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Colorado Health Insurance Insider

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uninsured

Hospital Payment Assistance Program Will Benefit Colorado’s Uninsured Population

April 26, 2012 By Louise Norris

[…] SB12-134 will result in some significant changes in terms of how uninsured patients are billed when they receive treatment in a hospital (note that the bill only applies to hospitals – outpatient clinics, medical offices, and other non-hospital providers will not be impacted). Most people are aware that private health insurance carriers have negotiated rates that are lower than the “retail” price for medical services. Medicare and Medicaid have even lower negotiated prices. The reason SB12-134 is so important is that uninsured patients (usually those who have the least ability to pay medical bills) typically get charged the retail price. There is usually a cash discount available, but most uninsured patients typically don’t have enough cash sitting around to pay the whole bill up front. So – assuming they are able to pay the bill at all – they often end up on a payment plan (sometimes through a third party where interest rates can rival those of credit cards) and ultimately pay far more than any insurance carrier would pay.

SB12-134 applies to medically necessary care provided to uninsured patients who have a family income of not more than 250% of the federal poverty level ($57,625 for a family of four in 2012). And SB12-134 applies only if the care is not eligible for coverage through the Colorado Indigent Care Program (CICP). For those patients, hospitals may not charge more than the lowest rate they have negotiated with a private health insurance plan. This is a huge change from the status quo.

SB12-134 also requires hospitals to clearly state their financial assistance, charity care, and payment plan information on their website, in patient waiting areas, directly to patients before they are discharged, and in writing on the patients’ billing statements. Hospitals will also have to allow a patient’s bill to go at least 30 days past due before initiating collections procedures. […]

Filed Under: Consumer Directed Health Plans, Health Care Goodies, HRA, HSA, Providers

Why People Don’t Buy Life, Disability, and LTC Insurance

October 20, 2011 By Louise Norris

[…] Insurance just isn’t that much fun to buy, period. It’s a product that we purchase while hoping we never have to use it, and if we ever do have to use it, things aren’t going so great. Having insurance does contribute to our peace of mind though, and that’s valuable in and of itself.

Filed Under: Policy

Does The Pink Ribbon Trivialize Breast Cancer Deaths?

October 19, 2011 By Louise Norris

[…] I can see how awareness is a good thing if it encourages people (men and women) to be in tune with their health and current on the screening exams that they and their doctor feel they need. And it’s a reminder to all of us to do whatever we can to provide support to those who have cancer. But what about the people who know that their cancer is terminal? What about those with metastatic breast cancer? Or with another form of advanced cancer like my friend? The people who know that there is almost no chance they will beat the disease, and that their life will almost certainly be cut short by it? Do all the pink ribbons trivialize their deaths? […]

Filed Under: Health Care Goodies

Stuck In A Mini-Med

October 6, 2011 By Louise Norris

[…] So he applied for an individual policy with Anthem Blue Cross for his family, and was approved. But then when he tried to cancel his mini-med plan, his employer told him that he couldn’t cancel it until the open enrollment period next April. It would seem that trapping enrollees into a year-long contract with a mini-med plan is not in line with the spirit of the HHS guidelines that call for full disclosure regarding the waivers and directives to steer enrollees towards healthcare dot gov if they are interested in getting a policy that does comply with the ACA rules regarding annual policy limits. […]

Filed Under: Anthem Blue Cross, Colorado Division Of Insurance, Group Health, Health Care Goodies, Health Care Reform, Health Insurance Reform, Individual/Family Health

Grand Rounds – Colorado Fall Colors Edition

October 4, 2011 By Louise Norris

Henry Stern of InsureBlog brings us an interview with the whistleblower who has brought a lawsuit against LabCorp for allegedly charging a lower price to United HealthCare than to Medicare. The post is particularly interesting because Hank adds his own thoughts after the interview, and he sees things a little differently than Andrew Baker (the whistleblower). Hank agrees that it does look like LabCorp lowered their fees for UHC […]

Filed Under: Health Care Goodies, Health Care Reform, Health Insurance Reform, Medicare, Medigap, Policy, Providers, United Healthcare

Colorado Health Insurance Exchange Board Hires Attorney General’s Office

September 27, 2011 By Louise Norris

[…] I’m confident that the Colorado Attorney General’s office will be able to provide competent legal advice to the exchange board. In addition, it appears that the board is getting an excellent value, since they’ll be paying less than $79/hour for a lawyer. But I assume that John Suthers is hoping to prevail in the lawsuit challenging the individual mandate, and I am a bit skeptical about whether the rest of the ACA (including the health insurance exchanges) could survive without the individual mandate.

