Summit County braces for higher health-care costs as annual cutoffs approach
December 12, 2016
Changes may be coming to the way Americans obtain health insurance with the transition in presidential administrations, but for now it remains a federal law that citizens be covered. And deadlines for compliance are fast approaching.
This Thursday, Dec. 15, is the last day to complete registration on Colorado's health insurance marketplace, Connect for Health Colorado (coloradoforhealthco.com), to ensure coverage starting Jan. 1. The last day to enroll for coverage for the year barring a major life event that changes one's coverage status is Jan. 31. The nearing cutoff points, as they do each year since implementation of the Affordable Care Act (ACA), have made health counseling appointments hard to come by.
"At this point, we're completely full until after the 15th," said Tamara Drangstveit, executive director of the Family & Intercultural Resource Center (FIRC), of appointments for free health insurance sign-up assistance. "If you need coverage by Jan. 1, the best thing to do is get online today or tomorrow, really, or to call them, too."
Connect for Health Colorado is available by phone Monday through Friday, from 7 a.m. to 10 p.m., and on Saturdays from 8 a.m. to 10 p.m. In anticipation of the deluge of potential customers ahead of the mid-December deadline, however, it is offering extended hours on Dec. 15, 7 a.m. to midnight. Certified application counselors and insurance brokers are available during those times at (855) 752-6749.
The key to those online applications is starting the process before Dec. 15. From there, if potential issues arise in what can be a complex system with pitfalls related to finding a plan that fits you or your family's needs based on income and necessities, that can be addressed after the fact to still make that Jan. 1 coverage target.
New to Colorado's marketplace for Summit County this year is the introduction of another insurance provider and the departure of a longtime mainstay for all of the Western Slope outside of Mesa County.
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Startup Bright Health announced entry into the state in May with an exclusive partnership with Centura Health, owner and operator of St. Anthony Summit Medical Center in Frisco. The agreement intends to decrease costs by establishing reduced reimbursement rates between the two on most forms of care. Those discounts are in theory then passed down to the consumer.
"One of the things we did with Bright Health was provide them our network of physicians and a good contract rate to be able to be on the marketplace exchange," said Suzanne Lifgren, St. Anthony Summit Medical Center's marketing manager. "We are still working with Anthem Blue Cross and Blue Shield and Cigna, and our direct employer solution that both the county (government) and Summit School District have, but it's just another way to work with insurance companies to help control those prices and premiums in the area. What we offer them just doesn't always go out to the insured.
"We like the Bright Health product," she added. "It provides a lot through the Centura Health Neighborhoods Network around Colorado and the region — it keeps care local — but obviously we encourage people to sign up and get covered either way."
In July, independent provider Rocky Mountain Health Plans announced its sale to UnitedHealthcare. For all intents and purposes, that removes Rocky Mountain as an option for the region's population in search of individual plans on the marketplace.
Regardless of the existing alternatives — those from Kaiser Permanente on top of Anthem, Cigna and newcomer Bright Health — consumers will notice that both premiums and deductibles have gone up, in some cases substantially, across the board. Premiums expanded by about 10 percent throughout the state in 2016, but will rise by an average of 20 percent statewide in 2017 — with some areas by as much as 46 percent.
"I couldn't be more disappointed," said Summit County Commissioner Dan Gibbs. "This continues to be a huge breaking point for many individuals and many families. The state of Colorado cannot continue to sustain itself with these huge increases. The rest of the United States is doing things to contain the cost of health care; we are doing nothing."
Because of a provision in the ACA that kicks in next year and allows insurance companies to recoup more money to ensure solvency, deductibles are going up by more than a $1,000 per year for a lot of plans as well.
"I don't think we can wait on the federal government for what changes might happen with the new administration," said Gibbs. "There are a lot of unknowns. In Colorado, we have an opportunity to move forward with reform. We really need meaningful legislation."
Single persons and families on the state exchange at certain income thresholds — less than $47,520 for individuals and less than $97,200 for families of four — are still eligible for subsidies as they acquire insurance. Colorado's exchange reports that consumers using the marketplace received an average of $294 per month in 2016 to reduce their cost burden. This, of course, also guarantees avoiding the federal penalty for not being covered, coming in at $695 per person or 2.5 percent of one's household income — whichever is greater.
"Individuals often do qualify for a tax credit," said Drangstveit. "Insurance really can be affordable — even in Summit County — and it's way more affordable than having an accident, like blowing out a knee while skiing or having a very sick kiddo, and not having insurance."
For those less concerned or not required to hit that Dec. 15 mark based on their individual situations, FIRC will be hosting a walk-in open enrollment event at its Breckenridge location (1760 Airport Rd.) on Monday, Dec. 19, from 9 a.m. to 5 p.m. All are welcome no matter their income or health insurance status.
"We understand how hard it is for families to make health insurance work as part of a budget," Drangstveit added. "We're here to help in whatever way we can."