I'll keep my health insurance crap in this thread so it's more easily ignored.
Meeting this am, rates for individuals in Colorado will surpass small group insurance rates for the first time. With the removal of medical underwriting carriers are forced to increase costs.
One issue is that of rural providers. Those Coloradans who live in rural or mountain communities have the highest insurance premiums in the nation. The reasons for this are many, but the biggest issue is that the cost of healthcare is more expensive in rural areas.
Another issue is medicaid and how to improve that program. As it stands, reimbursement for medicaid is lower than the cost of providers. We are seeing doctors still accepting medicaid patients, but they can only afford to see a limited number since they lose money by seeing those patients. Those who are told that they have to wait but still need care will go to the closest place that will see them, the ER. On average consumers will pay ten times in an ER that they would pay for the same treatment at a family doc. Expanding medicaid coverage is one of the solutions brought on by the ACA.
The fundamental disagreement with the ACA is cost versus access. There are big items that are missing or not addressed in the legislation. I would have thought they could find a spot in a 2,000 page bill but I guess not. Lowering the cost of health care is not mentioned or addressed, reimbursement increases to medicaid providers is also absent, and the biggest reason for these ridiculously high rates is the fact that there are no teeth in the individual mandate. Other troubling trends are insurance companies leaving the market which decreases access, the narrowing of networks in reduce costs, drastically high utilization coupled with adverse risk. There are still unanswered questions, such as how medicaid expansion will affect doctors and how they practice medicine, participation in the individual marketplace, and the potential for executive orders depending on who wins the election (we the people lose no matter what when our choices are a turd sandwich and a giant douche. Thank you south park.
Repealing the ACA is not anywhere near realistic and it's a waste of time. While I am not a fan, I do have to credit 'the system' for reducing the number of uninsured, the popularity and wide acceptance of the ACA, but the fact that there is no agreement on ideology with legislators is a nonstarter, and it is becoming more and more clear that true insurance reform can not happen in a purely voluntary system as it stands.
Amendment 69 will create a pilot program for a single payer system. Funded by a 10% payroll tax (third for employees, 2/3 for employers) On top of that, there would be a ten percent increase across the board on any and all non-payroll income, all streams. This would create the highest tax rate in the country, and the only requirements to be on the 21 member board are that you are over age 18 and a resident of this state. The requirements to vote are more rigorous than those to be on the board, which would not have to answer to anyone and they could impose unlimited tax increases to fund the program.
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General Info-
Carriers affected effective 1/1/2017-
Humana
United
Rocky Mountain Health Plans outside Mesa county)
Anthem PPO
Prioritize what matters when you are shopping for a new plan. We ask our clients to rank premium, doctors, hospitals, level of benefit, prescription, and then dental, and medication.
A very important question is, 'Do you have ownership in a business'. As we see individual rates rise, we see small group rates decrease to single digits. There is a lot of potential for creating 'micro-groups', association plans, groups of two with only one enrolling. We are encouraging our self employed clients to hire a non-spouse, pay them minimum wage for two pay periods at 30 hours per week, and then you have a two person group and the high rates for the same benefits become much more affordable. Also keep in mind ancillary benefits, vision, life, dental, STD and LTD etc. Subsidy qualification is also something that should be considered.
Our general agency has decided not to write business on the exchange due to major issues with access, tech support, online enrollment, processing payments, paying claims, missing information as well as a general attitude of laziness. It is unfortunate but we aren't willing to risk any compliance issues or deal with products that our E & O insurance doesn't cover.
Oh what fun it is.
