State legislators are not waiting for Congress to pass a comprehensive health care bill. Here in Colorado, 17 bills offer some kind of change to how health insurance may be delivered in the future.

Working out's not enough; got to drop those pounds

Today, insurance companies offered up HB10-1160, modifying incentives and rewards for individuals who use wellness programs. Currently, if individuals use such a program, they can receive discounts up to 20 percent on their premiums. This bill tightens up the rewards by tying them to outcomes. Lose weight... get a reward. Stop smoking...get a reward. You can't just work out. An outcome has to happen.

Disability groups and medical organizations objected to the bill sponsored by Rep. Joe Rice (D) and Rep. Amy Stephens (R). The bill, these groups say, discriminates against people with disabilities for whom specified outcomes may never occur.

Individuals with rheumatoid arthritis, for example, may never be able to work out hard and long enough to lose weight, but any activity can help the disease. Same with MS and heart disease. Same with most people over 55, this writer notes, whose metabolism seems to slow down to zero even with strenuous workouts. This bill has been laid over to figure out what an "outcome" is.

Plain English for insurance documents

Writers will delight in HB10-1166 that requires auto, health insurance, and long term care insurance plans be written in plain English. This bill, if it passes, may keep former Rocky Mountain News reporters and editors busy for many years.

The plans must be written at an education level not to exceed 10th grade. Undefined is what tool will determine the grade level. Most common is the Fog Index, or the Flesch-Kinkaid Grade Level tool based on the number of big words (3 syllables or more) to total words in a sentence. Using this method, HB10-1166 works out to a 12 twelfth grade level. Apparently, this is a "do what I say, not what I do" bill, a phrase that comes out just right for 7th graders.

Simplified health insurance applications

Two other bills, HB10-1004 and HB10-1242, require health insurance providers to use a common application form for individual purchasers of health insurance. Rep. Tom Massey's (R)bill, HB10-1004, wants the application with explanations of benefits ready to go in 2011. HB10-1242 requires a common application by 2012. The difference in time frame, one might surmise, depends on whether HB10-1166 (see above) passes.

Want to know who's getting gifts from PhRMA?

Not to leave out transparency and PhRMA, Sen. Morgan Carroll (D) is trying another time to bring transparency to the drug industry. SB10-126, The Pharmaceutical Transparency Act, requires manufacturers of drugs, medical devices, or supplies to identify any transfers of value or payments made to health care practitioners prescribing these items. Other conflicts of interest to be reported include ownership or investment interests by health practitioners in the manufacturers. The Secretary of State would manage the reporting.

Last year Carroll cited instances where medical practitioners received skiing trips to high priced resorts and other nice gifts for doing research and reading their papers at conferences. That effort went down to a resounding defeat in the first committee hearing. PEN, Colorado Capitol Watch

 

This post was published on February 7, 2010. Permalink ». Comments are disabled at this time.

Women on individual health care plans, about 144,000 Coloradans, can pay as much as 84 percent more than men for their health insurance at various points in their 25-55 year age span. Marcy Morrisson, commissioner of the state's division of insurance, says it's because of "women's plumbing."

Breasts, uteruses, ovaries cost more early on

More precisely, it's their breasts, uteruses, ovaries, cervixes, and other reproductive parts that affect costs, and that's excluding coverage for maternity and contraceptive care. Health insurance providers wisely stayed away from the Health and Human Services Committee hearing Thursday on HB10-1008, the gender equity bill for health coverage for individuals, sponsored by Rep. Beth McCann (D-Denver) and Rep. Sue Schafer (D-Lakewood). That way, they didn't have to explain rate setting on individual health plans. Insurers also say gender equity is "the right thing to do."

Women buy more often than men, even though more expensive

Most people with health insurance get it through company benefit plans. These plans, under federal ERISA regulations, cannot set premiums based on gender. Not so for individual plans in Colorado.

Insurers selling individual plans have traditionally built in the extra cost of covering women for pap smears, mammograms, and other expense that comes with the female physiology. Even at that, women buy these plans at significantly higher frequency than men, probably because they're following doctor recommendations for yearly pelvic exams and breast examinations.

Men, whose medical expense exceeds women after 55, apparently skip the young age physicals.  They receive lower premiums primarily because of lower usage. Fortunately for them, their regular annual checks for their particular parts come into play after 55, and at 65, they're covered by Medicare.

How insurers set rates based on gender an unknown

Lawmakers couldn't make much progress on understanding the rate setting by gender because insurers took their pass at the hearing. No one can tell whether HB10-1008 will cause premiums to increase if gender is removed from the process.

Men will probably drop policies if rates go up, says Swalm

Rep. Spencer Swalm (R-Centennial) thinks premiums for men will go up, causing more men to drop coverage. Men already purchase individual insurance less frequently than women, 106,000 v. 144,000. Rep. Sue Schafer noted that women pay significantly higher rates and yet more of them are insured. 

