Health Law and Policy Update
Headlines of the week
Sebelius asks health plans to stop blaming rate increases on the Affordable Care Act
In a letter sent this week to Karen Ignagni, president and CEO of America's Health Insurance Plans (AHIP), Health and Human Services Secretary Kathleen Sebelius wrote: "It has come to my attention that several health insurer carriers are sending letters to their enrollees falsely blaming premium increases for 2011 on the patient protections in the Affordable Care Act. I urge you to inform your members that there will be zero tolerance for this type of misinformation and unjustified rate increases. ... According to our analysis and those of some industry and academic experts, any potential premium impact from the new consumer protections and increased quality provisions under the Affordable Care Act will be minimal. ... Given the importance of the new protections and the facts about their impact on costs, I ask for your help in stopping misinformation and scare tactics about the Affordable Care Act. Moreover, I want AHIP's members to be put on notice: The administration, in partnership with states, will not tolerate unjustified rate hikes in the name of consumer protections. ... We will also keep track of insurers with a record of unjustified rate increases: Those plans may be excluded from health insurance exchanges in 2014. Simply stated, we will not stand idly by as insurers blame their premium hikes and increased profits on the requirement that they provide consumers with basic protections."
Colorado health plans to stop offering child-only policies
An item in Health Law and Policy Update last week reported that several insurance companies doing business in Colorado -- Aetna Life Insurance Co., Assurant Health, sold in Colorado as Time Insurance Co.; Cigna Corp. and Humana Insurance Co. -- will no longer offer new child-only plans as of Oct. 1. United Healthcare has since confirmed it will continue to offer new child-only plans.
Health reform will have minimal effect on health spending
The Affordable Care Act will have a minimal effect on total national health spending during the next 10 years, according to study released this week by the Office of the Actuary at the Centers for Medicare and Medicaid Services. The report was published online by the journal Health Affairs. Other coverage is available from Kaiser Health News, which also pulled together information from other sources:
The New York Times reported: "The government report, by the office of the chief Medicare actuary, undermines the claims of the law's fiercest critics and some of its biggest champions." Critics had said the overhaul would fuel explosive health spending growth; supporters, that it would curb the already exploding trend. "In 2009, the report said, national health spending, public and private, totaled $2.5 trillion and accounted for 17.3 percent of the economy, as measured by the gross domestic product. The report predicts that health spending will rise to $4.6 trillion and account for 19.6 percent of the economy in 2019." That's up from $4.5 trillion that year, according to an earlier estimate by the same economists.
In a blog post, however, the White House contended that, if the math included only people with insurance coverage, the per-person cost of care actually would go down. White House health czar Nancy-Ann DeParle wrote: "Specifically, by 2019, overall health spending per insured person will average $14,720 instead of the $16,120 projected by the actuary before the act was enacted into law. This is great news for many Americans."
Advancing the debate
Colorado among the worst in enrolling eligible children in Medicaid and CHIP
Colorado has the third-worst rate in the nation of Medicaid and CHP+ participation, according to an analysis of 2008 data reported in an article this week in the journal Health Affairs.
The report discusses the fact that while coverage rates for children have been rising since 1997, when the State Children's Health Insurance Plan was passed, close to two-thirds of uninsured children appear to be eligible for but not enrolled in Medicaid and CHIP. In addition, the report finds substantial variation in enrollment across states and among subgroups of children.
Some key data: In 2008, some 7.3 million children were uninsured on an average day. Of those children, 4.7 million, or 65 percent, were eligible for Medicaid or CHIP. Of the 4.7 million uninsured children, 3 million had family incomes of less than 133 percent of the Federal Poverty Level (FPL) and 1.2 million had incomes between 133 percent and 200 percent of FPL.
Colorado is reported as having a Medicaid and CHP+ participation rate of 68.9 percent, behind only Utah and Nevada. The participation rate is the number of eligible and enrolled children, a 68.9 percent participation rate means 31.1 percent of eligible children are not enrolled. Contrast Colorado's numbers with states like Massachusetts or Washington, D.C., which have participation rates higher than 95 percent.
The study relies on 2008 data, the most recent available. There have been significant efforts under way in Colorado to enroll eligible children since then, although there are also significant impediments to enrollment, particularly notable is the continuing problem of application delay.
What's new
A health reform resource for Spanish speakers
In an effort to address high uninsured rates and chronic health disparities in Latino communities, the Department of Health and Human Services introduced www.cuidadodesalud.gov, as the first consumer-focused website in Spanish to provide information on public and private health coverage options and the Patient Protection and Affordable Care Act. CuidadodeSalud.gov is the partner website to www.Healthcare.gov.
Next Colorado exchange meeting
The next Health Insurance Exchange Forum will be 3 to 5 p.m. Monday, Sept. 13, from in the Denver Public Library central branch, 10 W. 14th Avenue Parkway. More information is available on the governor's health reform website.
What you can do
Schedule a presentation on health reform
Health reform can be confusing. The health staff at the Colorado Center on Law and Policy is ready to help community groups, medical professionals, lawmakers and others understand the complexities of health reform and how it will roll out during the next few years. Please contact us to schedule a presentation.
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
Communications Director
Perry Swanson
Released Sept. 10, 2010