[…] There is no simple solution to the issue of balancing guaranteed issue health insurance, an individual mandate, and personal liberties. It will be interesting to see what 2011 brings in terms of court battles over the constitutionality of the individual mandate, and whether any other options become viable alternatives.
[…] Political analysts generally agree that a repeal vote in the House is likely to pass, but much less likely to clear the Senate. If it did, it would be virtually impossible to override a presidential veto. So the vote next week is basically symbolic – which can also be looked at as a waste of congressional time and resources. A more productive solution might be to start looking for ways to significantly reduce the actual cost of health care. […]
Colorado was one of 15 states to receive a grant from the federal Centers for Medicare and Medicaid Services this week, thanks to changes that the state made in the enrollment process for Medicaid in order to expand the program. Colorado got $13.7 million, which will be used to help finance the state’s Medicaid system. […]
[…] While many other aspects of reform are generally popular (like the provision to allow young adults to remain on their parents’ health insurance until age 26, and the requirement that all policies be guaranteed issue starting in 2014), the individual mandate has raised a lot of hackles, with people feeling that the government is infringing on their rights by telling them that they have to buy a product (and in most cases, that product will come from a private company). […]
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). […]
[…] I can’t imagine huge numbers of people simply opting to be uninsured if employers stop offering coverage, especially once individual health insurance is guaranteed issue and pre-existing conditions are no longer an issue. I would guess that in 2014 we will see at least some shift away from employer-sponsored coverage in favor of individual health insurance, but I imagine that plenty of employers will continue to offer at least some level of coverage as a way to attract and retain quality employees.
This article is not the first I’ve seen that calls into question whether Obama was being truthful when he said that health care reform would be structure so that people would still be able to keep their existing health insurance if they wanted to. And it would seem that his statements did amount to a bit of over-promising. But even before the PPACA came up for a vote, many Americans weren’t in control of whether or not they got to keep their existing health insurance. […]
[…] Even when policies are free or very low cost (such as Medicaid or Child Health Plan Plus), a significant number of eligible individuals continue to go without coverage, for a myriad of reasons. So it stands to reason that plenty of uninsured people who are eligible for GettingUsCovered won’t apply. Some likely aren’t aware of the availability, and many others simply can’t afford to pay the premiums. But apparently Colorado is enrolling people at a fairly fast pace – as of November 1, there were 20 states that had fewer than 50 people enrolled in their newly-created high risk pools.
For months now, one of the main arguments against the PPACA is that it doesn’t address health care costs or provide a means to pay for the reforms that it includes. Opponents of the reform law have used the money argument to drum up support for their cause, and – along with opposition to the individual mandate requiring everyone to have health insurance starting in 2014 – it remains one of the first things that people will mention when asked why they oppose the PPACA. […]
This week’s Grand Rounds included an article by David Williams about mini-med plans that I thought was worth sharing. David explains that although he’s not a fan of mini-med policies, sometimes they are indeed better than nothing. Mini-med policies come in all shapes and sizes, and David’s article describes policies with $25,000 or $50,000 benefit maximums… a far cry from the $2,000 maximum policies that I wrote about earlier this month. […]
[…] As I said, I have no knowledge of this particular family’s situation. But child-only policies have always been rare, and there is usually another option for those children to obtain coverage. They can be covered as a dependent on a parent’s policy (which can now include policies in the individual market), by Cover Colorado, or possibly by Medicaid or CHP+. Even situations like Thomas Wilkes, who was maxing out the lifetime caps, now has a solution because Healthcare Reform has removed lifetime maximums. There is a long way to go, and this situation is frustrating. But if you ever hear anybody say that they have no options to get their child covered in Colorado, please pass this information along. I hope that Mr. Serrano signs Maria up for some health insurance today, whether it is on a family policy with him, Cover Colorado, or CHP+. We should not be hearing anymore stories about uninsured children simply because their parents aren’t aware of the options available.
[…] We need to make sure everyone has health insurance (first step in expanding access). We need to make sure there are enough primary care physicians (and other care providers) to go around. And then we need a systematic, coordinated effort between health care providers, hospitals, and health insurance carriers to make sure that everyone is on the same page. Expanding access to primary care is part of the solution, but it will only work in tandem with the other parts.
[…] Copays and deductibles have risen for most families over the last few years, even those who don’t have policies that qualify as high deductible. And at the same time, economic stability has decreased for most families. This isn’t a good combination, and Joe’s right about the fact that when people skip necessary routine medical care, it will likely lead to increased medical costs (and declining health) in the future.
