Colorado's Senate advanced another piece of Democratic Gov. Jared Polis' health care agenda on Tuesday by tentatively endorsing a study on creating a state-run health insurance option.
The bill would direct state agencies to recommend a plan that would compete with existing private insurance plans and those offered on Colorado's health care exchange. Another Senate vote sends the study bill to the governor. It's already cleared the House on a bipartisan 46-17 vote.
On the surface, this sounds pretty much like the state-level Public Option bill which has quietly been rushed through the Washington State legislature over the past few weeks. Unlike the Washington bill, however, it looks like the Colorado legislature is covering a few more bases...particularly funding:
A couple of weeks ago I reported that the Colorado legislature was moving on an ACA reinsurance bill which, on the surface would seem to be similar to other reinsurance programs implemented in over a half-dozen other states to cut down on individual market premiums. The Colorado bill, however, had an unusual funding mechanism:
While similar programs have gone into effect in a number of states, Colorado’s funding mechanism for reinsurance would be an innovative approach. This mechanism utilizes Medicare reference-based pricing to bring down health care costs (what is paid to hospitals and doctors). Medicare-reference-based pricing means that the hospitals, doctors and other healthcare providers would be paid a percentage of what Medicare would pay. For example, the program may pay 150 percent (or 1.5 times) of what Medicare would pay for services, which would be less than what is currently paid to healthcare providers. That savings is then passed on to consumers in the form of lower premiums.
Back in January I reported that the state of Colorado is joining several other states in cracking down on non-ACA compliant so-called "Short-Term, Limited Duration" healthcare policies. As of April 1st, STLDs:
Can last no longer than 6 months/year (still longer than the 3-mo limit under Obama)
Have to stick to the ACA's 3:1 age band limit on premiums
Must be guaranteed issue (no more medical underwriting)
They can still exclude coverage of pre-existing conditions, but there's a limit of 12 months on the lookback timeframe
Must cover all 10 of the ACA's Essential Health Benefits
Must follow other ACA community rating requirements (limiting variances to age, tobacco use and geographic area)
A minimum Medical Loss Ratio of 80% to match the ACA's MLR (currently CO only requires a 60% MLF)
In other words, Colorado just made STLDs follow most of the same rules as ACA-compliant policies.
A couple of weeks ago, I noted that Colorado is joining over a half-dozen other states in moving forward with their own ACA reinsurance program 1332 waiver request. At the time, I was a bit vague as to just how much the program, if approved, would actually lower unsubsidized premiums, especially since the wording of the bill differentiates between different rating areas:
The Commissioner shall set the payment parameters at amounts to achieve:
Via Email from the Connect for Health Colorado exchange...
Customers Receiving Financial Help Through Connect for Health Colorado® Seeing a 14% Drop in Net Monthly Premium Cost
DENVER – Coloradans who get financial help buying health insurance through Connect for Health Colorado® are paying an average 14 percent less in “net premium” – what they pay after assistance – compared to the average net premium in 2018, according to data released today.
Three of every four current Connect for Health Colorado customers qualify for financial help to reduce the monthly cost of health insurance. The average net premium for those Coloradans is $117 per month, down from $136 per month last year.
“We are happy that we are able to make health insurance affordable for so many people,” said Kevin Patterson, Chief Executive Office of Connect for Health Colorado. “The number of our customers receiving help rose this year by seven percentage points, to 76 percent, an important increase. We know we have more work to do, and are committed to expanding our impact as we work with policy makers, our stakeholders and our customers throughout the state.
In the 5 1/2 years that I've been operating this website (has it really been that long?), I was surprised (pun intended) to realize that out of the 5,600+ blog entries that I've posted, only 2-3 have mentioned "Surprise Bills" (also known as "Balance Billing", although I think there are some differences between the two):
OK, I'm not sure how this one slipped by me...over the past year, a half-dozen states having 1332 Waiver Reinsurance programs approved by CMS (among the few modifications of default ACA provisions approved by the Trump Administration that I agree with).
The states approved have included red ones like Wisconsin and Alaska...but also blue ones like Maryland and New Jersey. For whatever reason, CMS Administrator Seema Verma, while doing all she can to sabotage the ACA in other ways, seems to have a soft spot in her heart for reinsurance, which I'm not going to complain about.
