Colorado: Single Geographic Rating Area Would Limit Health Plan Availability, Report Finds

Consolidating Colorado's nine geographic rating areas into a single region could lead carriers to offer narrow network plans, withdraw plan offerings in high-cost areas, or exit the market altogether, according to a consultant’s report commissioned by the State Legislature and released by the Division of Insurance. The report, which studied whether a single geographic rating area would reduce statewide premium price disparities, recommends introducing a rating band to limit premium variation between regions instead of a single geographic rating area. Officials are seeking options for limiting the 36% price differential in per member per year premiums that now occurs across geographic rating areas.

Colorado: Budget Deficit Projected for Single-Payer Initiative

A Colorado Health Institute report projects that ColoradoCare, the single-payer initiative on the November 2016 ballot, could face revenue shortfalls of $253 million in its first year and $7.8 billion over 10 years as healthcare costs outpace program revenue generated by a 10% payroll tax increase. The ballot will permit State residents to vote to replace Connect for Health Colorado, the State-based Marketplace, with ColoradoCare, a universal healthcare coverage initiative.

Connecticut: Marketplace and Medicaid Enroll 41% of Individuals Losing Medicaid Coverage

Access Health CT (the State-based Marketplace) and the Department of Social Services enrolled 41% of the approximately 13,800 individuals whose Medicaid coverage ended on July 31, 2016 after income eligibility requirements for Medicaid parents and relative caregivers were lowered. Roughly 2,100 of those individuals enrolled in a Markeptlace plan and nearly 3,500 were re-determined eligible for Medicaid. Last year, the State approved a two-year budget that reduced income eligibility requirements for Medicaid, from 201% of FPL to 155% of FPL.

Illinois: State Improves Birth Control Coverage

Governor Bruce Rauner (R) signed legislation (HB 5576) guaranteeing birth control coverage without cost-sharing for all FDA-approved contraceptive drugs, devices, and supplies for women in State-regulated individual and group health plans. While the law does not require all FDA-approved methods to be included on plans’ formularies, it does require coverage of FDA-approved non-formulary methods when prescribed by a provider based on medical necessity. The new law also permits women to obtain up to 12 months of contraception at one time and ensures coverage of patient education and counseling on contraception, contraceptive follow-up services and voluntary sterilization, all with no cost-sharing. The law is scheduled to take effect on January 1.

New York: Department of Financial Services Approves 2017 Rates

The Department of Financial Services (DFS) has approved rate increases for 2017 individual and small group plans ranging from 8.3% on average in the small group market to 16.6% on average in the individual market. According to DFS, rate increases were primarily driven by increasing medical and drug costs, as well as the end of the federal reinsurance program, which provided additional funding to insurers whose enrollees incurred high claims costs. DFS emphasized that more than half of NY State of Health (the State-based Marketplace) purchasers qualify for premium tax credits, offering some protection from the increased rates, and that the increases will not affect members enrolled in New York’s Basic Health Plan, which will continue to offer premiums of $20 or less for those who qualify.