Affordable Care Act

On a brisk morning in Denver recently, an ambulance pulled up in front of a downtown office tower. "I think the patient is going to make it," Dr. Irene Aguilar said as a team rolled out the gurney.

Many Health Co-Ops Fold, Others Survive Startup Struggles

Nov 26, 2015

Thousands of Americans are again searching for health insurance after losing it for 2016. That's partly because some large, low-cost insurers — health cooperatives, set up under the Affordable Care Act — are folding in a dozen states.

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On Wednesday, the Census Bureau gave Obamacare some good news: the number of people without health insurance dropped to 10.4 percent in 2014, down from 13.3 percent in 2013.

Colorado may be doing even better. When the Affordable Care Act launched two years ago, about 1 in 7 of the state's residents, or 14 percent, were uninsured, according to the nonprofit, nonpartisan Colorado Health Institute. That figure is now 6.7 percent, according to the organization's latest data.

The number of Coloradans who don't have health insurance has dropped by about half since President Barack Obama's signature health care law went into effect. The state's uninsured rate fell from 14.3 percent in 2013 to 6.7 percent in 2015. Not only does the Colorado Access Health Survey say that the uninsured are at a record low, it also finds that more people have enrolled in Medicaid.

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After nearly 30 years, the Obama administration wants to modernize the rules nursing homes must follow to qualify for Medicare and Medicaid payments.

The hundreds of pages of proposed changes cover everything from meal times to use of antipsychotic drugs to staffing. Some are required by the Affordable Care Act and other recent federal laws, as well as the president's executive order directing agencies to simplify regulations and minimize the costs of compliance.

Updated at 1 p.m. ET

The U.S. Supreme Court on Thursday handed the Obama administration a major victory on health care, ruling 6-3 that nationwide subsidies called for in the Affordable Care Act are legal.

"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," the court's majority said in the opinion, which was written by Chief Justice John Roberts. But they acknowledged that "petitioners' arguments about the plain meaning ... are strong."

Despite state lawmakers failing to pass a bill to fund the effort, a program to provide long acting reversible birth control to young, low-income women in Colorado is being extended for another year.

The long acting contraceptives, according to state figures, have helped cut teen pregnancy rates in the state by 40 percent. Abortions have gone down too.

The states that set up their own insurance marketplaces have nothing to lose in King v. Burwell, the big Supreme Court case that will be decided by the end of June. But that doesn't mean those states are breathing easy.

With varying degrees of difficulty, all of the state-based exchanges are struggling to figure out how to become financially self-sufficient as the spigot of federal start-up money shuts off.

Dana Lam was insured under her parent's health plan until the end of 2014, thanks to a provision of the Affordable Care Act that allows young adults to stay on family health insurance until they turn 26.

The arrangement worked out well until she needed treatment for depression. Lam knew that if she used her parents' health plan to see a psychotherapist or psychiatrist, her visit would show up on their insurance statements.

She wasn't ready to talk to them about her mental health issues. "I was just so afraid of having that conversation with them," she says.

Got a high-deductible health plan? The kind that doesn't pay most medical bills until they exceed several thousand dollars? You're a foot soldier who's been drafted in the war against high health costs.

Delta County Memorial Hospital, Urgent Care
Laura Palmisano / KVNF

The federal government has changed the way it pays hospitals through Medicare. It now factors in patient satisfaction. To discuss the affects on a local hospital, KVNF’s Laura Palmisano speaks with Jason Clecker, the CEO of Delta County Memorial Hospital. Over 60 percent of DCHM patients are on Medicare.

To see how your local hospital scored visit http://ow.ly/KGQk4

A total of 16.4 million non-elderly adults have gained health insurance coverage since the Affordable Care Act became law five years ago this month. It's a reduction in the ranks of the uninsured the the Department of Health and Human Services called historic.

