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Individual/Family Health

Puppies and kittens and the future of healthcare reform

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Hank Stern hosted the Health Wonk Review this week, with a theme — Puppies and Kittens — designed to unite us around something we can all agree on, after a rough election season. There are tons of great entries in this edition of the HWR. Since I’m particularly focused on the future of healthcare reform,… Read more about Puppies and kittens and the future of healthcare reform

Don’t Get Caught By The ACA Individual Mandate Penalty – It’s much higher than it used to be

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This post was originally written in March 2014, but was updated in November 2015 to reflect the changes in the penalty calculation for 2016, and again in November 2016 to address the penalty for 2017. The penalty in 2017 will remain unchanged from 2016, but it’s considerably higher than it was in 2014 or 2015,… Read more about Don’t Get Caught By The ACA Individual Mandate Penalty – It’s much higher than it used to be

You’re eligible for cost-sharing subsidies. Does that mean you should always pick a silver plan?

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A recent article published by the Colorado Center on Law and Policy (CCLP) caught my attention on Twitter today. One part of the article stood out, and I wanted to address it here. The article states that “Anyone who purchases insurance on Connect for Health Colorado would be wise to check eligibility for assistance and,… Read more about You’re eligible for cost-sharing subsidies. Does that mean you should always pick a silver plan?

New Benefits in Colorado for 2017 – Bariatric Surgery, Infertility, Chiro?

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Open enrollment is just around the corner, and you may have started receiving information from your health insurer regarding changes to your premium and coverage for 2017. I maintain a detailed overview of Colorado’s exchange at healthinsurance.org, so if you have questions, you might find answers there. But after receiving our own family’s renewal packet… Read more about New Benefits in Colorado for 2017 – Bariatric Surgery, Infertility, Chiro?

Pre-Election Health Wonk Musings

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Joe Paduda hosted last week’s Health Wonk Review at Managed Care Matters. It’s a great edition, with excellent articles from several of our favorite health wonks. I highly recommend Brad Wright’s article, detailing how the ACA has expanded coverage. My own article in this edition explains why so many health insurance carriers are leaving the exchanges at the… Read more about Pre-Election Health Wonk Musings

Pregnancy and Special Enrollment Periods

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EDIT, September 2023: As a result of legislation that was enacted in 2022, Colorado will consider pregnancy to be a qualifying event starting in 2024. This will allow a pregnant woman an opportunity to enroll in health coverage without having to wait until the baby is born. Several other states that run their own exchanges… Read more about Pregnancy and Special Enrollment Periods

Prescription Drug Coverage: Terms and Concepts You Need to Know

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What is a drug formulary? How do prescription tiers work? If you’re shopping for health insurance and take prescription drugs, you likely have questions about the prescription coverage offered by the various plans. The good news is that all of the plans available today have to cover your pre-existing conditions. They can’t deny your application… Read more about Prescription Drug Coverage: Terms and Concepts You Need to Know

HR 5447 – Should employers be allowed to reimburse individual health insurance premiums?

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HR 5447 is the Small Business Health Care Relief Act of 2016. It passed the House earlier this month, and is with the Senate now. This bill would allow employers to contribute to their employees’ individual health insurance premiums, up to a maximum of $5,130 for a single employee, or $10,260 if the reimbursement also includes… Read more about HR 5447 – Should employers be allowed to reimburse individual health insurance premiums?

Health Talk at Health Affairs

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At Health Affairs Blog, Chris Fleming hosted the Health Wonk Review this week, and it’s an excellent edition. Be sure to check it out if you’re looking for some weekend reading. Here are some of my favorites this time around: Joe Paduda’s summary of Hillary Clinton’s plans to enhance healthcare reform. Anthony Wright’s explanation of California’s… Read more about Health Talk at Health Affairs

2017 Rate Increases for Colorado Individual Health Insurance Market

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EDIT, 9/25/2016: Rates were approved recently by the Colorado Division of Insurance. The following average rate changes (actual changes will vary by plan) will take effect January 1, 2017 for the seven carriers that will offer individual market coverage through the exchange. They will also apply off-exchange, as all of these carriers offer their plans both… Read more about 2017 Rate Increases for Colorado Individual Health Insurance Market

Should Colorado become a single rating area? DOI conducting study

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Earlier this month, Governor Hickenlooper signed HB1336 into law. The law directs the Colorado Division of Insurance to “study the impacts and viability” of merging the whole state of Colorado into a single rating area for health insurance premiums. DOI spokesman Vincent Plymell noted that the DOI was eager to get going on the study. Per… Read more about Should Colorado become a single rating area? DOI conducting study

Open enrollment for 2017 coverage, and HSA contribution and coverage limits

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Open enrollment for 2017 coverage starts on November 1, 2016. The schedule for open enrollment will follow the same November 1 – January 31 dates that were used last year (that schedule will continue to be used for 2018 coverage as well, but it will shorted to just a six week window in November/December for… Read more about Open enrollment for 2017 coverage, and HSA contribution and coverage limits

Simple Choice plans in the federally-facilitated exchange

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Last month, I wrote about the standardized plans that will be optional for insurers to offer on Healthcare.gov this fall. I noted that standardized plans do not signal the end of HSA-qualified health insurance, and outlined the basic details surrounding standardized plans. The standardized plan designs that HHS finalized in the 2017 Benefit and Payment Parameters… Read more about Simple Choice plans in the federally-facilitated exchange

Health News at the Population Health Blog

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Jaan Sidorov did an excellent job with the Health Wonk Review this week. Surprisingly enough, none of the entries in this week’s edition have anything to do with the presidential campaign or the candidates’ views on healthcare reform, so Dr. Sidorov dubbed it the “presidential politics-free” edition. There’s lot of good stuff in this round… Read more about Health News at the Population Health Blog

Standardized plans don’t signal the death of HSAs

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Is the HSA (health savings account) an endangered species? Yes, if you believe this National Review article. But at InsureBlog, Hank Stern explains why a lot of the National Review’s points are essentially conjecture. I agree with Hank on this one, and there’s more to the story if you read the details in the 2017 Benefit… Read more about Standardized plans don’t signal the death of HSAs

Last week’s HWR, and an upcoming “blab” chat

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I’m a bit behind the times here, but Charles Gaba hosted the Health Wonk Review at ACAsignups last week, and there’s plenty of good health wonkery over there for your reading pleasure. In addition, the Health Wonk Review is teaming up with David Harlow – of HealthBlawg fame – to begin hosting a “blab.” This… Read more about Last week’s HWR, and an upcoming “blab” chat

Commission cuts aren’t the same in states with state-run exchanges

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EDIT, March 29, 2016: In addition to having state-run exchanges, there’s another factor involved here, which is much more likely to be the correct explanation. California, Colorado, Connecticut, and Kentucky are the four states that have taken regulatory action to prevent health insurance carriers from cutting commissions. Although my initial hypothesis wasn’t bad, direct action… Read more about Commission cuts aren’t the same in states with state-run exchanges

Healthcare Reform: The Path Forward

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Welcome to the Health Wonk Review! It’s been nearly six years since the ACA was signed into law. And although most aspects of the law have now been implemented, the debate over its merits have not let up. In this election year, healthcare reform continues to be a hot topic, even dividing Democrats in terms… Read more about Healthcare Reform: The Path Forward