Committee Chair Jim Riesberg (D-Greeley) said that women use insurance more for coronary care, diabetes, asthma, anxiety..." Rep. McCann offered that one reason women were so depressed is because of the high cost of their insurance.

The bill is on its way to the House's Committee as a Whole on an 8-2 vote.

This post was published on February 7, 2010. Permalink ». Comments are disabled at this time.

Individual health insurance policies for women seeking pregnancy and contraception coverage are hard to find and expensive, reported researcher Rachel Kline, who testified to the House Business Affairs and Labor Committee on HB10-1021 this afternoon.

“I spent 15 hours on the phone looking for individual pregnancy and contraceptive coverage,” said Kline. “ Of the nine insurers in the state, two don’t offer coverage and the seven that do wouldn’t discuss the details with me.  A pregnancy/contraception rider costs $400-$500 a month, with $500 deductible and 50 percent coverage.  Any plan has to be bought before conception; otherwise pregnancy is considered a pre-existing condition.”

Amended bill takes out contraception mandate

The bill, sponsored by Rep. Jerry Frangas (D-Denver) and Beth McCann (D-Denver), mandates that private insurers must provide women seeking individual insurance coverage with pregnancy and contraceptive care.  At the last moment, the bill was amended to take out contraception and mandate only that insurers must offer at least one policy with the pregnancy option.

Physicians and March of Dimes support bill

Physicians from the state’s leading OB-GYN and family practice associations supported the original bill based on the serious health problems that often occur for mothers and babies without prenatal care.  They were joined by March of Dimes.

“Pregnancy accompanied with prenatal care is how we end up with healthy children,” said McCann.  Employees with companies of 15 or more workers receive pregnancy care and contraception through ERISA.  It’s the woman who doesn’t get insurance through work who’s in trouble.

According to Scott Matthews of the March of Dimes, “Colorado has a 12 percent prematurity birth rate, which matches Africa’s.”  Premature babies are 10 times more expensive than babies that go full term, with costs rising up to $1 million, not counting the ongoing costs of permanent physical disability or the tragedy of mortality.

OB-GYN physicians say coverage saves lives, reduces costs

Physician Liza Byers, OB-GYN, stated that there’s “no coverage issue more important than maternity care.  When women buy policies assuming that pregnancy and contraception are covered, and then find out they’re not, it’s devastating.  They can’t get coverage and out of pocket costs are staggering.  The confusion can result in delaying or not receiving prenatal care, which Medicaid considers a must for women.”

Andrew Ross, MD, represented the pro-contraception side of the bill.  Without family planning, women can have as many as 12 to 15 babies in their 30 years of fertility.  “Contraception can also reduce ovarian and uterine cancer.  IUD’s can help with painful menstrual periods, endometriosis, and peri-menopause.”  Ross said that women find it odd and unhelpful that they can have tubal ligation coverage but not an IUD, which is reversible and cheaper and safer. 

Insurance underwriters say coverage will raise rates 20-50%

Charlene Yabbi weighed in with the financial consequences of mandating pregnancy and contraception coverage.  “Insurance can’t be all things to all people,” said Yabbi.  “If pregnancy and contraception coverage are added, excluding pre-existing conditions, premiums may rise as much as 20 percent.  If pre-existing pregnancy is not excluded, rates could go up as much as 50 percent.”  The Committee did not inquire as to how these increases are calculated.

“We do know we’ll see rates go up,” said Yabbi, “and that’s all it takes for some people to decide that any insurance is too expensive.  Insurers are doing what they feel is effective to keep rates down.  The beauty of the current system is that there’s choice.  People don’t have to do business with a carrier that doesn’t offer contraceptives.”

And there’s always condoms

Or people can use condoms.  “Condoms help prevent HIV infections, Chlamydia, and other venereal diseases,” said Yabbi.  “We’re concerned about people not getting the right information about their policies.  We want people to make educated decisions.  We want to do what’s necessary to keep rates down.”

Committee Chair Joe Rice (D-Arap) tried to revise the amendment to re-include contraception in the bill, but Rep. Karen Middleton (D-Aurora) advised that the bill should go to the House as amended.  “I’m always happy to have a woman telling me what’s good for me,” said Rice.  “My intent is to get women coverage for contraception.” 

Some members of the committee are concerned about mandates affecting insurers’ cost of business.  Rep. Larry Liston (R-CO Spgs) suggested that more and more mandates hurt companies.  “Nothing’s free,” said Liston.  “A lot of people are teetering on the edge, deciding whether they can get health care coverage at all.  It’s difficult.”

