This isn’t “consumer protection”: it’s state-mandated equal sharing of misery:

https://www.colorado.gov/pacific/dora/news/updated-regulation-govern-short-term-health-plans-colorado?inf_contact_key=add714bd3ea171cf2aa5ce879e9473b5

There will be virtually NO short-term medical plans available in Colorado after this regulation goes into effect, I predict. Since when did “consumer protection” extent to The State simply demanding that all things must be one size/shape/form, eliminating any chance of the consumer being able to make his own decision for his or her own needs, supplanted by the “we know what’s best for you” overregulation that actually causes more harm than good? Elections have consequences: Big Brother won, and guess who loses.

Oh, and to be clear: the intent of this regulation is a thumb in the eye to the Trump Administration, and its attempts to bring market forces to work, to expand choices, and provide relief for people who simply want to buy something that might work more effectively for them, even if it *gasp* isn’t a lock-step, over-priced, ACA clone that many can’t afford. Egads! We can’t have that, can we?

Government: we know what’s best, so shut the hell up.

Many years ago (ancient history for many, since it was in the last century) a certain Colorado Governor demanded the reform of Colorado’s health insurance regulations, or he’d bring a “single payor system” down on our heads. it was to be called, if memory serves, ColoradoCares. Reform happened, so it went away. But you know, the relentless need to have a government-run health care system never goes away with Democrats.

Well, its back, and it’s even worse. Here’s a quote: ” a “risky and untested state-run health insurance system.” State-run, as in, the state of Colorado, and financed with a whopping big tax increase, larger than the size of the entire Colorado budget. It will replace Obamacare. And no, that would not be the kind of replacement I’d be in favor of!

If you love Obamacare, you’ll love this – until you don’t.

Read the full story here.

It should not come as a surprise that the current Administration would eventually take steps to abolish or otherwise destroy Health Savings Accounts, which were legalized as part of a deal made with Democrats to get Medicare Part D passed in 2003. Democrats universally loathe the idea that you could be allowed to buy a higher deductible plan and then contribute to your own “medical IRA” to pay for out-of-pockets expenses; they’d prefer you give the whole amount to an insurer (and the government) so they can re-distribute it properly. They’ve been gunning for HSA’s for at least a decade.

Health Savings Accounts represent one of the fastest, if not the fastest, growth segment in health insurance, and this has not gone un-noticed by the one-size-fits-all redistributive Left. I originally thought HSA’s would be eliminated via executive fiat in 2012; lo and behold, the gov needed the flexibility of HSA’s to keep Obamacare from foundering on the rocks. Those days are long gone; since the ACA has weathered all of the legal arguments thrown against it, regulators at CMS feel confident that they can now move against HSA’s, at least as far as the exchanges are concerned (and this will have repercussions in the private, individual market as well, I’m sure).

For 2017, it is highly unlikely that HSA’s of any kind will be legal or allowable on any exchange, federally-facilitated or state-run. The reason for this has to do with the ever-increasing deductibles required by the ACA, as well as new requirements, laid out in a brand-new, 500+ page rule, that mandate that some services other than preventive care must now be covered under the deductible. Since, under HSA plans, services other than preventive can’t be covered until the deductible is met, this means that, in CMS’ convoluted reasoning, that HSA’s are simply not relevant to their ever-higher deductibles and ever-expanding “first-dollar” coverage requirements. Its – yes – death by executive fiat, via a thousand cuts.

What is of course not talked about yet is the idea that, as soon as the new benefit plan design become mandated, old plans will bo longer be ACA-qualified: in essence, the elimination of ALL HSA-qualified plans in own fell swoop, and also the elimination of ANY HSA deductions into your HSA account.

Based on this, HSA’s as a valid health coverage will disappear by 2018. Who are you voting for in 2016?

Here’s an article that explains it more fully – go here.

The Colorado Division of Insurance moved swiftly to remove Colorado HealthOP from the list of approved insurers in Colorado and through the Connect 4 Health Colorado Marketplace Exchange. See the news release here.

