Colorado’s junior senator, Micheal Bennet, has made health care reform a major priority during his time in Washington, and has campaigned tirelessly for stronger consumer protections and expanded access to health insurance. Since Colorado is so divided in terms of political views and opinions on health care reform, Bennet’s stance has won him both enemies and friends.
His website has a summary of reforms that are included in the bill the Senate passed last month. The removal of lifetime limits on health insurance benefits reminds me of Nathan Wilkes and his family, for whom this legislation can’t come soon enough. The standardization of benefit explanations and medical bills will benefit just about everyone, since wading through paperwork is rarely considered fun. The removal of pre-existing condition limitations will mean that more people can take the leap into self-employment without being tied to a group health insurance policy (of course, in order for guaranteed issue coverage to really work, everyone has to be in the health insurance pool, not just sick people).
But I’m a bit hung up on item number 7. Free preventive care – no copays for screenings, check-ups, and vaccinations. Sounds good, but we all know that nothing is free. The fees for the services will still be there, we just won’t be paying them at the time of service. Perhaps premiums will increase to cover more preventive care. Perhaps taxes will increase so that the government can subsidize care. Maybe fees for other services will increase in order to offset the cost of preventive care. However they get around it, we’ll still be paying for it. My concern is that if all policies have cover preventive care with no copays, that limits choice and flexibility for people who would rather pay lower premiums for their health insurance and pay for their own preventive care (via an HSA or other personal funds). And what would count as preventive care?
We have sometimes had clients who prefer to pay additional premiums in order to get a health insurance policy with good preventive care. For them, there are policies in the individual market (like the Anthem Blue Cross Blue Shield Lumenos HSA) that offer great preventive care. But other clients prefer to have lower premiums and pay for their own preventive care on an as-needed basis, or to utilize services like the 9Health Fair. Flexibility and options are a major advantage of individual health insurance, but I’m concerned that by mandating preventive care benefits with no copay on all policies, premiums will rise to offset the cost.
In Colorado, a similar law took effect last week, requiring health insurance companies to cover various preventive care at the level of the policy co-insurance. It will be interesting to see how this law impacts both premium and health in Colorado over the next few years. Will more people seek out preventive care? Will we be healthier as a result? Will our health insurance premiums increase even more than they already do? We’ll have to wait and see.