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October 01, 2009 12:58 AM UTC

Report: House Reform Bill To Greatly Improve Health Care for Coloradans

  • 28 Comments
  • by: Progressive Promoter

(Good info – promoted by Colorado Pols)

From Colorado Consumer Health Initiative and Families USA…

Report: House Reform Bill To Greatly Improve Health Care for Coloradans

Coloradoans Will See Significant Gains in Availability of Reliable, Affordable Coverage

A new Families USA report details health care industry abuses that affect both the quality and availability of health insurance-and the dramatic improvements that Colorado businesses and families can expect with the passage of the U.S. House of Representatives health reform bill.  

The report addresses Colorado’s major health coverage changes:

Gender and Health Status: Insurance companies will no longer be permitted to charge Coloradans higher premiums based on their health status or gender. Under current laws, insurance companies can charge Coloradans whatever they wish to charge for premiums based on gender, health status, and claims experience in the individual market. A 40-year-old-women in Colorado is charged as much as 15% – 37% more for premiums, according to a study by the National Women’s Law Center.

Affordable Premiums: Premiums will be affordable for families, and there will be more and better insurance options.Affordability is a particular concern in Colorado, where health care premiums have risen 4.2 times more quickly than median earnings in the past decade. Under the House bill, Coloradans with moderate incomes will receive sliding-scale subsidies to be used toward the purchase of a high-quality health plan. In addition, all Coloradans will have access to an array of high-quality, comprehensive insurance plans through a new Health Insurance Exchange. No one will be forced into any particular plan, and individuals and business who like their current plans can keep them. The House bill also contains a public plan option.

Aid for Small Business: Colorado small businesses will receive tax credits to help with the cost of providing health care coverage for their employees. Small business coverage is often more expensive than coverage for workers in larger businesses.  In 2008, only 38% of Colorado businesses with fewer than 50 workers offered health insurance to employees, compared to 98% of large businesses (with 50 or more employees).      

Caps on Cost Sharing: Insurance plans will have to place caps on how much Coloradans are required to spend out of their own pockets on cost sharing. In 2009, 241,000 non-elderly Colorado residents with insurance spent more than 25 percent of their pre-tax income on health care in the form of deductibles, co-insurance and other cost-sharing. High out-of-pocket medical costs are what drive many American families into debt and even bankruptcy. Starting in 2013, there will be an annual cap of $5,000 for individuals and $10,000 for families and a sliding scale will give lower-income people even greater protection from out-of-pocket costs.

Low-Income Coverage: There will be expanded coverage for low-income people. Low-income Colorado residents often can’t get insurance that state’s federal coverage program doesn’t cover any adults under age 65 unless they are parents or have a disability. (Working parents can get coverage if their incomes are less than 60 percent of Federal Poverty Level or $18,310 for a family of three in 2009.). The legislation will expand Medicaid to cover all low-income, uninsured residents, including adults without dependent children and those who do not have a disability. (HB09-1293 will eventually expand eligibility to this population, but the details are not clear yet on the benefit package).

Maintaining And Renewing Coverage: Individuals will be able to maintain affordable coverage and to renew such coverage when they get sick. In a practice known as “rescission,” insurance companies revoke policies when policyholders become sick and begins filing claims. Insurers typically accuse individuals of intentionally withholding information about a medical condition on their applications, while those accused may have been unaware of the condition or considered it too minor to mention.  Reform legislation calls for an opportunity for an external reviewer to examine any such situation, and the insurer will be required to continue paying medical bills during the review period. Insurers will be able to rescind policies in Colorado only in clear cases of fraud.

COBRA: Unemployed workers will have new options for quality coverage as alternatives to COBRA. Rising unemployment has driven up the number of uninsured working-age individuals in Colorado, in part because the state’s average unemployment benefit of $1,484 is not sufficient for families to afford to continue their health insurance and meet other essential expenses.  The average monthly family COBRA premium is $1,051, almost 71% of the monthly unemployment benefit. The stimulus bill passed earlier this year provides some assistance but runs out in 2010. COBRA coverage will remain an option under reform, but sliding-scale subsidies for unemployed workers will allow them to purchase coverage through the new Health Insurance Exchange that is comparable to what is provide by large employers.

The Uninsured: The House bill will aid uninsured Colorado residents in gaining health coverage.  Roughly 790,000 Colorado residents were uninsured in 2008.  The House bill will provide coverage for an additional 651,000 Coloradans who are currently uninsured.  

