Monday, December 28, 2015

HEALTHCARE RX - State Co-Ops

"Popular health insurance co-ops ‘orphaned by politics’" PBS NewsHour 12/21/2015

Ah, yes.  Money before people's health (too expensive to pay for).  The God of Money is snickering in the background.

Excerpt

SUMMARY:  As consumers rush to enroll in the insurance exchanges, one change that's complicating signups is that more than half of the state-run health co-ops -- an alternative to private insurers -- were forced to shut down this year.  The government was supposed to offset the costs, but Congress sharply curtailed that money.  Special correspondent Mary Jo Brooks reports on the effects in Colorado.

GWEN IFILL (NewsHour):  But, first, the demand for health insurance and concerns over choice.

The federal government reported higher demand this year for people trying to enroll on insurance exchanges for coverage.  Six million had signed up by last week for coverage that begins next month.  More than two million of them were new customers.

But, in 11 states, there’s one change that’s complicating the picture this year:  Half of the state-run health co-ops were forced to shut down.

Special correspondent Mary Jo Brooks looks at what happened in Colorado.

MARY JO BROOKS (NewsHour):  It’s been a tough year for 36-year-old Jessica Peck, a Denver attorney and divorced mother of two.  Peck suffers severe vascular and neurological ailments which over the years led to soaring medical bills.

In 2014, she signed up with a brand-new health insurance company called Colorado HealthOP.

WOMAN:  The co-op provides health insurance that is built around all needs.

MARY JO BROOKS:  It was a nonprofit co-op formed under the Affordable Care Act and funded with loans from the federal government.  Peck says she chose it because the price was right.

JESSICA PECK, Colorado HealthOP member:  At least 50 percent in terms of premiums and out-of-pocket co-pays from the year before.

MARY JO BROOKS:  Fifty percent.

JESSICA PECK:  Fifty percent.  So this cost saving was a difference.  When I was at my sickest of being able to pay my bills, to be able to put gas in my car, and at one point having the difference in premiums was probably the only thing that kept me afloat.

MARY JO BROOKS:  At her sickest last year, Peck was forced to have her right leg amputated and was hospitalized for more than 23 days.  Peck is the first to admit that the co-op wasn’t perfect, including some billing errors she is still trying to sort out.  But she was dismayed when she heard the news that the co-op was being shut down.

JESSICA PECK:  Now I have to go back into a marketplace of players that I have worked with before, the big, big guys out there, who hurt me before, who sent me to collections on bills, who denied care that was absolutely 100 percent essential.  And I have to go back into that marketplace and pay twice as much as what I’m paying right now.

Colorado HealthOP was one of 23 co-ops started around the country as a concession to Democrats who wanted the ACA to include an alternative to private insurers.

Michele Lueck heads up the policy research group Colorado Health Institute.

MICHELE LUECK, Colorado Health Institute:  There were a number of politicians and legislators who wanted to have a government choice, something like Medicare that people could opt into.

And when that wasn’t politically feasible, an olive branch essentially that was offered to the left was this idea of creating co-ops, that this would be something that was owned and operated by the people who needed it the most.

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