Archive for Health Insurance’ Category



Colorado officials listen in on Health Care reform as Supreme Court wraps up

As the reform progresses, there will be a lot of interesting articles. I founf this one in the Colorado Statesman.

As members of Colorado’s congressional delegation from both sides and Republican Attorney General John Suthers anxiously sat this week as the U.S. Supreme Court’s historic hearings on President Barack Obama’s federal health care law, listening in as the high court weighed questions that could lead to overturning .

The issues being debated by the court highlight the larger, highly politicized concerns surrounding the most sweeping and dramatic health care policy overhaul the nation has seen in four decades.

The conversation is not isolated to Washington, D.C., but has landed hard in Colorado, with legislation aiming to address some of the most explosive issues, including whether institutions have the right to moral health care objections on the basis of religious grounds, such as requiring contraceptive care. The question has become synonymous with the so-called “War on Women,” a series of controversies both parties are hoping to exploit as the election nears.

But, ostensibly at least, the high court this week was required to put politics aside and focus on only two key legal components in the debate, including whether the court can even rule on the case, and whether the mandate in the law requiring individuals to carry health insurance or pay a penalty is constitutional.

On Monday, the exchange in court centered on a unclear 1867 law reputed to be the Against-Order Act, which bans petitioners from soliciting a discount on an assessment until that charge has in fact been paid. The predominant concern the court will ought to choose is in case the single command and coverage prerequisite as a matter of fact ends up as a charge.

The justices appeared to be leaning toward rejecting the notion the mandate is a tax, which would allow the court to rule on the broader constitutional questions, likely to be in late June when the high court announces decisions on its most prestigious cases. Many of the justices appeared eager to get on with the case and even began asking broader constitutional questions by the end of Monday’s hearing.

Justice Ruth Bader Ginsburg said the case did not seem to rest on a tax issue, arguing, “This is a suit that is challenging the ‘must-buy’ provision, and the argument is made that, if, indeed, ‘must-buy’ is constitutional, then these complainants will not resist the penalty. So what they’re seeking is a determination that … ‘must-buy’ is unconstitutional, and, if that’s so, that’s the end of the case. If it’s not so, they are not resisting the penalty.”

Justice Samuel Alito and Chief Justice John Roberts, however, seemed to agree that a tax was indeed involved, with Roberts stating, “The idea that the mandate is something separate from whether you want to call it a penalty or tax just doesn’t seem to make much sense. It’s a command. A mandate is a command.”

Suthers said he was confident on Monday that the high court was leaning in the direction of not calling the mandate a tax and therefore would consider the broader constitutional questions.

“That’s not the way the Supreme Court is feeling,” Suthers told The Colorado Statesman. “They said, ‘Hey, look, Congress didn’t call it a ‘tax,’ they called it a ‘penalty,’ why should we consider it a ‘tax?’”

Some observers believe conservatives would prefer the case not be decided until after the November presidential election. If the Supreme Court upholds Obama’s most prominent legislation, then Republicans could essentially suffer a defeat, as the GOP has made the mandate the centerpiece of their opposition, dubbing the law “Obama-care.” Even if the Supreme Court overturns the law as unconstitutional, some say, Democrats could use the ruling to argue that Republicans prefer skyrocketing health care costs in the name of conservative, free-market principles.

But U.S. Rep. Doug Lamborn, R-Colorado Springs, who had the honor of attending the hearing on Tuesday, said Democrats have much more on the line. Lamborn said he glanced around the hearing and saw Secretary of Health and Human Services Kathleen Sebelius looking “not so happy.”

“The reason being is because they’re in a lose-lose situation, they have nothing to gain and everything to lose,” Lamborn told The Statesman on Wednesday. “It hurts them politically however it comes out because, if the law’s upheld, that’s going to fire up the Republican base even more, and if the law is struck down, I think that’s going to discourage the Democratic base because this is [Obama’s] signature achievement and it will have evaporated.”

