Health Law and Policy Update
Headlines of the week
Key aspects of reform went into effect Thursday
Thursday marked the date of implementation of some of the most anticipated consumer protections included in the Patient Protection and Affordable Care Act. Those protections include elimination of pre-existing condition exclusions for children, a requirement that health plans permit parents to cover their adult children up to age 26, restrictions on annual insurance coverage limits and bans on lifetime limits, increased access to primary and preventive care, and the end of unjustified cancellation of insurance policies when people get sick -- known as rescission. Thursday also marks the six-month anniversary of the date the Affordable Care Act became law, an important milestone for the legislation.
The health team at the Colorado Center on Law and Policy released an issue brief Tuesday detailing how the law has changed the nation's health care during its first six months and the effects on Colorado.The Affordable Care Act builds step by carefully designed step toward full implementation in 2014. The changes made during the first six months lay an important foundation for reforms to come as well as provide a bridge to coverage for people who cannot wait until 2014 for relief. Provisions of the ACA implemented these first six months provide increased coverage opportunities and peace of mind for millions of Coloradans.
Other overviews of the changes taking effect Thursday are available from The Denver Post in a news story and opinion piece, The New York Times and a video from KUSA-TV in Denver featuring Health Care Attorney Adela Flores-Brennan.
State authorities require health plans to hold child-only open enrollment
The Colorado Division of Insurance issued emergency regulations Thursday requiring health insurance companies to hold an open-enrollment period for child-only policies.
The move was designed to ensure compliance with the Affordable Care Act provision that bans health plans from denying coverage to children with pre-existing conditions, while also creating greater certainty for insurance companies. At least six insurance companies responded to the provision requiring them to cover children with pre-existing conditions by announcing plans to stop offering child-only policies in Colorado. Similar maneuvering has played out in other states. Colorado Center on Law and Policy Health Care Director Elisabeth Arenales discussed the issue on Colorado Public Radio this week.
Under the emergency regulations, insurance companies must sell child-only health policies from Thursday, Sept. 23, to Oct. 31. Subsequent open-enrollment periods will be required annually, in January and June, the Division of Insurance said in an announcement of the regulations. Insurance companies may still charge higher premiums to cover children with pre-existing conditions.
Required open-enrollment periods will permit greater certainty for health insurance plans, which had complained the new law would allow parents to wait until a child gets sick to buy a policy, Insurance Commissioner Marcy Morrison said in a prepared statement. There is no word yet on whether the new regulations have prompted insurance companies that pulled out of the child-only policy market to reconsider.
What's new
ACA provision leads to projected decline in Medicare Advantage premiums
Premiums for Medicare beneficiaries enrolled in Medicare Advantage private insurance plans are expected to decline 1 percent next year, the federal Centers for Medicare and Medicaid Services said in projections released this week.
About 11.3 million Medicare beneficiaries nationwide are enrolled in Medicare Advantage plans and enrollment is expected to increase 5 percent in 2011. The lower average rates projected for 2011 are a result of federal officials negotiating more aggressively with private health insurance companies. The Affordable Care Act granted government officials additional power to negotiate for favorable rates and reject bids.
Another option to ensure compliance with advance medical directives
Despite a Colorado law requiring hospitals to obey patients' directions for end-of-life care, some seniors remain concerned Catholic hospitals will not follow their advance medical directives. The Colorado Center on Law and Policy has worked to protect patient rights in that area through its legal and administrative advocacy around the implementation of Catholic ethical and religious directives at some Denver-area hospitals.
The Denver-based advocacy group Compassion & Choices has created another way of ameliorating a potential problem -- a form to be executed by the person indicating a desire to be transferred if the patient's wishes will not be followed.
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. 24, 2010