[…] Hopefully the fact that insurers can designate an open enrollment period for children to be accepted on a guaranteed issue basis will make it more likely that parents will keep their children continuously insured. The spirit of the law regarding coverage for children is good: It isn’t right that sick kids should be unable to get health insurance at any price. But with no requirement that all kids be insured, and without a designated open enrollment period, the new law would absolutely have encouraged adverse selection.
[…] With budget cuts all over the county, now is probably not a good time for state agencies to add staff who focus on helping parents enroll their kids in public health insurance programs. But existing community based organizations could be a great resource for parents with uninsured kids. And this might also be an excellent position to fill with volunteers who are willing to work with parents in their own communities. […]
[…] It will be interesting to watch public opinion of health care reform over the next few years. I imagine a lot of it will depend on what happens to premiums. If health insurance carriers can comply with the requirements of the new law without substantial premiums increases, we’ll probably see even more favorable public opinion of the law, especially once government subsidies kick in to help people pay for health insurance.
The new Colorado health insurance program for people with pre-existing conditions is supposed to become available next week, but there seems to still be a lot of confusion about how it’s going to work. Since Colorado already has a policy available for people with pre-existing conditions (Cover Colorado), we are one of the states that is opting to use the federal money to set up another risk pool for applicants who cannot qualify for medically underwritten individual policies […]
[…] People who can least afford to pay large sums of money out of pocket for health care are the ones most likely to have to do so. Medicaid is there for the lowest income earners, but some states are very restrictive in terms of income levels required to qualify for Medicaid. Colorado has started to expand access to Medicaid and Child Health Plan Plus (CHP+) but this is not the case in all states. And people on the lower end of the income spectrum are far more likely to be uninsured than those on the higher end. […]
[…] The PCP shortage is likely to become even more of a problem once the health care reform provisions kick in and millions of currently uninsured Americans become insured and presumably start to seek out more health care. Unless we can make primary care more attractive to people in medical school, all of those newly insured people are going to end up seeing expensive specialists instead of PCPs, and the burden of paying for health care will only become harder to bear.
[…] Finding a doctor who takes Medicaid is significantly more difficult than finding a doctor who takes private health insurance, and I wonder if that might be a contributing factor in the crowding of our emergency rooms. If a person with Medicaid is sick and unable to find a nearby doctor who accepts Medicaid, he might end up not seeing a doctor at all and his condition might worsen to the point of needing emergency room care. Maybe efforts to make Medicaid more attractive to doctors might help to alleviate some of the over-crowding in emergency rooms.
A new state law that imposes fees on hospitals went into effect this week. Over the next few years, it’s expected to allow Colorado to expand access to health insurance to about 150,000 of the state’s 800,000 uninsured residents. The funds generated from the hospital fees will allow Colorado to expand access to Medicaid for adults, increase the income limit to qualify for Medicaid, and expand access to Child Health Plan Plus (CHP+) for children and pregnant women. […]
[…] We definitely needed a solution to make health insurance available for everyone, and there’s no way to do that without taking away some of the freedoms from both sides (including the ability for insurance companies to decline applicants, and the ability for people to choose to not have health insurance). The legislation isn’t perfect, and it won’t please everyone, but hopefully a decade from now, the problem of millions of Americans living without health insurance will be a memory.
[…] Carol indicated that it was the consensus of everyone she has talked with that $5 billion won’t come close to covering the cost of these high-risk pools in 50 states for four years. She and a number of other Medicaid commissioners are leaning away from expansion or development of new high-risk pools in their states, not for political or philosophical reasons, but because the pools don’t make economic sense. As the federal bill is written, if states don’t act, a federal high risk pool is to be created to fill essentially the same function.
One of the provisions of the new health care reform law is $5 billion in federal funding for high risk pools, set to begin operating this summer, that will provide health insurance for people with pre-existing conditions who don’t currently have health insurance. This is intended to be a stop-gap until 2014, when high risk pools will presumably no longer be necessary, since private health insurers will have to begin accepting all applicants in 2014. […]
One of the provisions in the health care reform bill allows children to remain on their parents’ health insurance policies until the age of 26. You may recall that a couple of years ago, Colorado passed a law allowing children here to remain on their parents’ policies until the age of 25, so the new law won’t have as much of an impact here as it will in states that currently boot young adults off of their parents’ coverage at younger ages. […]