Health Law and Policy Update
Headlines of the week
Amendment 63 the most extreme among anti-reform measures
Proposed Amendment 63, one of a number of anti-health reform measures across the country, contains uniquely broad language that might have unintended consequences for health care in Colorado if passed by voters, an analysis by the Colorado Center on Law and Policy found. CCLP formally released the analysis this week.
The Denver Post's editorial board on Thursday advised readers to vote "no" on Amendment 63, noting "(t)he measure could limit Colorado's ability to implement health care reform while allowing costs to continue rising."
Colorado receives nearly $1 million for exchange planning
The U.S. Department of Health and Human Services awarded Colorado just shy of $1 million this week to help the state plan for the development of a health insurance exchange. The exchange will be a one-stop marketplace where eligible consumers and businesses will be able to easily compare benefits, prices and quality, purchase health insurance, and access premium tax credits.
Colorado's exchange, assuming the state creates one, must be in place by Jan. 1, 2014. While it is more than three years before exchanges must be up and running, states including Colorado are already beginning to look at information technology capacity, issues of coordination with public programs like Medicaid and CHP+, conduct needs assessments and engage in stakeholder processes. Colorado will use the grant award to support its interagency implementation board; perform an insurance market analysis and health information technology assessment; conduct economic analysis and modeling; convene community forums to gather stakeholder input; and, establish parameters for the governing structure of the exchange. More funding will be awarded in the coming years for development and implementation.
Colorado's last metro area meeting on the development of Colorado's exchange in 2010 was held this week. The topic was governance, and there was an initial review of a draft of a summary document available for comment. The next four meetings will be outside the metro area. For more information see Gov. Bill Ritter's health care reform website.
Grants will support public health and prevention
Colorado agencies will receive more than $1 million in grants from the federal government to support public health and prevention programs, the Department of Health and Human Services announced Sept. 24.
The grants are part of $100 million in awards nationwide that are made possible through the Prevention and Public Health Fund established in the Affordable Care Act. The Colorado grants include $63,390 to the state government for HIV surveillance, $73,927 to the state health department to support a tobacco quit line, and two grants to the health department of $531,825 and $393,807 to support emerging infections programs.
"This investment in prevention and public health will pay enormous dividends both today and in the future," said Health and Human Services Secretary Kathleen Sebelius in a news release. "In order to strengthen our health care system, we need to stop just focusing solely on sick care and start focusing more on proven evidence-based ways to keep people healthy in the first place."
Aetna pulls out of Colorado's small group market
Insurer Aetna has announced it will begin pulling out of Colorado's small group health insurance market, saying it does not believe it can remain competitive in that market. The small group market is for smaller businesses of up to 50 employees. Aetna will not sell new plans but will allow its current customers to renew their policies for one more year.
Health care reform, explained in nine minutes
The Kaiser Family Foundation has produced an easy-to-understand, light-hearted video explaining the nuts and bolts of health reform, all in nine minutes. The video explains how the law works, why it is needed, political considerations and much more. It's a great resource for people who need a quick understanding of health reform.
Expanding the primary care workforce
The federal government this week announced $320 million is available to help expand and train the primary care workforce, an effort to ensure sufficient doctors and other health care professionals are available to treat people who become insured under the Affordable Care Act.
The funding will go to primary care residency and training programs for physicians, physician assistants and nurses, as well as to grant programs for workforce development and training for low-income individuals to become health care professionals.
Secretary Sebelius issues letter to insurers
U.S. Department of Health and Human Services Secretary Kathleen Sebelius issued another letter to America's Health Insurance Plans last week encouraging the organization's members not to continue to pull out of the child-only market. The Sept. 23 implementation of the Affordable Care Act provision prohibiting insurers from denying coverage to sick children has been met with considerable industry resistance. Citing uncertainty and high costs, several major insurers have announced they will no longer sell child-only policies in the individual insurance market. The decision is harmful not only to sick children whose parents were waiting to be able to purchase coverage, but also to healthy children whose only access to health coverage might be the individual insurance market.
Sebelius enclosed with her letter a document clarifying the implementation of the pre-existing condition exclusion for children younger than 19. The document notes permissible actions for insurers to mitigate their concerns, such as limiting enrollment periods. It also says, if permissible under state law insurers may charge more for sick kids than for healthy children, and they may impose a surcharge in the event a parent drops a child's coverage and then picks it up again a short time later when the child becomes ill.
Colorado's Division of Insurance last week issued emergency regulations allowing insurance companies to offer child-only policies only during limited open-enrollment periods, but so far none of the companies that pulled out of the child-only market have announced plans to return.
A blog maintained by the Georgetown University Center for Children and Families notes some important context for the issue: "As states continue to grapple with insurance companies ceasing to write child-only insurance policies now that they are required to cover kids with pre-existing conditions, we are reminded of one simple fact - Medicaid and CHIP have never discriminated against sick kids. These cost-effective public programs have long been a lifeline for low-income children, and for children with disabilities who's health care needs may be more extensive. Medicaid often serves as a back-up plan for families whose private insurance is inadequate and doesn't meet the medical needs of their children."
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 Care Director
Health Care Attorney
Released Oct. 1, 2010