I’ve long avoided using the adage “You can’t have your cake and eat it too” because I don’t like cake – pie is all a dessert should be – but there is few other catchy ways to describe what happens when someone tries to achieve two mutually exclusive goals at the same time.
In this case, the state government is trying to reduce health insurance premiums while increasing benefits. It doesn’t count as anyone who’s taken a math course knows. Colorado politicians want to have their cake and eat it too.
In a month, I will lose my health insurance plan because the carrier leaves the state and I will pay more in monthly premiums, regardless of the plan I choose. On average, insurance costs will increase by 10.4% next year. Every year since 2019, Colorado lawmakers have passed new
hedging mandates that have driven up the cost of premiums in the retail market by 5.5-7.9% per year.
I don’t need acupuncture, gender reassignment plastic surgery, HIV prevention drugs or any of these new benefits and yet I pay for the extra coverage. Lawmakers promised lower-premium insurance plans would be more available when they passed the much-publicized Colorado Option Bill HB21-1232 last session. Health insurers in individual and small group markets are required by law to offer a standardized, low-cost health benefit plan that meets stipulations set by law and the state insurance commissioner. Plans must reduce their premiums by 5% in 2023, 2024 and 2025 for a total reduction of 15% from the baseline.
Lawmakers were so confident of success that the Polis campaign touted the legislation as one of more than 100 ways the administration was saving money in Colorados. It turns out that’s not the case. Cheapest Plans in State Healthcare Exchange Aren’t Colorado Option
plans but rather plans designed by the carrier.
That’s because Colorado Option plans require more “free” benefits such as nonpreventive primary care and mental health and addictions visits than traditional plans while forcing insurers to lower premiums. These are mutually exclusive objectives since more
benefits require higher premiums to cover additional costs.
In addition to coverage mandates, the government has imposed several unnecessary and intrusive requirements on insurers. Insurance companies should strive to create “a network that is culturally appropriate and, to the extent possible, reflects the diversity of its enrollees in terms of race, ethnicity, gender identity and orientation sex in the region where the network exists”.
This means that they must recruit medical providers based on their physical characteristics and gender identity so that these providers match the insured population. Some employees will have to be responsible for this unnecessary exercise and this cost will be incorporated into the bonus.
Frankly, I don’t need a medical professional like me; I am happy with another human who is good at his job.
Insurers are also obligated to report whether providers in their networks have undergone anti-bias training as if the insurance company were an accrediting agency overseeing ongoing training courses. Unless the Awakened Fairy pays the lucky employee responsible for counting those beans, the extra cost will be borne by whoever pays the bounty.
The imposition of new mandates and price controls on insurance companies has not led to the cost savings promised by politicians. It has, however, made it more difficult for insurance companies to remain viable in this state. My insurer, Bright Health, and another, Oscar Health, are leaving and over 58,000 of us are looking for a new carrier.
As a writer and adjunct teacher whose income fluctuates month to month, I need a low premium, high deductible plan with no extra benefits that I don’t need and don’t can’t afford. Will the legislature admit its missteps in the upcoming session and give us self-employed Colorado a break? Or will they just say, let them eat cake?
Krista L. Kafer is a weekly columnist at the Denver Post. Follow her on Twitter: @kristakafer
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