Filed Under: Health Insurance Exchanges, Health Insurance Reform

Transferring Costs From Medicaid To Emergency Departments

September 21, 2011 By Louise Norris

[…] Denying arbitrary “non-emergent” ED claims for Medicaid patients doesn’t seem like a way to actually reduce ED overutilization. Instead, it seems like a way to cut Medicaid costs by increasing the number of unpaid claims that EDs have to write off each year. In order to cover their costs, hospitals will have to further increase prices for privately insured patients. That in turn causes health insurance premium hikes, which leads to calls for negotiations to artificially lower premiums. Where does it end?

Filed Under: Health Care Goodies, Health Insurance Reform, Providers

Low Enrollment And Adverse Selection In High Risk Pools

September 7, 2011 By Louise Norris

[…]CoverColorado – the high risk pool that Colorado has had in place since the early 90s – instead allows eligible applicants to enroll as soon as they are without another coverage option, but makes them wait to receive coverage for pre-existing conditions if they have been uninsured prior to applying. That system encourages people to sign up as soon as they are eligible rather than waiting until they need care. It would seem that the federally-funded high risk pools might be able to boost their enrollment and also avoid adverse selection by switching to a similar eligibility model.

Filed Under: Health Care Goodies, Health Care Reform

Federal Requirements For State Exchanges

August 31, 2011 By Louise Norris

[…] The guidelines that HHS set forth were designed to make sure that state-specific exchanges meet basic minimum standards, while still allowing the states to accomplish many of those standards however they see fit. And although some would criticize HHS for being too restrictive, others have said that the agency did all they could to keep things as simple and flexible as possible. […]

Filed Under: Health Care Reform, Health Insurance Exchanges

Health Insurance For Everyone Is Just The Beginning

August 26, 2011 By Louise Norris

[…] Insuring the entire population isn’t going to solve all of our healthcare woes. For starters, even with health insurance, healthcare can still be unaffordable. And even if we were to make health insurance more comprehensive than it is now, with lower out-of-pocket costs (not likely, as the trend over the last decade has been towards higher out-of-pocket costs in order to keep premiums from increasing even faster than they already do), there would still be more than one in five people without realistic access to care – for reasons that aren’t directly related to paying for care. […]

Filed Under: Health Care Reform, Health Insurance Reform

COBRA Subsidies Coming To An End

August 25, 2011 By Louise Norris

[…] The subsidy program was extended to help people who were involuntarily terminated on or before May 31, 2010, and allowed them to receive up to 15 months of COBRA premium assistance. For most people who qualified for the subsidies, the 15 months has already ended. But for the last people who qualified – those who were laid off in the final days of May, 2010 – the 15 months of premium assistance will come to an end next week. […]

Filed Under: COBRA, Health Care Reform

Thoughts On Direct-Pay PCPs

August 23, 2011 By Louise Norris

[…] Those are a few of the thoughts that come to mind when I think about direct-pay medical care. I can see pros and cons to the idea, and I’m sure that there are many PCPs who would love the chance to focus more on medicine and less on administration/payer issues. But I think that most PCPs also want to make sure that everyone – regardless of financial status – has realistic access to medical care. And I’m just not sure that would be the case if more PCPs started pulling out of the health insurance networks – especially the networks that serve low income populations.

Filed Under: Health Care Goodies, HSA, Providers

Is High Risk Pool Eligibility Guideline Hampering Enrollment?

July 5, 2011 By Louise Norris

[…] In terms of underwriting actions for less serious conditions (those that don’t result in a decline), GettingUsCovered only takes people who have been offered a policy with an exclusion rider… which most carriers don’t do anymore. Perhaps this is resulting in GettingUsCovered being comprised mostly of members who have a condition that would result in a decline in the individual market, while CoverColorado has those members as well as members who have less serious conditions that simply result in a higher-priced policy in the individual market.

Filed Under: Health Insurance Reform, Individual/Family Health

Support For Hospital Fees Varies From One State To Another

June 22, 2011 By Louise Norris

[…] This is a good example of how similar legislation does not necessarily have the same support or outcomes in different states. That’s not to say that the Health Care Affordability Act is universally supported in Colorado – it’s not. But it’s working relatively well as a vehicle to fund Medicaid here and to support Colorado hospitals that treat a large number of uninsured patients.

Filed Under: Health Care Goodies, Providers

Governor Hickenlooper Vetoes Bill To Charge Premiums For CHP+

June 1, 2011 By Louise Norris

[…] Even if parents with kids in CHP+ do smoke and buy lottery tickets at a higher rate than parents with private health insurance, what’s to make us think that they would all of a sudden stop spending money on those things and instead pay premiums for CHP+? Is our goal to punish those parents for what better-off families view as poor choices, or is the goal to make sure that as many kids as possible have health insurance? If it’s the latter, then the point made by Senator Brophy is irrelevant.