In any event, along with the states which have already had their reinsurance waivers approved, there are several other states where reinsurance proposals have been proposed by either state legislators or governors, including the newly-elected governors of Michigan (Gretchen Whitmer) and Connecticut (Ned Lamont) respectively.
By the close of this year’s Open Enrollment, Coloradans had selected 169,672 medical insurance plans, which compares to 165,777 medical plan selections for the 2018 Open Enrollment period.
Hmmm...I'll have to look into these numbers a bit further. Colorado's 2018 Open Enrollment total was indeed 165,777 according to C4HCO...but according to CMS's official report it was only 161,764 QHP selections. This is the same thing which happened last year, when C4HCO reported 172,361 QHPs vs. CMS's 161,568. It's therefore possible that the final/official 2019 CMS report will put Colorado's total around 4,000 enrollees lower than my own numbers.
However, either way, Colorado joins Massachusetts in increasing their ACA open enrollment numbers every year for five years straight, bucking the national trend!
As I noted a few weeks ago, I haven't written a whole lot about the idiotic (but terrifyingly so) TexasFoldEm lawsuit in awhile. Part of this is because I was out of the country over the holidays; part is because there hasn't been a whole lot of movement on the case since right-wing federal Judge Reed O'Connor ruled that the ACA was unconstitutional using a legal argument so thin it hula hoops with a Cheerio.
Last year I briefly attempted to keep track off the dozens of various state-based "ACA 2.0" protection/improvement bills flying around various state legislatures. I eventually abandoned this project since it became too difficult to keep up with, but I'm still reporting case studies as they come to my attention...and Louise Norris has just alerted me to some pretty big changes going into effect in Colorado this April.
First up: Short-term plans are being heavily neutered. In addition to being limited to 6 months per year (which is still longer than the Obama Administration's 3-month cut-off)...
Short-term plans will have to charge older adults no more than three times as much as they charge younger adults. Short-term plans are generally not available after a person is 64, but a quick check of plans currently available in Colorado show that some insurers are charging a 64-year-old up to seven times as much as a 21-year-old. That will have to stop as of April.
Connect for Health Colorado® Sees Increase in Number of Coloradans Receiving Financial Help in Sixth Open Enrollment Period
DENVER – More than 169,000 Coloradans selected health coverage for 2019 through the state health insurance Marketplace by the close of Open Enrollment Tuesday, an increase of 2 percent over the previous Open Enrollment period, according to new data released today by Connect for Health Colorado®, and the number getting financial help buying insurance grew sharply.
About three of every four people—77 percent – who chose health insurance through Connect for Health Colorado qualified to receive financial help to reduce their monthly premium. That is up from 69 percent in 2018 and 61 percent in 2017.
If you encounter long hold times today and are unable to get through to our Customer Service Center on Jan. 15 to complete your enrollment, please contact our customer service center no later than 6:00 p.m. on Friday, Jan. 18 to complete your enrollment. At that time, you must let the representative know that you were unable to get through on Jan. 15.
Oddly, the message didn't include C4HCO's actual phone number: 855 752-6749
Covered California’s Iconic Bus Tour Rolls into San Francisco to Promote Health Insurance Enrollment Ahead of Final Deadline
Covered California’s bus tour promotes enrollment and encourages consumers to see if they are eligible for financial help in obtaining quality health insurance.
The San Francisco visit coincides with the release of Governor Gavin Newsom’s budget which focuses on making health care more affordable through increased financial help and a state individual shared responsibility provision.
Consumers have through Jan. 15 to sign up and select a plan, through Covered California or directly with health plans, for Feb. 1 coverage.
An estimated 1.1 million uninsured Californians are eligible to enroll in Covered California and research shows that 82 percent of uninsured consumers surveyed, who are eligible for financial assistance, do not know that they qualify.
Rural Counties Lead Connect for Health Colorado® 2019 Health Coverage Sign Ups; Many Have Already Passed 2018 Totals
DENVER – Rural counties are leading the way in Connect for Health Colorado® sign ups as the state health insurance marketplace heads to the last week of the 2019 Open Enrollment period.
Overall, 2019 health plan selections through Connect for Health Colorado are running about 3 percent ahead of the comparable period a year ago but many rural counties have already exceeded the number of plan selections made in the entire two-and-a-half-month Open Enrollment period in 2018.
By January 3, 2019, 30 of the state’s 64 counties had matched or exceeded the number of plan selections made during all of last year’s Open Enrollment.This year’s Open Enrollment runs through January 15.