I haven't really been following the saga of Colorado's H.B. 1232 "Standardized Health Benefit Plan Colorado Option" bill as much as I should have been over the past year. The last time I wrote anything substantive about it was over a year ago...in fact, it was just a few weeks before the COVID hit the fan:
The issuers will offer the plans on and off the Exchange in the individual market.
The issuers will offer qualified health plans (QHPs) at Bronze, Silver, and Gold metal tiers.
The premiums of the plans will reflect facility reimbursement levels that vary by facility. The formula for determining facility-specific reimbursement levels was provided by DOI, utilizing hospital specific financial information provided by HCPF. Maximum reimbursement levels by facility are set between 155% and 218% of Medicare payment rates.
The plans will be offered beginning in calendar year 2022.
The state intends to apply for a 1332 waiver and use Federal pass-through savings for additional benefits or expanded coverage. The Baseline scenario presented below reflects the current federal and state regulatory market, including a state-based reinsurance program. The second scenario reflects the results of offering a Colorado Health Insurance Option with additional benefits, a premium wrap and a cost-sharing wrap.
Federal health officials on Thursday advised Americans who are fully vaccinated against the coronavirus that they could stop wearing masks or maintaining social distance in most settings, the clearest sign yet that the pandemic might be nearing an end in the United States.
The new recommendations from the Centers for Disease Control and Prevention caught state officials and businesses by surprise and raised a host of difficult questions about how the guidelines would be carried out. But the advice came as welcome news to many Americans who were weary of restrictions and traumatized by the past year.
“We have all longed for this moment,” Dr. Rochelle P. Walensky, the C.D.C. director, said at a White House news conference on Thursday. “If you are fully vaccinated, you can start doing the things that you had stopped doing because of the pandemic.”
It's important to note that "in most settings" caveat:
UPDATE 5/17/21: (sigh) Never mind...again. There were several opinions announced this morning but the ACA case wasn't among them...again. The Sword of Damocles continues to dangle.
UPDATE 5/21/21: Annnnnnd the Supreme Court website now shows more decisions to be announced this Monday, May 24th...here we go again (maybe)...
UPDATE: 5/24/21: (sigh) Never mind...again. There were two opinions announced this mroning but the ACA case wasn't among them...again. The Sword of Damocles continues to dangle.
UPDATE: 5/25/21: Annnnnnnd the Supreme Court website now shows more decisions to be announced this Thursday, May 27th...
Over at the New York Times, Sarah Kliff and Margot Sanger-Katz have written an excellent summary of the problem and the proposed solution:
Surprise bills happen when an out-of-network provider is unexpectedly involved in a patient’s care. Patients go to a hospital that accepts their insurance, for example, but get treated there by an emergency room physician who doesn’t. Such doctors often bill those patients for large fees, far higher than what health plans typically pay.
Becerra Pressed On Surprise Billing, Short-Term Plans, Medicare
Lawmakers from both parties pressed HHS Secretary Xavier Becerra over surprise billing implementation, Medicare policy and non-ACA-compliant plans, including the Trump-era short-term plans and Association Health Plans during a wide-ranging hearing on the department’s fiscal 2022 discretionary budget. The former congressman and California attorney general also assured GOP lawmakers that Medicare for All is not on the agenda.
...The House Progressive Caucus has called for the potential $456 billion in savings to be used to add benefits to Medicare, although the caucus also supports making permanent the ACA’s enhanced tax credits. The White House also made clear that it wants the ACA tax credits to remain.
Molina exchange business grew by 302,000 consumers to reach a total 620,000 enrollees in the first quarter, outpacing the company’s earlier 500,000 estimate, growth that CEO Joseph Zubretsky says was driven by strong product design and pricing, higher effectuation rates, lower attrition and the special open enrollment period.
Molina’s marketplace business had a Medical Loss Ratio of 77.3%, which was due to the higher-than-expected direct COVID-related costs as cases surged in many areas.
There's a lot packed into that first paragraph.
First, their ACA enrollment (which presumably includes off-exchange) for Q1 was 24% higher than expected, which is quite an eye-opener.
Florida accounts for nearly one-third of the country’s new Obamacare sign-ups
Florida leads the country in new Obamacare sign-ups during an ongoing six-month special enrollment period announced by President Joe Biden shortly after he took office.
The state saw 264,088 new people enroll in the healthcare.gov marketplace between Feb. 15 and April 30, higher than the number of new enrollees during the shorter enrollment periods of 2020 and 2019 combined, the White House told McClatchy on Tuesday. Florida accounts for nearly a third of all new enrollees so far this year in the entire country.
Most of the article is just a general overview of how the ongoing COVID-19 Special Enrollment Period is doing, but there's two major problems with it.
Several fellow health wonks have chimed in. I spitballed perhaps 95%. Fann puts it at 96-97%. Cynthia Cox of the Kaiser Family Foundation thinks it could be even higher:
The Biden administration said Monday it will provide protections against discrimination in health care based on gender identity and sexual orientation, reversing a policy of its predecessor’s that had been a priority for social conservatives and had infuriated civil liberties advocates.
The reversal is a victory for transgender people and undoes what had been a significant setback in the movement for LGBTQ rights.
The shift pertains to health-care providers and other organizations that receive funding from the Department of Health and Human Services. Civil rights groups had said the Trump administration policy would allow health-care workers and institutions, as well as insurers, to deny services to transgender individuals.
The reversal is the latest step Biden officials are taking to reorient the federal government’s posture on health care, the environment and other policy areas away from the conservative cast of the Trump era, replacing it with a more liberal stance.
Medicaid expansion will not happen in Wyoming this year.
The state’s Senate Labor, Health and Social Services Committee killed a bill Wednesday morning to expand the federal insurance program, which would have insured an estimated 25,000 additional Wyomingites.
Lawmakers have defeated similar proposals for nearly a decade. Advocates hoped this year might be different. Many House Republicans voiced a change of heart after the COVID-19 pandemic and the decline of fossil fuels rocked the state’s economy, leaving many without health coverage. This session was the first in which a bill to expand the program passed a legislative chamber.
