Renewing Individual Policies
Since January 1, 2011, all new individual health insurance policies issued in Colorado have included maternity coverage as required by a new state law. The text of the bill was quite clear in stating that its provisions would apply to all “policies issued or renewed on or after the applicable effective date of this act.” (see the top of page 3 of the text). But until now, there was still some confusion around maternity coverage and policy renewals, and inconsistencies in how the law was being applied. […]
Mandatory Health Insurance Does Not Prevent Medical Bankruptcies
[…] The study’s authors note that implementing mandatory health insurance rules is not likely to result in a significant decline in the number of medical bankruptcies nationwide unless we also focus on improving the level of coverage that people have (to reduce out of pocket exposure), and on expanding access to disability insurance that can help provide income to people who are unable to work because of a major illness or injury. […]
Interesting Data Regarding Pay For Performance Studies
[…] There has been much debate recently about what is the most efficient and cost-effective method of reimbursing doctors and hospitals. While most providers now are paid on a fee-for-service model, there’s concern that such a model tends to encourage over-utilization. ACOs might pose a possible solution, although their designers would be wise to ponder the data regarding pay-for-performance, since much of the success of ACOs could hinge on providers’ ability to “perform” in terms of keeping their patients healthy and avoiding costly hospitalizations.
SB 168 Introduced With Goal Of Creating Colorado Health Care Cooperative
In a continuation of the string of healthcare-related legislation we’ve seen recently, Colorado Senate Bill 168 was introduced earlier this week. SB 168 would create a nonprofit healthcare cooperative to act as the benefits administrator and payer for health care services in Colorado. Similar to several other healthcare bills we’ve seen over the years, this one would implement change in a multi-step process: first by creating a proposed Colorado Health Care Authority, which would design the cooperative and take it to the legislature and then voters for approval. […]
Repealing The Mandate – Some Simple Math
[…] As I’ve mentioned before, health care costs are what drive health insurance premiums. And until we figure out how to reduce the amount we spend on health care, health insurance premiums will continue to rise. But they will rise even faster if we require health insurance carriers to accept all applicants without imposing some sort of system that eliminates the possibility for people to wait until they are sick to purchase coverage.
Removing HSA Contribution Cap Does Not Solve Any Health Care Problems
[…] People who already max out their HSA contributions and still have money left over to contribute more would likely appreciate the removal of the HSA contribution cap. But those are not the people who are struggling to afford health insurance or pay for medical care. They are not the people our elected representatives should be focusing on when coming up with solutions for health care reform. Although I like our HSA and the flexibility it gives us to save for future medical expenses, I acknowledge that HSAs are not a panacea for what ails our health care system. […]
Few Carriers Offering Child Only Policies During Open Enrollment
[…] 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.
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. […]
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). […]
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. […]
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. […]
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.
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.
430 People Already Enrolled In GettingUsCovered
[…] Even when policies are free or very low cost (such as Medicaid or Child Health Plan Plus), a significant number of eligible individuals continue to go without coverage, for a myriad of reasons. So it stands to reason that plenty of uninsured people who are eligible for GettingUsCovered won’t apply. Some likely aren’t aware of the availability, and many others simply can’t afford to pay the premiums. But apparently Colorado is enrolling people at a fairly fast pace – as of November 1, there were 20 states that had fewer than 50 people enrolled in their newly-created high risk pools.
Funding Cover Colorado
For nearly two decades, Cover Colorado has been providing health insurance to people in Colorado who don’t have access to group health insurance coverage and have pre-existing conditions the make them uninsurable (or unable to get coverage without exclusion riders or rate increases that put their premium above that offered by Cover Colorado) in the individual health insurance market. While we’re lucky to have such a resource, it doesn’t come cheap […]
Health Reform Not Having Much Impact On Colorado Premiums
Although the increases we’ve seen this year are similar to what we’ve seen over the last several years, there have been more questions since the PPACA was signed into law in March about whether federal health care reform is the driving factor for this year’s increases. To clarify, the Colorado Division of Insurance has released a statement noting that federal health reform is responsible for less than 5% of the total health insurance premium increase in Colorado this year. […]