The bill passed as amended, 10-1, for a second reading in the House chamber. PEN, CCW

This post was published on February 4, 2010. Permalink ». Comments are disabled at this time.

When some animal owners encounter some animal control officials, it's not just fur that can fly.  A man in southern Colorado shot a dog attacking his livestock.  An arrest warrant was issued for shooting the dog.  A SWAT team went out to arrest the man.  Later, investigators from the Douglas County Sheriff's office decided not to press charges, but another detective did press charges. 

After all the confusion, the man is still in court, proclaiming self defense given the tragic incident of Jennifer Brooks who was killed by a dog pack two years ago.

Animal owners claim harassment by protection officers and agencies

HB10-1124, sponsored by Rep. Wes McKinley (D-SE CO), addresses the rights of animal owners and the responsibilities of animal protection agencies.  Some owners cite harassment by animal control, including the Humane Society and the Dumb Friends League.  

Owners have had doors kicked in by animal control officers and their animals impounded.  Owners are then charged for food and shelter for their animals during the ten day holding period used to resolve cases, even when the owner is not guilty of any wrong doing.

Animal protectors reject bill's price tag

Allied against the complaining owners are the Humane Society, the Dumb Friends League, the Colorado Association of Animal Control Officers, the Colorado State Veterinarian Association, the Colorado Municipal League, and city and county governments. 

The bill will require animal control officers to receive formal training from the University of Missouri, at the officer's expense of approximately $1700.  Veterinarians, cities, and animal protection associations protested the potential of animal shelter expense transferred to them when owners are not guilty of charges. 

Some associations objected to the requirement to raise liability coverage on non profit animal organizations protecting animals from $100,000 to $1 million.

Pit bull, a disability dog, caught in the middle of the dog fight

A Desert Storm veteran uses a legally obtained disability dog that he got when living in California.  The dog is a pit bull, and Denver has ordinances banning these dogs.  The dog is trained and docile, but the City and County of Denver wants to destroy it, violating American Disability Act waivers on dogs used for disabilities. 

House Agriculture Committee chair Randy Fisher, citing six amendments to the bill, decided that dog can't hunt.  He laid over the bill until next week.  Kiley Larsen and Paula Noonan, CCW

This post was published on February 3, 2010. Permalink ». Comments are disabled at this time.

HB10-1155: Precious Metals TABOR Reserve

Gold and silver would support the TABOR reserve, based on HB10-1155 sponsored by Rep. Kent Lambert (R-CO Spgs).  Lambert wanted the state to buy precious metals, such as gold, silver, platinum, and palladium, as long term assets to store in a vault in the state Capitol. 

The bill required the state to take precious metal severance tax and invest it in precious metals.  This would involve about $1 million in precious metal purchases this year, and $2 million for next year.  The money would be stored in a safe in the treasurer's office in the Capitol and would be available for viewing by the press at least once a year. The state could consider selling tickets to the press to further boost revenues. Rep Joe Miklosi (D-Denver) calculated that $1 million in precious metals could be put in a shoebox.  The bill was postponed indefinitely.

HB10-1137: People First Language In Laws

The "People First" language bill, sponsored by Rep. Bob Gardner (R-CO Spgs), requires the state to use "People First" language when referring to people with disabilities as people with disabilities rather than disabled people.  This wording is not to be confused with the Jefferson County Democratic Party motto, "Putting People First." Rather, the bill demonstrates the legislature's belief that words matter. It passed unanimously.

HB10-1088: Devolve State Commuter Highways To Local Governments

To save state money, Rep. Glenn Vaad (R-Mead) wanted to pass control of urban area highways to local governments. Easy for him to do as he lives in decidedly un-urban eastern Colorado. Once legislators grasped the idea of devolution, they saw trouble.  The City of Lakewood protested.  It would have to take care of C-470, Wadsworth, Sheridan, and Kipling, and said it wasn't qualified.  West metro area residents sighed in relief that the city recognized its limitations, as traffic on all these thoroughfares is already jammed by construction projects.  The bill was postponed indefinitely.

HB1--1018: Reduce Waste Tire Stockpile Risks

Colorado has lots of throw-away tires piling up. Rep. Marsha Looper (R-Calhan) and Dianne Primavera (D-Broomfield) say the rubber has hit the road and the state needs to clean up its act.  According to DC consultants, Colorado is at the bottom of the heap in tire recycling and disposal.  The state has over 50 million waste tires, enough to insulate lots of environmentally correct homes for rich people in the mountains. 

Apparently Colorado has become the Africa of tire dumping for the US, as many of the waste tires come from other states.  To combat the pile up, the bill requires the use of a decal program to track tires.  The bill passed unanimously. 

Kiley Larsen and Paula Noonan, CCW

This post was published on February 2, 2010. Permalink ». Comments are disabled at this time.