Health Law and Policy Update: Consumers want choice, affordable prices from health exchange, research shows
This week's updates
- Consumers want choice, affordable prices from health exchange, research shows
- Health groups join physicians seeking official review of Exempla deal
- Institute of Medicine urges consideration of cost in setting essential benefits
- CU plans health center for Colorado Springs campus
- Ask your senators to support a balanced deficit-reduction deal
Headlines of the week
Consumers want choice, affordable prices from health exchange, research shows
Choice, ease-of-use and lower costs are just some of the features consumers expect from the Colorado Health Benefit Exchange, the new competitive marketplace for comparing and purchasing health insurance.
The Colorado Center on Law and Policy, Colorado Consumer Health Initiative and Colorado Public Interest Research Group worked together to conduct a series of focus groups in July to gauge consumer perceptions and expectations of the exchange. Participants in five cities across Colorado - Denver, Grand Junction, Pueblo, Greeley and Sterling - spoke about their expectations and priorities for the exchange. The full research report offers a detailed analysis of perspectives offered by participants.
The Colorado General Assembly established the path to create the exchange in 2011 with the passage of Senate Bill 200. The exchange is a key component of the state's implementation of the Patient Protection and Affordable Care Act and must be ready for open enrollment by Oct. 1, 2013.
The cost of coverage was a universal and primary concern for focus group participants when asked about their concerns and preferences for finding and buying health insurance. Participants also emphasized the importance of provider networks and having the ability to identify health plans that meet their families' unique needs and budget.
Prospective consumers were interested in tailoring health plans to specific needs so that the range of choices would be highly individualized. Some wanted choices based on affordability while others said the range of benefits or access to particular providers was important. While the number and scope of options varied, participants agreed being able to choose a highly-specific and individual plan was important.
Tax credits and subsidies will play a significant role in an individual's decision about whether to buy health insurance through the exchange. Lower-income and uninsured people felt the tax credits would let them purchase insurance for themselves and their families. Participants who already had health insurance said they would consider using subsidies to purchase health coverage with better benefits through the exchange.
Participants said the exchange should be easy to use and include clear comparisons of health insurance plans. They want the new exchange to be transparent and accessible, with knowledgeable support staff to assist in navigating and plan selection.
The exchange will be successful if it can contain costs, facilitate comparisons of health insurance products, and reduce the number of uninsured.
The exchange focus groups are part of a larger Colorado project designed to promote consumer engagement in the design and implementation of the Colorado Health Benefit Exchange. The project is funded by the Affordable Care Act Implementation Fund through support from The Atlantic Philanthropies, The California Endowment, The Nathan Cummings Foundation, Ford Foundation, The Jacob and Valeria Langeloth Foundation, The Rockefeller Foundation and with local matching support from The Caring for Colorado Foundation, and the Rose Community Foundation. Community Catalyst manages the Affordable Care Act Implementation Fund initiative. The public health research and consulting firm John Snow, Inc., was hired to conduct the focus groups.
Health groups join physicians seeking official review of Exempla deal
Colorado Attorney General John Suthers should conduct an official review of the transfer of control of hospitals in the Exempla system to a Kansas-based Catholic charity, the Colorado Center on Law and Policy and the Colorado Consumer Health Initiative said in a Monday letter to Suthers.
The two nonprofit organizations joined with a group of seven Exempla physicians seeking official review of the transaction, including at least one public hearing. The physicians earlier this year challenged the transaction whereby Community First Foundation ceded control of the Exempla to Sisters of Charity of Leavenworth Health Systems.
What's new
Institute of Medicine urges consideration of cost in setting essential benefits
Federal officials should consider affordability and effectiveness when setting an essential health benefits package all insurers will be required to sell in health insurance exchanges, the Institute of Medicine said in a report issued Thursday. The recommendation has some experts worried the benefits mandated by the package will be limited.
"They made affordability the first imperative here. That means very limited coverage for people because of the underlying cost of health care," Sara Rosenbaum, a health policy professor at George Washington University, told Kaiser Health News.
The Institute of Medicine did not suggest the specific benefits that should be included in the package, but did recommend a set of methods and criteria that the Department of Health and Human Services should use when determining the package. HHS has yet to set a date for the release of the actual package, but it is expected to come out in 2012.
Find more coverage in The New York Times.
CU plans health center for Colorado Springs campus
The University of Colorado Colorado Springs is planning to build an Academic Health Services Center where seniors and people with low incomes will get health care. A new, 56,000-square-foot building in Colorado Springs will house the center, where operations of various health programs will be consolidated and expanded including the CU Aging Center, the Gerontology Center and the wellness programs operated by the Beth-El College of Nursing and Health Sciences. Details are in the university faculty and staff newsletter.
What you can do
Ask your senators to support a balanced deficit-reduction deal
The Joint Select Committee on Deficit Reduction, known as the "Super Committee," has held a series of public hearings and closed-door meetings but does not appear to have overcome the ideological differences necessary to reach a deficit reduction deal.
The bipartisan group is tasked to find $1.2 trillion in budget savings over 10 years, although many have pushed for a bigger deal that could reduce the debt by as much as $3 to $4 trillion. That scenario now appears unlikely as Congressional Republicans seem to be unwilling to agree to significant increases in revenue. The group must put a proposal before Congress by Nov. 23 or a series of automatic cuts, including a 2 percent reduction in Medicare provider payments, will be triggered. However, to give the Congressional Budget Office time to score a proposal, the Super Committee will most likely need to have a deal in place before Congress recesses at the end of October, making the next few weeks crucial for the committee.
If the Super Committee is to approve a deal, it is essential that it is a balanced package that includes both increases in revenue and thoughtful reductions in federal spending. Super Committee members must not be afraid to walk away from a deal that includes major reductions in entitlement spending, while only offering minor increases in revenue through the closing of selected tax loopholes.
It is also important that spending cuts will not simply shift costs to states or put the burden of deficit reduction on the backs of low-income individuals, as large cuts to the Medicaid program would. Options such as turning the Medicaid program into a block grant or paying states a blended rate for Medicare and the Children's Health Insurance Program would not provide an actual reduction in the cost of Medicaid. Instead, these measures would put an increased burden on already strained state budgets, asking them to fund a greater portion of the program. This would force states to make cuts elsewhere in the budget or to the Medicaid program, reducing benefits for low income individuals.
Finally, it is not acceptable to allow cuts to entitlement programs to occur now, with a promise of tax reform in the future, as has been suggested by Sen. Mark Warner. Colorado Sens. Mark Udall and Michael Bennet signed a letter circulated by Warner last month, calling for a deficit reduction package larger than $1.2 trillion. However, the senators should not to agree to any cuts to entitlement programs unless they are accompanied by significant increases in revenue.
If a deficit deal is going to be reached, the next few weeks will be critical. Call both senators and tell them the nation needs a balanced deficit reduction plan that does not allow harmful cuts to Medicaid and other safety-net programs.
Call Senator Mark Udall, 202-224-5941, or e-mail him.
Call Senator Michael Bennet, 202-224-5852, or e-mail him.
Health Law and Policy Update is issued weekly by the health staff of the Colorado Center on Law and Policy. Subscribe by e-mail or read previous editions.
Health Care Director
Elisabeth Arenales
Health Care Attorney
Adela Flores-Brennan
Special Counsel
Ed Kahn
Rice Fellow
Danny Rheiner
Communications Director
Perry Swanson
Released Oct. 7, 2011