The higher up Coloradans live, the higher the cost of new health insurance premiums seems to soar.
U.S. Congressman Jared Polis represents Summit County as part of Colorado’s second district. On Tuesday, Oct. 15, Polis spoke with Colorado Division of Insurance (DOI) commissioner Marguerite Salazar about lowering the cost of health insurance premiums in Rating Area 11, which includes Summit County.
Last week, Polis wrote a letter to Salazar asking about the discrepancies for what Summit County residents are paying for health insurance compared with residents of neighboring counties such as Clear Creek and Jefferson, located in Rating Area 3. Polis said those counties more accurately represent health insurance costs facing Summit residents.
“These high rates make it much more likely that Coloradans living in these areas will choose to forgo coverage entirely, choosing to pay the federal penalty rather than purchase health insurance,” he wrote.
A 40-year-old individual in Summit County purchasing a bronze level plan from the Rocky Mountain Health Plans Statewide PPO would pay a minimum of $427.80 per month compared to $339.18 for the same plan in Boulder and $296.41 for Denver.
“The congressman gave me a lot of ideas and concerns from his constituents in Summit County,” Salazar said. “He gave me examples about how low-income individuals or services workers might be affected.”
Under the Affordable Care Act, often called “Obamacare,” states were required to establish geographic rating areas in the small group market — employers with 50 or fewer employees — and the individual market. The DOI decided to develop a unique structure for Colorado with 11 geographic rating areas that required federal approval.
“Based on our conversation I’m optimistic we’ll eventually be able to move Summit County over to [Rating Area 3],” Polis said.
According to a DOI fact sheet, two factors significantly affect the cost of providing medical care to the residents in the mountain resort communities, which resulted in higher premiums for those counties: direct costs, including the price per health care service delivered such as doctors, prescriptions and labs, and utilization, the frequency with which the population uses the health care system.
In a prepared statement, Summit County commissioners Karn Stiegelmeier, Thomas Davidson and Dan Gibbs said Polis understands the affordability challenges people face in Colorado mountain resort communities.
“He has been a champion for health care access in Summit County, with his continuing support of our Community Care Clinic and now, responding to this affordability issue just as many residents are signing up for health care insurance through Connect for Health Colorado,” they wrote.
While the current geographic areas are set for 2014, Polis said he hopes to move rating areas and therefore reduce rates by 2015. He said being included in Area 11 with Pitkin, Eagle and Garfield counties, which have significantly higher populations, adds to the high costs in Summit.
“We’re focused now on how to fix it,” Polis said. “Most people [in Summit County] are going to look at [the exchange] in 2014 and say no. We need to continue to push for change to be made in 2015.”
On Monday, Oct. 13, officials with Connect For Health Colorado said 226 people had signed up for insurance using the exchange during the first week, for a total of 305 people getting coverage. More than 18,000 people have created online accounts to start shopping, exchange officials said.
For the last 25 years, mountain and resort communities have experienced higher premiums than the Front Range. These premiums varied from county to county, but the premium differences existed prior to 2013, the DOI claims.
“Insurance companies might have done this in the past, but now we’re doing it and it’s so transparent,” Salazar said. “People can see those comparisons for the first time.”
Salazar said her department is committed to looking into the issue, and plans to hold a series of community forums to listen to concerns.
“We are looking at coming up with a way that feels more equitable,” Salazar said.
In a prepared statement, Sarah Vaine, CEO of Summit Community Care Clinic, said Summit County has one of the highest rates of uninsured residents in the state.
“It is worrisome and disappointing that rates in our area may be priced beyond our residents’ ability to pay,” she said. “We are hopeful that something can be done to make products on the exchange more accessible.”
Polis plans to work on revising the rating areas during the next year, and said he hopes Summit County will see more realistic pricing by 2015.
“In order for the Affordable Care Act to work in Summit County, Summit County needs to be included with Jefferson and Clear Creek,” Polis said. “It could reduce current health insurance rates up to 50 percent.”
“The Division of Insurance is open to hearing other ideas and ways of making the rating structure more equitable,” Salazar said.