Across the Country in ACA World - Oct No. 2

Colorado made big news last week with its draft proposal for a public option.  The proposal is required to be submitted to the CO legislature by Nov. 15. Legislation passed last session required CO’s Division of Insurance and the Department of Health Care Policy and Financing to develop the plan. The public comment period runs through Oct 25.  Under the draft proposal, the State Option would:

• Be available to all CO residents regardless of eligibility for subsidies, beginning 1/1/2022;
• Be offered as a Qualified Health Plan through Connect for Health Colorado;
• Be offered by every carrier in CO over a certain size (tbd), both on and off the Exchange;
• Boost enrollment by adding 4,600 - 9,200 previously uninsured, unsubsidized people to the individual market, according to Wakely projections.
• Offer all Essential Health Benefits; include more benefits that are not subject to the deductible, plus other high-value services like dental, pending savings and federal approval;
• Incorporate value-based design elements;
• Save money by capping payments to hospitals at 175%- 225% of Medicare rate.  Insurers selling plans on the individual market in the state currently pay providers about 289% of Medicare.  Additionally the State Option will require at least 85 cents of every dollar of premiums to be spent on health care.  That’s more than the current federal requirement of 80 cents of every premium dollar; and
• By driving premiums down, save the federal government between $69.7M and $133.6M in premium tax credits.
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Where You Live Affects How Long You Live - Check out the amazing new “social determinants of health” tool from the Robert Wood Johnson Foundation. Enter a street address to see life expectancy at the neighborhood, county and state level.  See how much a neighborhood can impact people’s health.

New Jersey is investing $2 million in navigators as it starts the shift from healthcare.gov to its own state-based marketplace.  New Jersey’s state-based exchange is officially barely a month old.

For a highly impressive use of data based on the California Health Information Survey using brainpower from the UCLA Center for Health Policy Research, check out the AskCHIS Neighborhood Edition© web tool. The tool lets you search for top health indicators by ZIP code, city, county, and legislative district (state and federal). The sample below shows the prevalence of diabetes across California (diabetes increases health care costs which increase premiums…).  Of course, the tool is only for California. Connecticut could use its own version. 😊