Medicare Improvements: The ‘doughnut hole” will disappear and other personal expenses in Medicare will be covered. Colorado Medicare enrollees must pay up to $3,454 a year out of their own pockets-on top of their Part D premiums-because of the prescription drug benefit gap called the “doughnut hole.” This gap will be gradually eliminated, and an immediate 50 percent discount on brand-name drugs in the doughnut hole will make prescriptions more affordable right away. Many preventive services covered in Medicare come with out-of-pocket copayments, co-insurance and deductibles that discourage Colorado’s approximately 433,000 Medicare beneficiaries from using them. These will be eliminated.

Pre-existing conditions: Insurance companies will no longer be able to discriminate against Coloradans based on a pre-existing condition. Currently, if you try to buy a policy in the individual market  in Colorado, health insurers can refuse to sell you a plan because of any pre-existing condition.  The exception is CoverColorado, the high-risk pool, which is the insurer of last resort – but premiums are as much as 140% higher than market rate.

Spending caps: Insurance companies will be forbidden to place annual or lifetime spending caps on insurance policies. Currently in Colorado, a health insurance policy, including CoverColorado, the high risk pool, may stop paying claims if an annual or lifetime cap on coverage is exceeded. As a result of repeated, extended or expensive medical care, policy owners could “run out” of coverage and face mounting medical bills on their own.

A copy of the Families report for Colorado is available on the Web at www.familiesusa.org and at www.cohealthinitiative.org.

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28 thoughts on “Report: House Reform Bill To Greatly Improve Health Care for Coloradans”

  1. when all of the private insurance companies are driven right out of business, your socialist coverage can take over. That way an MRI can take six months to get, if you live that long. What a deal.

    Woo hoo.

    1. You’re first Gecko. In this short post you engaged in the fallacies of name-calling (“socialist coverage”), begging the question(“when all of the private insurance companies are driven right out of business”) and false analogy (“an MRI can take six months to get”) which is comparing the proposed reforms to Canada’s single-payer system or the UK’s single-provider system, neither of which are even close to what is being proposed in this country.

      Have a fabulous, fallacious day!

    2. It’s because they provide terrible service to their customers at too high a price.

      If a public option causes private insurance companies to fold, you won’t have to look far for a reason.

      When and if the private companies start providing a good product at a good price, they’ll have no trouble competing.

      If I have to wait months for an MRI to be approved by a public insurance company, I’m going to weigh that in my choice of insurance, if I ever get a choice.  Of course, if a private insurance company refuses to pay for one at all, that’s a data point too.

      Service vs. price.  Competition.  It’s about freakin’ time.

      What’s your worry Gecko?

      3. My main concern with your parties proposed “public option” is the fact that you KNOW, that it will be subsidized by our tax dollars. So when it loses tons and tons of money like Medicare, everything will be just fine because the feds will just take more money out of our pockets to pay for it. It does not have to be self supporting like my private company needs to be, so it just can’t be compared as apples to apples. What if Kaiser was able to just dip into the public pool everytime it was about to go into the red? And don’t tell me that they have huge profits, when in reality their overall profit margin is like what, 4%?

        If you believe their lies that it will be cost neutral, show me on paper where any other government program cost at or less than they figured originally.

        How much did they say Medicare would cost when it was first introduced compared to how much it actually costs in real life?

        This is nothing more than libs taking baby steps towards government controlled health care. Period. They (and you all) won’t be happy until all the private companies are driven out of business and our health is in the hands of our guvment…….who we all know are so good at managing things.

        1. But you’re the one who is calling people liars:

          If you believe their lies that it will be cost neutral…

          You’re the one making an accusation; you’re the one who needs to back it up with facts.

          I don’t need to show you shit.

          1. Our government that you say is so good at keeping cost down and projecting how much their social programs will cost……..how about Medicare like I mentioned above and you ignored?

            In 1966 the House Ways and Means Committee estimated that Medicare would cost 12 billion dollars by 1990. They allowed for inflation in this number.

            When 1990 arrived, Medicare cost us 107 billion dollars, prox 9 times more than these idiots figured.

            And you think they are not full of crap when they say putting them in control of health care for the entire country will be cost neutral? Who will pay the difference when they are proven wrong and we end up with another bill 9 times more than they thought?

            HA!!!!

            What do you have to say about that?

            1. Medical costs, and health insurance premiums, have been outpacing inflation for decades, and are on a tear lately. A big part of the health care reform proposals includes reining this in.

              And the public option will be funded by premiums, unlike Medicaid and Medicare. If outlays exceed income, premiums go up.  

              1. That is wrong too. Barack Hussein Obama himself while walking on water and promoting himself in the weeks before the election said his goal is single payer government run health care. Period.

                And we all know that is the goal of the liberals in power. Very few if any don’t want it. You know that.

                That is why they are taking baby steps on this reform. They don’t want to reform the system we now have by making it legal to buy insurance cross state lines or any other idea presented to them. They want single payer and the only way to get it is to run all of the private insurance companies out of business (along with most of the doctors too I’m afraid) and we will have no choice but to let the black hole in DC control us totally.