Insurers have a new year of data and the numbers don’t look good. It will be very interesting to see what Colorado rate increases will look like. As usual, for those on subsidized policies, this news will be met with a shrug, since the “I got mine” mentality is in full swing. For everyone else, the rates increases, be they at the low end (say, 10%)) or the high end (say, upwards of 30%) will be particularly savage, and, as individual rates continue to resemble small group rates in all states, it will be increasingly difficult to absorb rate increases coupled with assessment fees to Connect For Health Colorado (on ALL health policies sold in Colorado), along with high deductible and out-of-pocket costs. The reaction I get from people with families looking for individual plans run the gamut, with “HOW MUCH??” and simply stunned silence the most common refrains.

More Health Insurers Seek Double Digit Premium Increases

Everyone’s aware of the infamous Gruber statements. Let me paraphrase: you’re all idiots – now pay me. Followed by an evil laugh.

Well, apparently the good folks over at your local Marketplace Exchange, Connect For Health Colorado, fell for it, too. (And I should add a disclaimer that I am a Certified Agent for C4H-CO, and I’m just reporting the facts, Ma’am).

Those pesky folks over at the Independence Institute, namely their Health Care Policy Center, run by the charming Linda Gorman, an economist by trade and a member of Colorado’s Blue Ribbon Commission on Health Care Reform, have published a very interesting piece of analysis titled “How The Gruber Model Failed In Colorado”. You can get it here. The bottom line assessment? “Its poor predictions will likely end up costing taxpayers billions of dollars”.

This is so good it’s hard to summarize: I think anyone interested in the effects of Obamacare and the lackeys employed to carry the water for it should read it, re-read it, and pass it around. And, if you know anyone in Vermont …

Seriously, I’m no economics expert (or anything else for that matter, except maybe good coffee) but for really educated folks to buy into Grubers’ predictions, as highlighted in the reports and analysis he got paid to do by Colorado, simply defies explanation. I mean, really: the idea that, based on somebody’s economic assumption, there wouldn’t be an almost catastrophic rise in Medicaid recipients is simply stunning. As almost anyone who’s been around the health insurance business knows, it isn’t the folks who can buy insurance and don’t who are the biggest problem, it’s the folks who couldn’t buy coverage at all due to extreme low-income or other circumstances. The farcical notion that many more people would get subsidies rather than a short trip to Medicaid says that no one really understood what’s been happening in Colorado. Guess what? Medicaid enrollment has exceeded expectations by 40%, and drastically overestimated the demand for subsidized policies (one-sixth of what was projected!).

Even unsubsidized policies are far below Grubers’ prediction. (And here’s an odd thing: why would anyone buy an unsubsidized policy through the exchange, anyway? There is simply no reason to buy an unsubsidized individual policy through the Marketplace exchange – something that comes as a surprise to many people.)

The reports go on to (laughably) suggest that insurance premiums would go down “27% on average”, with people buying richer plans because of their tax savings. I should send this to my clients who have a) had their premiums rise at least that much, b) their deductibles go up dramatically, and c) their networks and doctor choices curtailed, seeing that the market switched from PPO to HMO offerings almost immediately. That would be all of them, by the way.

The list of predictions that were wrong read like a list of Obama statements, that’s for sure! Like Grubers’ predictions that people in grandfathered plans would “see no change in their premiums”. Actual fact: they rose by 37% by early 2014.

And we won’t even talk about how Obamacare wrecked a high-risk pool that was actually cheaper than it’s replacement (and rather than an HMO was an any willing provider network, to boot).

This, my friends, is what happens when common sense and good public policy get replaced with redistributive ideology: any argument works so long as it advances the political objective, true or not. And the essence of Obamacare wasn’t about “health insurance reform”, it was about federalizing the health insurance markets prior to a move to a single-payor system (that’s my own opinion, by the way, not anything taken from the report).

Best take-away quote: “.. substituting tax subsidies for direct payment does not affect the cost of health insurance”. Of course not.

Download it, have a good read, and discuss it. Better yet, share it with every Colorado legislator you can! Good job, Ms. Gorman!