Suthers says he has separated the politics from the case and that he isn’t concerned whether a delay in the case would benefit his party come the November elections. Suthers says he wants the high court to hear the case because of the constitutional issue, which is why he said he joined Colorado with 25 other states in a lawsuit challenging the legislation two years.

The conservative attorney general, who has been pilloried by political foes for entering Colorado into the lawsuit, said it was a spectacular experience to be at the Supreme Court for the historic proceedings. He called the case one of the most important in the nation’s history, ranking it with the landmark Brown v. Board of Education decision on school segregation.

Suthers scored one of only six seats awarded to the state attorneys general represented in the lawsuit. In what was apparently a testy process choosing which attorneys general won seats, Suthers came out victorious.

“I happened to be on a management committee managing this litigation for the states, so it is a real honor and a privilege to be here,” said Suthers.

“There were thousands and thousands of people in front of the court,” he added. “Everybody understands that this is a big moment in American jurisprudence.”

Constitutional questions

On Tuesday, the court turned to the crux of the debate, which is whether the individual mandate is constitutional. The lawsuit argues that Congress doesn’t have the authority to regulate interstate commerce in such a way to force consumers to carry health insurance or otherwise pay a penalty. The mandate takes effect in 2014, when nearly all Americans will be required to carry health insurance or face penalties that could run as high as $700 a year.

If the provision establishing an individual mandate falls, then the entire health care law could be in jeopardy, since many of its other provisions rely on a large insurance pool — including younger and healthier Americans — to lower overall costs.

It is on the individual mandate question that the nine justices appeared sharply divided, with the court’s four Democratic appointees appearing to lean toward upholding the law, while Republican appointees Justices Antonin Scalia and Samuel Alito appeared to join with Justice Clarence Thomas sounding prone to reverse the provision. Chief Justice Roberts and Justice Anthony Kennedy are emerging as the swing votes in the case, though court observers caution against predicting outcomes based on questions posed during hearings.

An argument made by the law’s opponents is that if the individual mandate is constitutional, then the government could foreseeably require a multitude of commerce purchases, such as imposing a mandate to purchase healthy foods or treadmills to combat heart disease.

Justice Scalia grilled the Obama administration’s attorney, Solicitor General Donald Verrilli, Jr., asking him, “It may well be that everybody needs health care sooner or later, but not everybody needs a heart transplant, not everybody needs a liver transplant. Could you define the market so that everybody has to buy food sooner or later, so you define the market as food, therefore, everybody is in the market; therefore, you can make people buy broccoli?”

Verrilli struggled with several questions, stumbling over some of his answers in an effort to articulate the administration’s position that the mandate merely regulates commerce that already exists because everybody uses health care services.

But he appeared to have the support of several of the court’s liberal members, including Justice Sonia Sotomayor, who argued that the federal government already regulates almost every product.

“There is government compulsion in almost every economic decision because the government regulates so much,” she said.

Ginsburg pointed to the costs associated with the health care market, arguing that fewer people in insurance pools results in higher health care costs for the nation as a whole.

“Those who don’t participate in health care make it more expensive for everyone else,” she said.

But Suthers said he sees the question more appropriately focused on the relationship between the states and the federal government.

“It’s the essence of the case,” he said, “saying nothing less than federalism is at stake.”

“Governments have always regulated economic activities through commerce,” he continued. “This is the first time we’ve punished people for not buying the product or service that we want them to buy.”

His comments resulted in sharp rebuke from Colorado Democrats, who pointed to Suthers’ comments in a release attacking the Republican.

“The Attorney General takes an oath to support the Constitution of the United States and of the State of Colorado,” said state Democratic Party chairman Rick Palacio in a statement, “but John Suthers can’t seem to find time for either while he pushes the latest Republican agenda item.”

U.S. Rep. Diana DeGette, D-Denver, who attended the hearing on Monday, said she believes the high court will uphold the law, noting a popular Democratic argument that the overhaul is designed to save Americans money and improve health care.

