‘Blown-out budget’ infuriates exchange board member
Colorado’s health exchange managers expect to spend $4 million more on their call center than anticipated this year, a revelation that spurred a heated argument among board members on Monday.
And why did this happen? This article doesn’t address the cause until the 3rd paragraph from the bottom….
Exchange managers have known for months that the open enrollment for 2015 would last three months compared to six months for 2014. But they only learned a couple of weeks ago that lower rates overall in Colorado would also dramatically decrease tax credits for customers. That has prompted them to predict that the call center will have to handle 60,000 more calls than anticipated. The first month between now and Dec. 15 is expected to be the busiest since people who need insurance by Jan. 1 must buy by Dec. 15 and pay by Dec. 25.
So what IS the cause of the lower rates? That would be Colorado HealthOp, the health insurance cooperative that was created with help of the Affordable Care Act legislation. Here is the problem: A key component in the health insurance subsidy calculation is the cost of the 2nd lowest cost silver plan. Colorado HealthOp has plans with two different networks, a statewide PPO and a geographical restrictive network with fewer doctors called an EPO network.
CoHealthOp created the problem by significantly reducing the cost of the 2nd lowest cost Silver plan with their EPO network plans. This has the effect of reducing everyone’s subsidy. Not a pretty picture for many consumers.