HHS today announced new PPACA guidelines pertaining to women’s health, listing several services that must be covered by health insurance plans with no cost sharing by the insured. In scrolling through healthcare news this morning, I saw numerous headlines stating that birth control and breast pumps must be covered by health insurance with no copays. This is true, but the requirements don’t take effect for another year (August 1, 2012) and will apply to new policies that begin on or after that date. […]
Welcome to Grand Rounds! It’s the third time we’ve hosted Grand Rounds at the Colorado Health Insurance Insider and we’re honored to be hosting again. It was a pleasure to read so many great articles for this edition. Since our blog tends to focus on health care policy and reform, I’m starting things off with the posts that pertain to that topic. Enjoy!
[…] 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. […]
[…] 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?
[…] 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. […]
Since January 1, 2011, all new individual health insurance policies issued in Colorado have included maternity coverage as required by a new state law. The text of the bill was quite clear in stating that its provisions would apply to all “policies issued or renewed on or after the applicable effective date of this act.” (see the top of page 3 of the text). But until now, there was still some confusion around maternity coverage and policy renewals, and inconsistencies in how the law was being applied. […]
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. […]
The New America Foundation (NAF) and the University of Denver’s Center for Colorado’s Economic Future recently published a new study in conjunction with The Colorado Trust and The Colorado Health Foundation. The study was designed to look at the projected economic outcomes for the state of Colorado with and without health care reform. For the reform scenario, the researchers concentrated on the recommendations created by the Colorado Blue Ribbon Commission (208 Commission) a few years ago. They compared that data with the projected outcomes if we do nothing and simply maintain the current system with regards to health care. […]
Anyone looking to compare plans with 2011 rates can start with Anthem BCBS, Assurant, and Rocky Mountain Health Plans (get quotes here). These will include maternity coverage. More coming this week….
America’s Health Rankings released their annual report this month, and Colorado fell from 8th place in 2009 to 13th place in 2010. Overall, Colorado does quite well in terms of current health outcomes, but we fall short in terms of some factors that could lead to lower health outcomes over time (insurance coverage, geographic disparity, and immunization rates). […]
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. […]
[…] 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.
[…] 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. […]
[…] 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.
[…] 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.
[…] 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 is the only state in a recent report by HealthGrades to rank in the top ten for all three aspects of women’s care studied (see appendix D on page 15 of the report). Although only three hospitals in Colorado received the HealthGrades 2009/2010 Women’s Health Excellence Award: North Colorado Medical Center in Greeley, Poudre Valley Hospital in Fort Collins, and Centura Health-Penrose Saint Francis Health Services in Colorado Springs. […]
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. […]
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
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. […]
[…] It would be nice to see more options available for our clients who are looking for maternity coverage. My preference would be if clients could select their health insurance policy based on all of the other features of the plan, and then add maternity benefits after they had settled on a policy, rather than choosing a policy by default simply because it is one of a very few options that offer maternity benefits.
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. […]
[…] Amy Romano has written an outstanding article comparing modern American maternity care with SUVs. Since maternity care takes up such a huge portion of our health care budget, this article is a worthwhile read for anyone concerned about the spiraling cost of health care. Hopefully the points that Amy makes will be taken into consideration when lawmakers decide what services should be covered by all health insurance policies.
Not surprisingly, House Democrats are going after the female vote by including several provisions in the current draft of their health care reform bill that are designed to expand coverage and reduce premiums for women. For starters, the bill includes a ban on using gender as a factor in setting premiums. This will result in lower premiums for women, but higher premiums for men. In Colorado, men are currently more likely than women to be uninsured. Raising their rates to compensate for lowered rates for women might result in more men being uninsured. But in terms of overall fairness, it does make sense to charge the same rates for men and women.
Specifically forbidding the practice of denying coverage to domestic violence victims is also part of the House bill, and will likely receive widespread support from both women and men alike. But in the eight years since we started selling medically underwritten health insurance, I can’t remember a single time that an applicant was declined for being a victim of domestic violence, nor have I ever seen a question on any application asking if the applicant has been abused. So while this provision makes sense, and will no doubt be beneficial for a few people, I imagine its strongest impact will be in helping to rid us of “blaming the victim” mentality […]
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. […]