I’ve said for some time that “health care reform” wasn’t the goal of Obamacare, and it certainly shouldn’t have cost however many trillions of dollars thats been forecast to pay for it (the actual figure isn’t important, save for one fact: it’s a lot more than we were promised, before we knew “what was in it”).

The mass media seems to be of the opinion that Republicans have no alternative to Obamacare, but the truth is that any number of alternative policies have been discussed within Republican circles. Most critics of outright repeal like to point out that the individual and employer mandates were Republican ideas; this canard has been bandied about for so long that it now been accepted as fact. The reality is that the mandates were viewed as essential only by a handful of think-tank policy wonks, and never really achieved critical mass with conservatives who study health care policy closely.

One of those individuals is John C. Goodman, from the Independence Institute. Mr. Goodman is considered to be the “father” of the health savings account, and he has a brand new article on what Republicans can do, now, to repeal the worst parts of Obamacare. In a previous article, “How The GOP should now deal with Obamacare”, he discussed the pitfalls that Republicans will likely encounter as they try to “repeal and replace” Obamacare with a new system that will inevitably be some version of what is currently in place.

In “A Republican Alternative To Obamacare”, he expands on his earlier work, by advising Republicans to concentrate on the promises made to voters in the 2014 elections: “keep your job; keep your health insurance; and keep your doctor”. And his solutions to health insurance, and health care, issues are the best I’ve read, encompassing great ideas and solutions to the kind of Washington-driven, centrally-planned health insurance environment we find ourselves in, with narrow networks, a return to highly steered “managed care”, rigid health care design, and lack of choice and flexibility.

I highly recommend the policy solutions he puts forward, and dearly hope that someone in the Republican leadership is listening and taking copious notes. The bottom line is this: without a clear cut and simple approach to replacing the disaster now known as Obamacare, Republicans will stand little chance of gaining any ground against entrenched interests, which include progressive Democrats, insurance company executives, and others who are beginning to reap the benefits of a quasi-monopoly driven by the central planners at HHS. Taking the alternative directly to the American people is the best way to get the message out, and that requires more than a statement in front of a podium at the Capitol, which is essentially all we’ve been given from the current Speaker of the House. It requires a full-court press by the leadership, because there isn’t a more pressing issue than repeal and replace Obamacare. I believe the political will can be found, and not just from Republicans.

Anyone who thinks that Obamacare was about heath care, let alone health insurance, reform, is either, at best, naive, or, at worst, completely ignorant of the law – and how it was passed, and the consequences of its various statutes, regulations, rulings, and case law.

Obamacare was about social engineering – much the same way that Common Core is about federal control of school curriculum, to advance certain, shall we say, dogmas that most of us would find puzzling, if not outright outrageous.

But I digress. I’ve often told those that will listen that I could have written a health insurance reform proposal that would have numbered a few hundred pages and would have been much, much more successful than the Affordable Care Act, assuming that its goal was the elimination of the chronically un-insured in these United States, probably around twenty million or so (it wasn’t, re-read paragraph two). And, it certainly would not have cost upwards of $2T plus that we see now (and that figure will continue to rise, even as deductibles rise, and out-of-pocket expenses rise, and so on). And I would agree that reform was needed, just not what we got.

James C. Capretta is one of a handful of experts who I respect wholeheartedly with regards health care reform policy. In this article he lays out the compelling reason why we need, not just to repeal, but replace Obamacare: because reform is just as needed now, as it was in 2009.

Here is the most interesting conclusion that Mr. Capretta advances: “The hard work of developing a credible alternative plan has already been mostly completed. What is needed now is a spirit of practical compromise among key Republican policymakers. It will not be possible to beat an incumbent program — the ACA — with abstractions, good intentions, and idealistic concepts. What’s needed is a workable, politically viable plan, one that voters can see for themselves would work better than the ACA.” 

As the article points out, the hard work for a viable replacement for the ACA has already been done. It will take Republicans to advocate for it in a forceful way. And, if SCOTUS disallows the payment of premium credits in the federal exchanges, as detailed in King v. Burwell, then Republicans won’t need to wait for control of the White House to replace Obamacare.

