Claiming the ACA tax credit after paying full price for your health insurance

Most people know that there are premium tax credits (often referred to as premium subsidies) available for people who buy their health insurance through Connect for Health Colorado. But claiming the ACA tax credit as an advanced subsidy requires you to estimate your income for the coming year and supplying supporting documentation to verify that […]

Treating Employees Differently: Employer Contribution Requirements

Employers offering small business group health insurance benefits have flexibility treating employees differently as long as the contribution policy complies with the insurance company’s employer contribution requirements and basic non-discrimination laws (HIPAA and Section 125). Employers can contribute a flat dollar amount, or they can require employees to pay a set percentage or a set […]

2018 Colorado Individual/Family Market Specialist Maps

Last week, I shared charts showing how many total providers are in each individual market insurer’s network, and compared that with total enrollment for each insurer. But the total number of providers doesn’t tell the whole story. Network adequacy issues still arise for specific consumers when an insurance plan might have many primary care providers, but […]

2018 Colorado Individual Market Enrollment and Total Medical Providers

2018 Connect for Health Colorado Individual Market Enrollment

2018 Essential Community Provider Maps

Network coverage is an important part of picking a health insurance policy. And while the insurers and the exchange have tools that will let you check to see if your doctor is in-network with the plan you’re considering, those tools aren’t as helpful if you don’t have a specific provider in mind and just want […]

State Approaches to Handling CSR Uncertainty for 2018 Premium

Joint post by: David Anderson, Charles Gaba, Louise Norris, Andrew Sprung Note: this post is a joint effort with colleagues who have closely tracked the CSR chaos induced by Trump and Republicans in Congress. Dave Anderson is a former health insurance analyst, now a health care scholar at Duke, and a blogger at Balloon Juice; Charles Gaba is […]

Weekend reading recommendation: The Summer Lull edition of the HWR

Peggy Salvatore has done an excellent job with this week’s edition of the Health Wonk Review, hosted at her Health System Ed blog. There’s something for everyone, and it makes for some great weekend reading. Two of my favorites in this edition are Harold Pollack’s explanation of why red states that voted for Trump would […]

2017: Made for health wonks

Joe Paduda hosted the Health Wonk Review on Friday, and it’s a must-read edition. It coincided perfectly with the release of the long-awaited, top-secret Senate GOP health care reform bill, and Joe’s edition includes an everything-you-need-to-know summary of the Senate bill, written by the inimitable Tim Jost and Sara Rosenbaum. In related news, Joe is […]

Groundhog Zombie Goes Back to the Future: AHCA Vote Day Health Wonk Review

Yesterday was a bit of a banner day in health care reform circles, with the passage of the AHCA in the House of Representatives. The vote came less than 24 hours after the final amendment was added to the bill, and before the CBO had scored the last three amendments that were added. It’s now […]

Health care reform: What’s next in Colorado?

2017 has been a whirlwind year for health care reform. As rate filing season draws near, there is still considerable uncertainty surrounding the future of the ACA and what lies ahead for health care reform. Here’s a summary of where things stand in Colorado: Failed: Bill to extend premium help to people above 400 percent […]

Pre-Passover edition of the HWR at InsureBlog

Hank Stern has done an outstanding job with the Health Wonk Review this week; don’t miss his pre-Passover edition. Hank has factoids about Passover interspersed with ten excellent articles from some of our favorite health wonks. Thanks for hosting, Hank, and Happy Passover!

What do the proposed HHS regulations mean for Colorado’s individual market?

HHS Secretary Tom Price was confirmed by the Senate last week, and the agency wasted no time in drafting new proposed regulations under his leadership. The new regulations are intended to stabilize the individual and small group health insurance markets. The comment period is only three weeks (it closes on March 7, 2017), which is […]

Health Wonks Wonder… Will ACA Repeal Really Happen?

Steve Anderson hosted this week’s “#Alternative_Facts” edition of the Health Wonk Review, at It’s an excellent edition, and each entry in framed in terms of an #alternative_fact… of course, the alternative-ness depends a bit on your perspective. My favorite? Joe Paduda’s assessment that ACA repeal isn’t actually going to happen soon, and might not […]

Joe Paduda has an excellent Health Wonk Review

It’s a crazy time in healthcare and even the biggest health wonks are struggling to keep up. Get up to speed with the concisely written Health Wonk Review from our friend Joe Paduda. Hot off the press.

Health Wonks know: Words Matter

Julie Ferguson hosted the “Words Matter” edition of the Health Wonk Review this week, at Workers’ Comp Insider. Julie did an excellent job, as always, and there’s plenty of good stuff in this edition of the HWR. Some of my favorites are: Joe Paduda’s at-a-glance summary of the direction the GOP is likely headed in terms […]

Puppies and kittens and the future of healthcare reform

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, […]

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

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, […]

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

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, […]

Election Season Edition of the HWR

Peggy Salvator hosted this week’s Health Wonk Review yesterday, at her Health System Ed blog – be sure to check it out, if you haven’t already. Peggy did a great job of hosting, and there are lots of great entries. My favorites from this edition are from Health Affairs (all about the future legislative improvements […]

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

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, so if you have questions, you might find answers there. But after receiving our own family’s renewal packet […]

Pre-Election Health Wonk Musings

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 […]

Short and Sweet Health Wonk Review

Jason Shafrin has the latest Health Wonk Review at Healthcare Economist. You’ll find some of the greatest writing by healthcare experts about health insurance, pharmaceuticals, the ACA, mental health, and physician pay.

Pregnancy and Special Enrollment Periods

A year ago, I wrote an article about a petition in Colorado that was trying to get pregnancy added to the list of things that make people eligible for a special enrollment period during which they can enroll in a health insurance plan. Nothing has changed in Colorado on this issue since then, but I wanted […]

Prescription Drug Coverage: Terms and Concepts You Need to Know

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 […]