Proposed ‘17 health-care premiums have Summit feeling sticker shock | SummitDaily.com

Proposed ‘17 health-care premiums have Summit feeling sticker shock

Help may be on the way, but, for now, Summit County and the rest of the mountain region should brace for the worst of proposed individual health-insurance rate increases in the coming year.

The state's Division of Insurance (DOI) released the initial premium cost requests made by insurers for 2017 on Monday, showing what many had feared — that rates are likely to surge for those who obtain policies through the state's health exchange. Not only are prices set to rise statewide — by at least an average of 35 percent with three providers — but also four companies will either exit the individual market entirely or substantially reduce their plan offerings.

"I couldn't be more disappointed with the news," said County Commissioner Dan Gibbs. "I just feel sick, to tell you the truth. We're looking at potential increases statewide that will be a breaking point for many working families that are trying to survive as it is."

Gibbs has recently become one of the region's leading voices on health care. During the state's latest legislative session, for example, he helped spearhead a bill, HB 16-1336, that Gov. John Hickenlooper signed into law to study the drivers of health-care costs throughout Colorado and the viability of a single geographic region rating area.

The results of that DOI study are due on Aug. 1, and there is a $100,000 companion analysis being conducted at the same time by the Colorado Commission on Affordable Health Care to look at the challenges of rural health care in the state. However, none of the data obtained from either will arrive in time to impact the 2017 rates, even with final approval on these newly-requested premiums not coming before late-September or early-October.

Coming and going

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An estimated 92,000 people throughout the state with individual plans from UnitedHealthcare, Humana, Rocky Mountain Health Plans and Anthem Blue Cross and Blue Shield will be affected and forced to find other coverage for 2017 during the enrollment period that starts in November. That total represents a little more than 20 percent of all Coloradans who obtain insurance through the individual market with Connect for Health Colorado or outside of the exchange.

UnitedHealthcare and Humana each announced in May that they would no longer offer individual plans in Colorado in 2017. On a potentially favorable note in the same month, Bright Health Plans declared itself a new entrant into the Colorado market. The Minneapolis-based startup is pursuing an increasingly popular model of teaming up with a single health system, in this case Centura Health, which runs St. Anthony Summit Medical Center in Frisco, to provide care to its members.

Not long after, though, Rocky Mountain Health Plans, which many in Summit County utilize, said it will pull out of the Western Slope with the exception of Grand Junction. Anthem also decided to no longer offer individual PPO plans next year, though will still provide HMO options.

Both Rocky Mountain and Anthem requested expanded premiums, a statewide average of about 35 percent and 27 percent, respectively. Of those insurers currently available in Summit County, just Anthem's HMO, Kaiser Permanente and Cigna will remain, and the latter two also requested individual premium increases of averages approaching 10 and 14 percent.

"I don't even know if anyone can afford Kaiser or any of the other lowest options," Sarah Vaine, CEO of the Summit Community Care Clinic, said of the proposed 2017 increases. "People say (those who go without insurance) choose to take the (federal) penalty, but, if you choose food or rent over health insurance, is that really a choice?"

Vaine joined the area safety-net clinic, offering health-care services to underserved populations, in 2008, but said she has only seen the number of under- and un-insured patients continue to grow. These expected premium increases next year almost certainly won't offer any relief, and she anticipates having to cut some services if the clinic doesn't soon receive additional funding from other sources.

"It's my hope that the rates stabilize in the next several years," she said. "In the meantime, over the last many years and then going forward, the Care Clinic is the only option for folks in terms of care in our community and really the surrounding communities."

Breaking point

This preliminary release from the DOI — which does not set premiums, but merely reviews requested rate changes — also pointed to some potentially positive news, that next year's rates for insurers' small-group plans will bump up only slightly, by a statewide average of only about 2 percent, if not in some cases actually go down. Still, while details of the Affordable Care Act continue to be straightened out as the nation approaches the fourth enrollment period, those seeking insurance for themselves and/or their families are taking the brunt of the new costs.

"It's really devastating for Summit County," Tamara Drangstveit, executive director of the Family and Intercultural Resource Center (FIRC), explained of the suggested 2017 rates. "Families are already reaching as it is now to be able to purchase insurance. It is the point at which we have to wonder how much more working-class families in Summit County can bear."

Among several assistance programs offered to area families, FIRC provides free health-care enrollment counseling, and Drangstveit worries that if these rates go up any more, it could drive current residents out of the community because of the elevated costs. Already, she said, she's seen a growing trend in the last year or so of middle-class families having to pick up and leave due to consistently swelling expenses between housing, childcare and health care.

"Families can't afford this," she said, "and that means that they're going to move elsewhere. Really, for working-class families, it's a crisis."

The numbers and information the DOI announced from insurers on Monday are not yet set in stone, and again, it won't be until this fall that final potential rate increases for 2017 are approved, based on whether the costs are justified and meet state and federal requirements. The DOI will accept consumer comments until July 6 to assist with its review process, and that can be done on the Health Insurance Filings page of its website at: http://www.colorado.gov/dora/node/100241.

Gibbs said that Summit County government will submit its own comments to the DOI as well and encourages all mountain residents to follow suit. It doesn't make the DOI's initial release any easier to swallow in the interim.

"We can't take this anymore," he said. "This is going to be catastrophic for many individuals in Summit County and throughout Colorado. Those are the individuals (whom) I continue to fight for on a daily basis who are, again, just getting hammered."