Much ballyhooed numbers on Obamacare enrollment are released, with an estimated six million enrolling, but  Rep. Marsha Blackburn (R-Tenn.) expresses doubt. See the video and news story here.

Even in the face of such strong enrollment numbers, though, which have not yet been verified, the government has moved to extend the open-enrollment date for federal exchanges, even after a Centers for Medicare and Medicaid (CMS) spokesperson said “we don’t actually have the statutory authority to extend the open enrollment period in 2014.” And of course, she is correct, as reported here. The open enrollment period is specifically defined by statute, and isn’t open to interpretation. Forbes has an interesting article on it, go here.

What this means is that people who have recently fallen ill or are otherwise uncovered will be able to get health insurance beyond the open-enrollment date, something that troubles insurers, some of whom are predicting double digit rate increases for 2015.

UPDATE: Here are three little questions about those Obamacare enrollment numbers.

The American Action Forum has published an eye-opening research paper on The Affordable Care Act, and comes to the conclusion that “regulatory costs exceed benefits by twofold”.

From the opening summary: “From a regulatory perspective, the law has imposed more than $27.2 billion in total private sector costs, $8 billion in unfunded state burdens, and more than 159 million paperwork hours on local governments and affected entities. What’s more troubling, the law has generated just $2.6 billion in annualized benefits, compared to $6.8 billion in annualized costs. In other words, the ACA has imposed 2.5 times more costs than it has produced in benefits.”

For the full report, including the employment impact and policy implications for small business, go here.

From The Foundry at The Heritage Network, originally published in National Review Online: “One excepted benefit that  .. could serve as a lifeboat if the voyage of the SS Obamacare goes as badly as we have feared: indemnity insurance .. anything that constitutes an excepted benefit under HIPAA remains exempt from all of Obamacare’s new insurance regulations.”

Well, not anymore it seems, as Centers for Medicare and Medicaid Services (CMS) unilaterally decided to amend HIPAA to suit themselves. As usual, the government drops its bad news on Friday evenings when we are all exhausted from working to pay for our health insurance premiums (or not, if you’ve decided to pay the penalty). Go here for the full story.

And this quote is especially telling: “.. this latest proposed Obamacare regulation, like many before it, isn’t even a remotely plausible interpretation of the statutes that Congress actually passed. This latest “fix” is worth fighting — both to keep the lifeboats intact during this dangerous voyage and to keep a sound insurance option in place for the long haul.”

One of the most frequently cited ways that insurers used to reduce costs for the new ACA compliant plans was to engineer new provider networks, primarily HMOs, with lower fee-for-service reimbursements, referred to as  per-member-per-month arrangements. These networks were reviewed at the state level for adequacy. In fact, the new networks were substantially smaller, as many physicians opted out of them due to reduced reimbursement rates or capitation necessitated by the new rules carriers must operate under due to Obamacare.

The federal government decided that this won’t be acceptable for 2015.  In a draft letter from the Centers for Medicare & Medicaid Services (CMS), insurers will be required to include 30% of “essential community providers” (ESPs) in their network.

ESPs serve primarily “underserved” populations, including community health centers, HIV/AIDS clinics, family planning clinics and children’s hospitals. From Insurance Business: “In order to assure this is the case, CMS plans to establish its own process for certifying adequate provider networks, cutting out the role of state regulators.” See the full story here.

CMS, in 2013, stated that, for 2014, they would “rely on state analyses and recommendations when the state has the authority and means to assess issuer network adequacy.” See the full text of the earlier guidance here. For 2015, with CMS expanding the ESP requirement,this will likely increase premiums further, due to an increase in network providers mandated by CMS.

Other changes that will have a cost effect on premiums include changes to stand-alone dental plans, and a new requirement to pay for a 30-day supply of any new drug that a new customer had been taking—even if the drug would not have ordinarily been covered.  For the complete 2015 guidance, go here.

Insurers are rightfully concerned about the new requirements, with America’s Health Insurance Plans (AHIP) already expressing its disapproval in comments filed on the proposed changes. Insurers have just weeks to present their changes, with some deadlines beginning in April of 2014.