                1. but given the resistance to even this incremental reform that’s being discussed now, it won’t be a political possibility–probably for decades, but certainly not in next 7.5 years Obama could be in office.

                  I have no idea why the right has such a protective instinct for health insurance companies, when they were frothing at the mouth over the lengths the government went to to secure the financial industry.

                  Right now the insurance companies are doing everything you’re saying the government will do in the future. People are fed up with how they run things, and all we want to do is level the playing field for the consumer by giving them other options. If the free market works, then a public option will create more competition.

                  If you’re going to criticize the current push for reform, you should probably try criticizing what’s actually being discussed, and not just what you’re afraid of potentially happening in the future if us libruls get our way.

                2. You’re so full of lies it’s a wonder you don’t explode.

                  Remember when George W. Bush said his goal was to restore honor to the White House? Where was your concern when that campaign promise went off the rails?

                  The Republican health care reform “ideas” — including buying insurance across state lines — would only make things worse, and Republicans have sworn to defeat health care reform, so it should come as no surprise these “ideas” are being ignored.

                  Private insurance companies will make less money than they are now, they won’t be driven out of business. Your lack of faith in private enterprise is disturbing.

                  1. buying insurance across state lines can hurt anything.

                    I am in the middle of selling my house and am going to move cross country. But I will be sending my wife first to live there while I stay for a few months or longer to work and build up more capital. In the mean time my wife will not be able to have health insurance through my policy because she will not live here. So she will have to buy it herself in the state we are moving to. This will cost us more than it would if she was on my plan. This is totally stupid and could easily be fixed.

                    Why won’t they even consider it?

                    I am in total agreement that health care needs reform. But making it paid for by taxpayer subsidies (you all know many many  people will be getting it for free as they will say they can’t afford it so the rest of us will have to foot the bill)is not the right way. Most Americans now have health care coverage and are fine with things as is. Giving total control to an entity that has proven it is inept, is foolish.

                    1. simply allowing us to buy insurance across state lines can do anything besides making the biggest thieves even bigger?

                      Good luck with that red herring, Gecko.  When you tell me how that’s going to help me, I’ll listen.

            3. I thought so.

              Look Gecko, our system is all effed up because we have no system. Every other developed county in the world pays less for better outcomes. Why? They take a systematic approach and they decided that everyone should have access to affordable health care. We, in turn, have a polyglot system that’s expensive and delivers poor results.

              This proposal is a lot closer to what Germany and Switzerland have than what Canada or England have. These regulations on mandates, caps, prior conditions, and recission have all worked elsewhere, in capitalist countries with private insurance companies. And, yes, those countries typically subsidize insurance for the poor and/or offer a public plan as an alternative.

              And as a parting shot, may I remind you that conservatives had several years of absolute power in which to do something and failed to act. Democrats were elected in 2006 and 2008 on a campaign platform that included health care reform. They’re just following through on what they were elected to do. That’s called democracy.  

        2. that people like Gecko keep trying to mislead on. A $24,000,000 salary for a CEO or $50,000,000 worth of annual bonuses to management are not figured in to your claim of a 4% profit margin. All of the huge compensation packages and expensive perks these people give themselves are part of the companies expenses and are not calculated as profits.

          Your 4% margin figure is irrelevant bullshit.  

    3. All of the claimed benefits are nonsense. The health legislation will take good access to care away from millions who buy insurance and are covered by Medicare to subsidize insurance for 70% of Americans.

      This is all about unionizing health workers and other employers.

      1. are worse in the U.S. than in other developed countries; Americans pay more per capital; in addition to the millions who are uninsured, the insurance that many have is dubious at best–in Calif. something like 1 in 5 claims were denied…to subscribers who paid their premiums and expected coverage.  America is the only of these nations with medical bankruptcies–again, affecting often people with coverage.

         

      3. This is all about unionizing health workers and other employers.

        Because we all know that everything wrong in America is somehow the fault of the SEIU.  

    4. Insurance companies make you wait for diagnostics and treatment all the time. Our family has what is considered great coverage yet when we discovered my spouse had a kidney tumor it took two months to get a biopsy (and yes, it was cancer) and another month to schedule the surgery. And even that took all sorts of hassling to expedite.

      You’re fooling yourself if you think we don’t have wait times and rationing under our current–and expensive–system.

      1. because they were combing through all your past medical records looking, hoping, and praying for some pre-existing condition that would allow them to deny coverage.

        That’s the system that AS and Gecko want to keep. I wouldn’t wish that on my enemies, much less fellow citizens that I happen to disagree with.:)

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