“Health care is something every American consumes, and we’ve already had a number of provisions (that are) very popular go into effect,” DeGette told The Statesman. She pointed to provisions that prohibit insurers from rejecting applicants based on preexisting conditions, allow young adults to stay on their parents’ insurance until age 26, lower prescription drug costs and allow for preventative care services.

“The Republicans, they keep saying that they’re going to repeal and replace it, but I haven’t seen a proposal from them to actually give all these wonderful benefits to Americans,” DeGette added.

Lamborn, however, believes reform is possible, but not through government mandates. He has been a leader in his caucus for calling for the repeal and replacement of the federal health care law.

“I am against the law in every possible way, which is why I worked against it before we voted and have ever since then,” he said. “It’s government intrusion into our daily lives. It erodes our freedom, and it does not help health care.”

“You can’t insure 30 to 40 million Americans for free,” Lamborn continued. “Right now all Americans do get emergency treatment, so we’re not talking about people suffering from that. But to go to a doctor, we do have a social safety net in place, and there has to be a role for personal responsibility.”

Debate lands in Colorado

The federal health care debate landed in Colorado almost immediately, especially last year with the passage of Senate Bill 200, a law that began the process for implementing a health care insurance exchange in Colorado. The legislation caused House Majority Leader Amy Stephens, R-Monument, heartburn for sponsoring the measure, which some conservatives attacked as an extension of Obama’s health care law.

The federal law requires implementation of state exchanges but gives states flexibility in developing the exchanges. Colorado health care exchange officials are still in the process of establishing a website that will allow Coloradans to purchase and compare insurance from a large pool, with the hope of lowering costs.

Lamborn, however, said he still has concerns with the concept of health care exchanges as it relates to the federal law, though he would not comment specifically on SB 200.

“Insurance exchanges can be used as a part of the scheme to implement Obamacare,” he said. “So, although there might be some positive benefits, that’s one big, big negative I’m concerned about.”

At the Legislature this year, state Rep. Marsha Looper, R-Calhan, who is challenging Stephens in a heated primary in Colorado Springs’ House District 19, ran legislation to repeal SB 200 if federal health care law is repealed or the U.S. Supreme Court rules that any part of it is unconstitutional. Looper’s measure died in the Democratic-controlled Senate.

There have been a host of other bills this year at the Legislature addressing the federal health care law, including House Resolution 1003, sponsored by Rep. David Balmer, R-Centennial, which was backed by the Republican-controlled House in January. The resolution calls for a constitutional convention to amend the U.S. Constitution to repeal federal health reform.

In addition, Sen. Morgan Carroll, D-Aurora, pushed through the Senate a bill that would require hospitals in Colorado to disclose to patients services don’t offer due to religious or moral beliefs, such as abortions, some kinds of contraception and various end-of-life measures. But the House State, Veterans and Military Affairs Committee killed the bill on a Republican party-line vote.

Just this week, the Senate State, Veterans and Military Affairs Committee addressed the issue of religious and moral objections in health care, backing Senate Memorial 3, sponsored by Sen. Tim Neville, R-Littleton.

The proposal asks the Legislature to send its support to Congress for the so-called “Blunt Amendment,” which seeks to address a mandate in the federal health care law requiring employers to cover contraception without co-pays. U.S. Sen. Roy Blunt, R-Mo., has proposed an amendment that would allow insurers to opt out of providing contraceptive coverage over religious or moral objections. Senate Democrats have already blocked the amendment, but the issue is likely to pop up again, as there is a companion measure in the GOP-controlled House.

On Monday, the Senate State, Veterans and Military Affairs Committee sent Neville’s measure to the full Senate for debate on a 3-2 vote. Sen. Betty Boyd, D-Lakewood, who adamantly opposes the proposal — calling it a “war on women” — voted to send the bill to the full Senate, she said, in the spirit of debate.

“I agree that this bill needs a wider discussion, which is not saying I’m going to commit to this thing on the floor,” she told the committee. “I move to the Committee of the whole because I think that the discussion needs to be wider.”

