What’s Next in Health Care Reform?

This is the final part of a series by RMHP President and CEO Steve ErkenBrack about the Affordable Care Act (ACA). We also encourage you to read Part One: What did October 1 Bring? Part Two: How Does it Work? and Part Three: Where did it Come From?



I expected to complete this last segment of my blog series on health care reform – What’s the Future of Health Care Reform — several weeks ago.  Why the delay? Many things: Technical dysfunction on the federal system. Eligibility issues on the Colorado Marketplace.  Bureaucratic backlogs.  Changing rules. Presidential press conferences.  All amid a political cacophony in which one side cursed the darkness and the other cursed those who cursed the darkness.


It seemed prudent to let winds die down a bit before lighting a candle for some illumination.


As we approach next Monday’s cut-off to sign up for a plan that will be in effect on January 1, it is a good time to take a look around, and re-evaluate our collective health care future.


I have said for some time that the changes we as a country must make in health care reform will be difficult, and that these changes will require a one to three year transition.

Remember what we are trying to do:  lower health care costs by improving health care value. Health care costs are the single leading cause of bankruptcy in the United States, and our general health as a country needs improvement. That focus on improving health care value and lowering the costs – sooner or later – is the future of health care reform.


So, with that in mind, I’d like to address the following: What is going well?  What needs to be improved?  What is the Most Important Next Step?


What is going well?

The Affordable Care Act has been in place since 2010, and much has already changed.  Some changes are popular; some are not.  But there have been two major developments to improve health care value and try to address the concerns of costs.

First, Colorado has its own Colorado-based Exchange known as Connect for Health Colorado, based on a free-market model. Our Colorado model has attracted more insurance carriers than far more populous states.  In fact, Colorado has more carriers with products on the Exchange than any other state. Colorado consumers, therefore, are at an advantage since competition lowers prices and raises value the consumer.  And Colorado is not a part of the healthcare.gov problems in Washington.


Second, as of January 1st, nobody can be denied health insurance or charged a higher premium for pre-existing conditions.  Who wants to remain in a system where – if your child gets sick and needs treatment – you can’t get insurance for that very reason?


There are a number of other changes that many consider positive:

  • More plan choices for more individuals
  • Adult children can remain on their parents’ plan until age 26
  • Requirement for coverage for mental health concerns, maternity care, hospital stays, prescription drugs and much more
  • No lifetime maximum for coverage


What needs to be improved?

The most immediate need is fixing the technical systems and process for enrollment.  The health insurance policies of hundreds of thousands of Coloradans will end on December 31.  We must be do everything we can to ensure that everyone who wants a replacement policy can navigate through the Exchange in time.


There is constant work going on to do this, but we must have an “all-hands-on-deck” approach to ensure that no one is forced to access health care without coverage – or not get the care they need – because of a technical processing issue.


Of course there are other changes and challenges that must be addressed in the coming months.  For example:

  • In 2014, some consumers may not be able to see their preferred doctor because they chose a plan with the lowest monthly premium cost which may have a smaller, limited network.
  • After the March 31 cutoff date to enroll in a plan, some people may get sick or have an accident, and then want to buy insurance and be frustrated to find that they will have to wait until 2015 for coverage.
  • Some people may underestimate their income for the premium tax credit, and have unexpected income tax liability in 2015.

What is the Most Important Next Step?

The single most important thing we can do as a state is to get working together.  Republicans and Democrats have legitimate differences of opinion on issues.  Great.  Fight it out while campaigning, have an election, and then work together for us all when governing.

The challenges of the past several months will not be the last challenges we face. We can try to anticipate issues and address them early, when they are easier to fix, but challenges will continue to arise.

In Western Colorado, across the state, and throughout the country, we must focus on an approach that recognizes we are all in this together. The system has flaws that need to be addressed and worked out, and the only way forward is working as a community, instead of fighting against each other.  We need to bring this approach back to health care.

After all, who wants to return to a system where a kid with cancer has to collect coins in a can at a grocery store checkout stand to pay for a needed operation?

We can do better for our neighbors here in Colorado.  Doing better is what’s next.  Or at least, what should be next.

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