Anne Roberson walks a quarter-mile down the road each day to her mailbox in the farming town of Exeter, deep in California's Central Valley. Her daily walk and housekeeping chores are her only exercise, and her weight has remained stubbornly over 200 pounds for some time now. Roberson is 68 years old, and she says it gets harder to lose weight as you get older: "You get to a certain point in your life and you say, 'What's the use?' "

In health insurance prices, as in the weather, Alaska and the Sun Belt are extremes. This year Alaska is the most expensive health insurance market for people who do not get coverage through their employers, while Phoenix, Albuquerque, N.M., and Tucson, Ariz., are among the very cheapest.

A Shots post earlier this week by NPR's John Ydstie detailed the "family glitch" in the Affordable Care Act. That's where people who can't afford their insurance at work aren't eligible for help in the new insurance exchanges. Many of these Americans, most of whom make middling incomes, will remain uninsured.

That story got us wondering: Who else is getting left out by health law? And who is getting coverage?

Don Benfield of Taylorsville, N.C., makes $11 an hour working for a mobile-home parts business, selling things like replacement doors and windows.

Benfield, 51, doesn't have health insurance.

"I haven't had health care insurance in years, simply because I haven't been able to afford it, especially with food prices, how they went up," he explains.

Benfield's employer does offer health insurance coverage, even though, with fewer than 50 employees, the business is not required to.

Connect for Health Colorado
connectforhealthco.com

Open enrollment for Connect for Health Colorado, the state’s health insurance exchange, has started. The enrollment period ends Feb. 15.

Connect for Health has health coverage guides across the state that help people navigate the marketplace and buy an insurance plan.

KVNF's Laura Palmisano speaks to Maria Forster, a health coverage guide for Volunteers of America, about the exchange and the people who are signing up for insurance.  

Connect for Health Colorado
connectforhealthco.com

Open enrollment for Connect for Health Colorado, the state’s health insurance marketplace, started Saturday. The enrollment period ends Feb. 15.

“It’s important for Coloradans to know that if they want their coverage to begin on Jan. 1, 2015, they need to enroll, select a plan and conclude the process by Dec. 15,” says Linda Gann with Connect For Health on the Western Slope. 

The state exchange, which is separate from the federal marketplace, allows people and small businesses to purchase health insurance and apply for federal subsidies. 

The second open enrollment season for health insurance offered through marketplaces created by the Affordable Care Act is just around the corner. Are you ready?

Here's a quick checklist for people who don't get their health insurance at work and plan to shop for coverage on the health law's online exchanges. Enrollment starts Nov. 15, but you can start kicking the tires now.

I write about health and health care, but even I'm not immune to the "young and invincible" mentality. My annual dental checkup is more than six months overdue.

A provision of the Affordable Care Act that took effect in 2010 aimed to make it easier for young adults to access preventive care by allowing them to stay on their parents' insurance until they turn 26. As of 2011, some 3 million young adults gained coverage through this provision.

So does this mean more young people are getting their annual checkups and cholesterol screenings?

Fall is enrollment season for many people who get insurance through their workplace. Premium increases for 2015 plans are expected to be modest on average, but the shift toward higher out-of-pocket costs overall for consumers will continue as employers try to keep a lid on their costs and incorporate health law changes.

A Gallup poll released Tuesday suggests the Affordable Care Act is significantly increasing the number of Americans with health insurance, especially in states that are embracing it. It echoes previous Gallup surveys, and similar findings by the Urban Institute and Rand Corp.

Colorado Division of Insurance, U.S. Department of Health & Human Services
Colorado Division of Insurance

The federal government has approved the state’s request to consolidate its geographic rating areas for health insurance. These insurance regions were created as a part of the Affordable Care Act, and are used by insurance companies to set premiums. 

The Colorado Division of Insurance said the U.S. Department of Health & Human Services has given approval for the state to shuffle its 11  regions for health insurance into nine next year. 

The reshape will combine four rural areas into two larger ones while keeping seven established urban areas.  

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As the Affordable Care Act takes effect this year, Delta County Memorial Hospital Administrator Jason Cleckler is navigating uncertain terrain.

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Elise Thatcher/Aspen Public Radio

Garfield County wants Governor John Hickenlooper to intervene with the state's new health insurance rules. The county has some of the highest premiums in Colorado under new guidelines. which are part of the Affordable Care Act.

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