That said, Boyd quickly added, “This initiative is a shot across the bow in the war against women.”

DeGette, who co-chairs the Congressional Pro-Choice Caucus, maintains that much of the health care debate has turned into an attack on women. She said she is striving at the federal level to make sure proposals like the Blunt Amendment don’t see the light of day.

“I’m working on making sure that people realize how extreme and dangerous that is,” she said.

But Neville insists the issue is not about contraceptive rights or a “war on women.” Instead, he said, it’s simply about protecting rights afforded under the Constitution.

“What benefit does freedom of religion give us if we cannot adhere to our deeply held beliefs?” Neville asked.

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Are Health Insurance Companies looking at retail sales as a new possibility?

As millions of Americans get closer to January 2014, a possible option for consumers to purchase health care coverage is though retail stores.

As insurance companies see it, retail stores are one more way, also online and telephones support, to support customer needs.

Highmark in Pennsylvania and BCBS of Florida have the largest retail stores and most
In New York, UHC operates a number of retail type stores as well.
Costco in the past has also tried to sell high deductible health plans back in 2005.
If you want to get an American enraged, get them talking about health insurance. Whether they have or they don’t, they tend to have a story somewhere in there, often not buried very far, about some kind of health insurance situation gone awry or another.

As health care becomes more and more a political battling point, BCBS of CA is looking to try and help make things a little clearer to consumers and has taken the bold step of opening a store in San Francisco to aid that effort.

The non-profit organization isn’t afraid to go bold when it wants to make a point. In 2008 it hosted had an exhibition of 40 nude statues in “vulnerable positions” to showcase the large number of uninsured Californians. It also made headlines last month when it was stated it was returning money to its customers, making good on apromise “to help policyholders cope with rising healthcare costs by making good on a pledge to return money when its net income exceeds 2% of its revenue.”

Now it’s reaching out directly to customers (current and potential) with a 500-square-foot store that will open Nov. 7 within a Lucky supermarket store in San Francisco.

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Child-Only Health Insurance Options

As many new expecting parents prepare themselves for their life with kids, one of the first items to come up is health insurance. Here are ALL the options parents can explore to provide health insurance.

Employer sponsored health plan: one of the parents works for a company that offers a plan that you can enroll the child onto.

Individual Health Insurance plan with parent: With the new health reform laws, you have to be at least 19 years old to participate on a plan by yourself.

child only health plan: Their are currently 2 open enrollment dates for child only policies. Jan for 03/01 effective date and July, for a 09/01 effective date.

state-sponsored health insurance program: offers coverage for anyone that has a preexisting condition that has been declined by a carrier.

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Obamacare will slash 717 billion from Medicare

Romney/Ryan are trying to figure out a feasible way to extend medicare past the 2024 or the 2016 dates that I keep reading. If Obama is re-elected and goes through with this health care overhaul, Medicare is the big loser in all of this. “The idea that restoring funding to Medicare could somehow hasten its bankruptcy is on its face absurd,” said spokeswoman Andrea Saul.

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What Is the Healthcare Exchange and What Do You Need To Know About It?

What Is It?

You may have heard it called the Health Insurance Exchange, the Health Insurance Marketplace, or the Healthcare Exchange. Don’t let all the names confuse you because they refer to the SAME thing (for your information, the official name is the Health Insurance Marketplace). According to Wikipedia, Healthcare Exchanges are “organizations set up to facilitate the purchase of health insurance in every state of the United States in accordance with the Patient Protection and Affordable Care Act (Obamacare). Marketplaces provide a set of government-regulated and standardized health care plans from which individuals may purchase health insurance eligible for federal subsidies.” Basically, the Healthcare Exchange is an online website where consumers can go to view and purchase all the new Affordable Care Act (Obamacare) compliant healthcare plans available in their state.

What Do You Need To Know About It?

