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. The politicians of Colorado want to have their cake and eat it too.
In a month I will lose my health insurance because the carrier is leaving the state. 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 passed new hedging mandates that increased the cost of premiums in the individual market by 5.5 to 7.9 percent annually.
I don’t need acupuncture, gender reassignment plastic surgery, HIV prevention medication or any of these new benefits, but I pay for the additional 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. The cheapest plans at the state health care exchange are not Colorado Option plans but rather carrier-designed plans.
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 goals are mutually exclusive, as more benefits require higher premiums to cover the additional costs.
In addition to coverage mandates, the government has imposed several unnecessary and intrusive requirements on insurers. Insurance companies should work to build “a network that is culturally sensitive and, to the extent possible, reflects the diversity of its enrollees in terms of race, ethnicity, gender identity and background. orientation 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 Glowing Healthand another, Oscar Healthare leaving and more than 58,000 of us are looking for a new carrier.
As a writer and adjunct professor 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 Denver Post journalist. Follow her on Twitter: @kristakafer
