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lundi 19 août 2013

Colorado Health Insurance Exchange Explained

By Andrea Davidson


The Colorado Health Insurance Exchange is officially known as Connect for Health Colorado (CHC). This is a new healthcare marketplace that enables previously uninsured individuals and small businesses to get insured at affordable rates. CHC will start enrolling customers starting Oct 2013, and coverage for those who are newly insured will begin no later than Jan 1, 2014.

CHC is one of many such exchanges established in states all over the nation to comply with the requirements of federal healthcare reform bill (PPACA or Affordable Care Act). Under this law, all citizens and legal residents in the U. S. Must have health coverage from 2014 onwards. The exchanges that will start offering coverage in 2014 are the main mechanism used to implement the law.

About 500,000 previously ineligible people in Colorado will be able to avail of plans using CHC. This eliminates two-thirds of the state's existing contingent of approximately 750,000 uninsured individuals. The exchange can also be used by those who are already insured but want to shop around to find a better plan.

CHC currently has two core components or areas of operation. One is the marketplace that is to be used by individuals, and the other one is for small businesses that have less than 100 employees. The latter platform, called SHOP, may be opened up to larger businesses with more than 100 workers after 2017, subject to the state approving implementation of this second phase too.

It is hoped that the establishment of CHC will reduce premiums by around 14-20 percent. This will be accomplished through an expansion of the market combined with competition for customers among providers offering plans in the exchange. Practically speaking, that works out to somewhere in between $1,510 to $2,160 per year in healthcare premium savings for families in Colorado.

The best part about this whole reform plan is that it transforms some of the worst rules in the old system. For example, providers participating in the exchange cannot turn away customers with preexisting conditions or charge them higher premiums than others. They also cannot refuse to cover a preexisting condition if it is normally covered under the plan for everyone else.

The federal government is funding the establishment of CHC, and will pay 100% of all operational cost until 2016. Starting from 2017, the state will pay 5% of costs. From 2020 onwards, the state must shell out 20% of CHC's operational costs. All said and done, Colorado is in line to get more than $12 billion in additional federal funding to help with the implementation of this exchange and other reforms.

The Colorado Health Insurance Exchange is the biggest change in federal and state assistance for ordinary people and small business owners since the New Deal. The debate over what is being billed as the socialization of healthcare continues, and business associations don't like the additional costs it will impose on them. The implementation of CHC and similar exchanges in other states is likely to face a few bumps as the confusion over the changes is sorted out. However, this cost and hassle pales in comparison to the undeniable fact that most people in the state will end up having access to health insurance.




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