• If you do not currently have health insurance, federal law requires you to obtain it or be charged a fine of $95 or 1% of your income, whichever is larger, on your 2014 tax return. There is one exception: if insurance will cost more than 8% of your income, you’re exempt from the fine.

• Plans became available for purchase on October 1, 2013 and coverage will begin January 1, 2014, according to federal law.

• Anyone can use the Healthcare Exchange tool, but it is specifically for individuals who do not currently have insurance or are unhappy with their current coverage.

• You can compare all available plans side-by-side.

• You can search plans based on personal factors like income, family size, etc.

• No plan can turn consumers away or charge more because of an existing illness or medical condition.

• Men and women receive the same price for the same plan, no exceptions.

• The marketplace is run by your state or federal government, not a private company.

• It is intended to be easy. Easy to understand and easy to find a plan that fits your needs and budget.

• Plans are categorized into four different groups: bronze, silver, gold, and platinum. Bronze being the cheapest and platinum being the most expensive.

• If you purchase a plan at the marketplace, your price will be locked in for 2014. Your insurer can increase premiums the following year, but you can also shop around for a new plan.

Want To Know More?

To find out more about the Healthcare Exchange and to shop for plans specific to Colorado, call us here at Rocky Mountain Health Brokers at 303-523-7650 or check out the resources available to you on our website including information about The Affordable Care Act and Obamacare.

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Colorado Health Insurance Laws

At one point or another, everyone finds themselves in a situation that necessitates the use of the American healthcare system. For a lot of us, our lives begin and end in a hospital. In order to protect ourselves financially, we purchase health insurance. Have you ever looked into the laws that govern our health insurance system? Maybe you have, now that ObamaCare is the talk of the nation. Even if you have been researching insurance laws, it’s likely that most people don’t spend their free time reading up on it. It’s unfortunate, but we will all get sick or injured at some point. We end up spending a lot of time and money on healthcare. So doesn’t it seem important to be familiar with the laws that govern health insurance? For your convenience, the following paragraphs contain brief explanations of a few of the most important health insurance laws in Colorado that may be important for you to know.

For the Consumer

Health Insurance Portability and Accountability Act or HIPAA. HIPAA has a lot of different facets. It…

  • Limits insurers’ power to deny/delay claims.
  • Minimizes your chances of losing your coverage.
  • Makes it safer and easier for you to change health plans.
  • Prohibits discrimination based on health problems.
  • Protects patients’ privacy if they are over 18—other than you and your health care providers, no one can gain access to your health care records unless you have expressly given your consent.

Other health insurance laws for the consumer include…

  • Coloradans are guaranteed renewable insurance plans, meaning your insurer can’t cancel your coverage if you get sick or injured.
  • Consolidated Omnibus Budget Reconciliation Act or COBRA. COBRA guarantees continuation of group coverage from a former employer for up to 18 months.

For the Insurer

All Colorado insurance plans are required to provide coverage for certain services including:

  • Breast and prostate cancer screenings
  • Treatment for certain diabetes-related conditions
  • Children’s vaccinations

The Affordable Care Act (Obamacare) requires insurers to…

  • Allow children to stay on their parents’ insurance until they are 26.
  • End the practice of denying coverage based on pre-existing health conditions.
  • Publicly justify their actions if they want to raise their rates by more than 10%.
  • Discontinue placing lifetime dollar limits on plans.
  • Cover preventive services with no deductible or co-pay.
  • Spend at least 80 cents of your dollar on health care and improvements to health care—not administrative costs—or give you a refund.

Other health insurance laws for the isurer include…

  • Insurers maximums for physical and mental health conditions must be the same.
  • Individual insurance plans must include maternity coverage.

These are just a few of the most important health insurance laws in Colorado. If you would like more information on these and other laws visit,, and Be informed about the health insurance laws that affect you. Knowing the laws helps you better understand how your health insurance works and what you can expect from your policy. You may also contact us, Rocky Mountain Health Brokers, at either 303-523-7650 or email us here. We’d be glad to answer all your health insurance questions!


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