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Maternity/Pregnancy

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

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

Contraceptive Coverage And The PPACA

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[…] Anyway, assuming that we’re talking about contraceptives for women, new health insurance policies – except those that are exempt based on religious reasons – will cover contraception with no copays or deductibles. Non-grandfathered plans (grandfathered means that the policy was in effect prior to the PPACA being signed into law and that the plan has not made any significant changes since then) will have to start covering contraceptives as of each plan’s renewal date. This is similar to how the state maternity mandate worked in Colorado last year. New policies had to start covering maternity on January 1, 2011. But existing policies added it throughout the year as each plan renewed (for example, my family’s health insurance plan renews each year in November, so our maternity coverage didn’t begin until November 2011). This brief from the Kaiser Family Foundation website has a lot of good information regarding contraceptive coverage and should help to clarify the issue a bit. […]

CHP+ Premiums Will Result In More Uninsured Kids

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[…] However, the real world is not always ideal. The Post editorial makes some very good points, and I don’t doubt that if CPH+ moves to a monthly premium system this summer, there will be some kids who lose their coverage, and fewer children will enroll in the future compared with how many would have enrolled if monthly premiums were not part of the deal. […]

Makena – No Good Options For Health Insurers

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[…] Over the last several years, most of the major health insurance carriers in Colorado have increased the out of pocket portion that an insured has to pay for prescriptions. Most individual policies now have prescription deductibles, and a lot of carriers have designated very expensive drugs as a separate tier that requires a percentage copay from the insured, rather than a flat amount. And of course, premiums continue to climb. The Makena story is an example of why this happens, and it has nothing to do with health insurance carrier profits. When insureds see their health insurance premiums skyrocket again, where do you think they will point their finger?

Does Colorado’s New Maternity Law Impact Underwriting?

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[…] 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. […]

A Bill To Extend And Enhance The Regulation Of Midwifery In Colorado

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I often write about bills in the Colorado legislature that pertain to healthcare, but Senate Bill 088 is one that is particularly important to me on a personal level. The law in Colorado regarding the regulation of direct-entry midwives is up for review this year. SB 088 renews the existing regulations, and would also allow direct-entry midwives in Colorado to provide some additional services, such as sutures and the administration of Vitamin K to newborns and RhoGAM to Rh- mothers. […]

Maternity Coverage In The Individual Health Insurance Market

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The House Committee on Energy and Commerce released a memorandum this week detailing the practices of the four largest private health insurance carriers (Aetna, Humana, UnitedHealth Group and Wellpoint) regarding maternity coverage on individual policies. For anyone who is familiar with the individual health insurance market, the details of the memo will come as no surprise. But since the majority of Americans are covered by group health insurance plans that cover maternity just like any other claim, the details of how maternity coverage works in the individual market may be eye-opening for a lot of people. […]

Healthcare.gov A Good Resource For Brokers

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I spent some time on the Healthcare.gov website this morning, and found some great resources that could be particularly helpful for people with pre-existing conditions who are unable to obtain coverage in the individual market. The website was set up in conjunction with the PPACA and was designed to help people navigate the myriad of health insurance options available, along with the changes that will happen over the next few years as the provisions of the PPACA go into effect. […]

Not Many Details Yet On Maternity Coverage In Colorado

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[…] We still have several months left in 2009 for regulators and insurance companies to work out the details, and I’m sure we’ll know more by the end of the year. When you combine this with the new Colorado law banning gender rating on health insurance policies, and the myriad of reforms coming from the federal government, I’d say that health insurance regulators in Denver are going to have their hands full for a while.

Standardizing Payments For Childbirth

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[…] that could become the standard payment for all births, regardless of whether a c-section were performed or not. There would be no financial incentive for doctors to opt for c-sections, as they would no longer receive higher compensation for doing so. The tough medical malpractice environment that OBs practice in would likely provide more than enough motivation for them to continue to do c-sections when there was a true medical emergency, despite the fact that they would know there would be no additional compensation for the birth. […]

An Economist’s View Of Midwifery

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[…] In addition, we have a malpractice system that provides a strong incentive for doctors to perform c-sections at the first hint of a problem. With a system like that, it’s hard to fault OBs for taking the c-section route, and intervening in general. We can wring our hands all we want about how we need to reduce the rate of c-sections and medical interventions during childbirth, but as long as our malpractice system penalizes doctors for avoiding c-sections, we won’t make much progress.

