Summit County Commission fights for lower health insurance premiums
March 31 marks the deadline for Colorado residents to enroll for health care coverage through the state exchange, Connect for Health Colorado, but for residents of the so-called “resort region” health insurance premiums under the Affordable Care Act are anything but a vacation.
According to a February Kaiser Health News report, Colorado’s Rating Area 11 — the resort region — is the most expensive insurance marketplace in the country. The region includes Summit, Eagle, Pitkin and Garfield counties.
Specifically, Kaiser reported that the average hospital inpatient cost for an insured person in Summit County was $786, or 61 percent higher than the state average even though hospital admissions in Summit County are 10 percent lower than the state average.
In Pitkin County, costs from doctors and other medical professionals averaged $1,932 per insured person, the report stated, which is 2.2 times higher than the state average even though the number of claims filed is 17 percent lower than the state average.
The estimates were based on monthly premiums for a 40-year-old person, the report stated.
In an effort to lower health care costs for local residents, Summit’s Board of County Commissioners has launched a four-pronged attack against high premiums.
The commissioners have been meeting recently with state lawmakers to draft legislation to reevaluate Colorado’s 11 rating regions in an effort to lower health insurance premiums.
“We’re at a critical point for a lot of people in this community and we think we’re being treated unfairly by the state,” said Commissioner Dan Gibbs. “I don’t see how it can be cheaper in the San Luis Valley, for example, that is more rural than we are and has less doctors and hospitals.
“We understand there is a premium to live and start businesses here in Summit County, but we do not believe we can be the most expensive region in the whole country.”
Although Gibbs has not yet seen a draft of the bill the commission is advocating for in the Colorado General Assembly, he said conversations have been ongoing with District 32 Sen. Irene Aguilar, D-Denver, and District 5 Sen. Gail Schwartz, D-Snowmass Village. The commission also is talking with House District 61 Rep. Millie Hamner, D-Dillon, and House District 26 Rep. Diane Mitsch-Bush, D-Steamboat Springs, to sponsor companion legislation in the Colorado House.
“What’s frustrating is so much of this is out of our control and out of our hands,” said Gibbs. “If there’s a silver lining, it’s exciting to see we have so many elected officials who are not affected by the costs of Region 11 that still think this is a big deal and want to help.”
In addition to pushing for legislation in the General Assembly, the commission sent letters Feb. 25 to Colorado Division of Insurance Commissioner Marguerite Salazar and Colorado Department of Health Care Policy and Financing Director Susan Birch, requesting a meeting to discuss the timing and substance of future improvements to the existing rating system.
The letters were sent after the Department of Insurance announced it would convene a task force to look at the state’s 11 geographic rating areas and launch a study of health care costs in the state, which is a key driver for premiums in Colorado, according to a Feb. 3 Division of Insurance news release. Regardless of the findings of the task force, health care premiums would not change when the public health care system launches on Jan. 1, 2015, the release stated.
Although Gibbs said Summit County residents don’t have the luxury of waiting for the task force to deliver its findings, the commission scored a minor victory in demanding that a member of the resort region participate in the task force. That person is Tamara Drangstveit, executive director of Summit County’s Family & Intercultural Resource Center.
As the commission waits for the task force’s findings and continues to work on legislation in the statehouse, Gibbs said local stakeholders are looking at direct cost and utilization numbers to determine why the resort region is the most expensive in the country. The direct cost and utilization formula was employed by Salazar to create Colorado’s 11 rating regions.
The commission also has reached out to U.S. Sens. Mark Udall and Michael Bennet, U.S. Rep. Jared Polis and Gov. John Hickenlooper urging them to support an extension of the March 31 deadline until a remedy for the high premiums can be found, Gibbs said.
“This is the county’s No. 1 priority and we’re working with urgency because we are getting to a breaking point for a lot of Summit County families,” Gibbs said. “We have people who simply can’t afford health insurance and had much lower rates before the Affordable Care Act passed.”
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