DENVER – Last Thursday, Connect for Health Colorado’s Board of Directors took a support position on House Bill 24-1258 Credit Covered Person Expenses Insurer Insolvency. This bill will require a covered individual’s new health insurance company to credit out-of-pocket expenses paid if their current health insurance company leaves the market mid-plan year and can no longer provide coverage. This bill also provides methods for health insurance companies to recoup any expenses and increase in claims liability because of crediting out-of-pocket expenses. Connect for Health Colorado has released the following statement:
CMS to Adopt Rules to Lower Health Care Costs in 2022 Federal Health Insurance Marketplace Plans
The Centers for Medicare & Medicaid Services (CMS) today adopted new provisions to lower maximum out-of-pocket costs to consumers by $400, while increasing competition and improving the consumer experience for millions of Americans who will rely on the Federal Health Insurance Marketplaces in plan year 2022. These actions demonstrate a strong commitment by the Biden-Harris Administration to protect and build on the Affordable Care Act (ACA), reduce health care costs, and make our health care system easier to navigate and more equitable.
This is a HUGE deal, especially in California, where an estimated 430,000 residents are enrolled in off-exchange ACA policies which are virtually identical to their on-exchange equivalent, with the sole distinction of those enrolled in them not being eligible for ACA subsidies.
With subsidies being beefed up and the 400% FPL subsidy cliff having been killed (for the next 2 years, at least), this means that hundreds of thousands of Californians have just become eligible for thousands of dollars in savings...as long as they transition to the same plan on-exchange.
(MOOP: Maximum Out-of-Pocket expense; please forgive my Seinfeld reference.)
When it comes to healthcare policy cost trends, my main focus has been on the average premium rate increases, which currently look (if approved as requested) like they'll go up around 22% on average next year on the individual market (perhaps half that for the small group market).
However, the other major cause of hand-wringing when it comes to healthcare costs these days are deductibles and co-pays...the out-of-pocket expenses which people may have to pay in addition to their premiums. Again, co-pays are a flat fee (usually $30-$50) which you have to pay for many doctor visits, while deductibles are the amount which you may have to pay towards various healthcare treatments/services before the insurance carrier actually starts to chip in their 60-90% of the bill. I don't think co-pays have really changed much over the years, but a whole lot of people feel that deductibles have shot up a lot since the ACA went into effect.