Too Much Medical Care

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[…] Much has been said about how we need to reign in health care costs in order for health insurance to be universally affordable. But we also need to figure out how to just use less medical care all around. We need to find ways to support health rather than react to illness (diet is a good place to start). And we need to question just how much we want our lives to revolve around medical intervention, pharmaceutical concoctions, and beeping machines. As Dr. Welch noted, some medical interventions are absolutely essential and worthwhile. But that is not the case for all medical care, and a “less is more” approach might create a healthier population and lower health care costs.

Information About Medical Cost Sharing Programs

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[…] But the reason I have health insurance is to protect our family in the event of a catastrophic illness or injury. If that were to happen, I want to know that I have a real health insurance company paying my bills, and legal recourse in the event of a dispute. I like knowing that my health insurance policy is regulated by Colorado’s Division of Insurance, and I like the fact that it doesn’t say “this is not health insurance” anywhere on my policy information. […]

Colorado Governor Signs Bill Requiring Maternity Coverage On All Policies

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Governor Bill Ritter signed Colorado House Bill 1021 into law last week, instituting what I consider to be one of the most significant changes to health insurance law in recent years. The law will require all health insurance policies in Colorado to provide coverage for both maternity care and contraception, starting next year. Without this law, people who purchase individual health insurance have very little in the way of options for maternity coverage. […]

Options For Maternity Coverage In Colorado Disappearing Fast

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Getting individual health insurance with maternity benefits just got a lot harder for women in Colorado.  For the last few years, there have only been three major carriers that offered maternity coverage on individual policies: Golden Rule (United HealthOne), Assurant, and Rocky Mountain Health Plans.  As of the end of April 2010, both Golden Rule… Read more about Options For Maternity Coverage In Colorado Disappearing Fast

Going In The Wrong Direction

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Amnesty International has released a shocking and sobering report about maternal mortality in the US. In 1987, there were 6.6 maternal deaths per 100,000 live births. Two decades later, that number had risen to 13.3 deaths per 100,000 live births. Part of the increase is due to better reporting, but there are also more women dying from pregnancy complications than there were in the 80s. […]

Colorado Legislative Sessions Opens With Health Insurance Reform Bills

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The 2010 legislative session in Colorado got underway this week, and included the introduction of a few bills aimed at health insurance reform on a state level. HB 1008 would make it illegal for gender to be used in the determination of health insurance premiums, HB 1021 would require reproductive services to be covered by health insurance, and HB 1004 would implement standardized explanation of benefit (EOB) forms for insureds. […]

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. […]

The Safety Of Planned Home Births

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[…] I’d like to see homebirth midwifery legalized and regulated in every state. I’d also like to see it as a covered expense on any health insurance policy that covers maternity. In Colorado, home birth midwifery is legal and regulated, but midwives have to jump through a lot of hoops to get paid on the rare occasions when their clients’ health insurance policies cover home birth expenses. […]

Overutilization Of Healthcare

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[…] Was my friend’s doctor practicing defensive medicine? Probably. Was she just trained to see problems, and thus spotted one that turned out to be nothing? Whatever happened, it absolutely had an impact on the healthcare costs associated with my friend’s pregnancy and birth. Eight extra ultrasounds and 24 hours of testing and monitoring in the NICU are not cheap. […]

Surgery Might Not Be Best For Breech Births

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[…] In the current quest to reform health care, everyone is talking about controlling costs. Lowering the rate of c-sections would have a significant impact on the cost of maternity care, since vaginal births are much less expensive than surgical births. Maternity care is something that most women eventually use, and lowered costs would translate to lowered health insurance premiums for all of us. […]

Hard To Please Everyone With A Single Health Plan

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[…] There really is no one-size-fits-all when it comes to health insurance. In terms of health care reform, unless someone just starts handing out free health care (without tax increases or premiums…), it will be tough to get people to agree on a single plan, or even a handful of coverage options. […]