Filed Under: Health Care Goodies

Handling Income And Job Fluctuations Under The PPACA

May 20, 2011 By Louise Norris

[…] There’s no simple answer to all of this. We’re trying to create a somewhat universal health insurance system based on a conglomeration of government-run health insurance, private coverage from hundreds of carriers, eligibility for coverage that is tied to employment and state of residence, and also based on income levels… of course it’s going to get complicated. Hopefully the suggestions raised by this report will help to guide regulations that will ensure health insurance coverage that is as gap-free as possible for most Americans.

Filed Under: Group Health, Health Care Goodies, Health Care Reform, Health Insurance Reform, Individual/Family Health

Uninsured Americans Virtually Unable To Pay For Hospitalizations

May 13, 2011 By Louise Norris

[…] A new report from HHS paints a pretty bleak picture of the ability of uninsured Americans to pay for their own medical care. Looking at all uninsured families in the US, the median amount of savings is $20 (the study considered only assets that could be easily liquidated: bank accounts, stocks, bonds, retirement accounts, CDs, money market accounts, and mutual funds). That won’t go far when it comes to paying for a hospital bill. Even uninsured families at the high end of the asset scale had an average of less than $13,000 in financial assets. […]

Filed Under: Health Care Goodies

DOI Report On Small Group Coverage In Colorado

May 9, 2011 By Louise Norris

The Colorado Division of Insurance recently released the 2010 small group market report. The number of employers in Colorado offering small group health insurance dropped by 10% compared with 2009, and the number of Colorado residents with small group health insurance coverage dropped by 7%. The report contains comprehensive data on the availability of coverage, carriers in the small group market, pricing, and how the rating flexibility laws have impacted the market. […]

Filed Under: Group Health, HRA, Individual/Family Health

CHP+ Premiums Will Result In More Uninsured Kids

May 4, 2011 By Louise Norris

[…] 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. […]

Filed Under: Group Health, Health Care Goodies, HSA, Individual/Family Health, Maternity/Pregnancy

Differing Views On Paul Ryan’s Health Care Reform Proposal

April 18, 2011 By Louise Norris

Last week’s Health Wonk Review included several articles about Rep. Paul Ryan’s “Roadmap for America’s Future”, which includes significant changes in Medicare and Medicaid, and a repeal of the Affordable Care Act. This article from Avik Roy is particularly interesting, and raises some valid points in support of some aspects of the proposed budget reforms. But there are definitely problems with some of the radical changes being proposed. […]

Filed Under: Health Care Goodies, Health Care Reform, Health Insurance Reform

Controversy Surrounding The Expansion Of Medicaid

April 14, 2011 By Louise Norris

[…] It’s true that we can’t just keep expanding Medicaid without figuring out ways to fund the expansion, but we also can’t ignore the needs of the uninsured population, many of whom are uninsured because of the cost of health insurance (even if they might not technically qualify for Medicaid under the current rules). Regardless of the future of the federal Medicaid mandates, hopefully the focus of the state leadership will be on finding additional ways to generate funds and increase efficiency in order to be able to provide real access to health care for as many Colorado residents as possible.

Filed Under: Health Care Goodies

Covering Primary Care Expenses With A Clinic Membership

March 28, 2011 By Louise Norris

[…] It’s always good to see new innovations that help to expand access to healthcare, and clinic memberships that allow people to cover their day to day medical expenses with a predictable annual fee and low cost appointments is likely to be quite popular, especially among people who can’t afford comprehensive health insurance. But as with any other product, a clear awareness of what you’re purchasing (or being offered, if an employer is covering the cost) will help to avoid future surprises.

Filed Under: Fort Collins, Health Care Goodies, HSA, Providers

Mandatory Health Insurance Does Not Prevent Medical Bankruptcies

March 11, 2011 By Louise Norris

[…] The study’s authors note that implementing mandatory health insurance rules is not likely to result in a significant decline in the number of medical bankruptcies nationwide unless we also focus on improving the level of coverage that people have (to reduce out of pocket exposure), and on expanding access to disability insurance that can help provide income to people who are unable to work because of a major illness or injury. […]

Filed Under: Health Care Reform, Health Insurance Reform, Individual/Family Health

New Study Finds Healthcare Reform Will Benefit Colorado Economy

February 28, 2011 By Louise Norris

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. […]

Filed Under: Health Care Goodies, Health Care Reform, Individual/Family Health

Colorado Senator Introducing Legislation To Study Health Care

January 24, 2011 By Louise Norris

Colorado Senator Irene Aguilar, a Democrat from Denver, will be introducing legislation next month to address the fact that there are still 700,000 people in Colorado without health insurance. Although Colorado has made strides recently in areas like the expansion of Medicaid, we didn’t even come close to fulfilling former Governor Bill Ritter’s hopes for health insurance for all Colorado citizens by the end of 2010. […]

Filed Under: Health Care Goodies, Health Care Reform, Kaiser Permanente

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