Nearly everyone can agree that children with conditions like asthma or autism should not be denied health coverage. Thanks to a provision of the Affordable Care Act that went into effect in September 2010, insurers are no longer allowed to deny coverage to children with these and other pre-existing conditions.
However, many insurers felt it was an untenable burden to cover children regardless of health status without requiring all children to carry coverage to even out the risk. They worried that families would only buy a plan for their child after a catastrophic accident or illness, and would drop the coverage when they no longer needed it.
As a result, many insurers decided to stop selling child-only health policies on the individual market. In fact, all Colorado insurers — except Kaiser Permanente and Rocky Mountain Health Plans — stopped selling such health plans. Meanwhile, states around the country scrambled to come up with a solution.
In Colorado, advocates and insurers worked together to pass Senate Bill 128 during the 2011 legislative session. This bipartisan bill was designed to guarantee access to child-only health insurance plans for all children, regardless of their medical history or health status.
The new law means that kids can no longer be denied coverage for a pre-existing condition. The law also contained market protections to mitigate the risks associated with child-only insurance plans for insurers. One of those protections is the establishment of two open-enrollment periods per year. The first open enrollment period for child-only health insurance expires Aug. 31. Subsequent open-enrollment periods will be held every January and July.
That means anyone who misses the August open enrollment period must wait until January 2012 to purchase a child-only policy unless they have a "qualifying event," such as job loss, loss of eligibility for Medicaid or Child Health Plan Plus (CHP+) and more. For more information about the open enrollment policy, read this fact sheet from the Colorado Department of Regulatory Agencies.
Colorado's response to this complex issue shows how our state is bringing people together — including unlikely bedfellows — to forge workable solutions. As a result of SB 128, everyone wins — including parents who have been unable to secure health insurance and insurers who now have protection against adverse risk pooling. Together, we can ensure that all of Colorado's children receive the coverage and care they need.