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Why tens of thousands of Coloradans choose to pay a fine rather than buy health insurance

By John Ingold / The Denver Post
A sign placed out on the 16th Street Mall, beckons people to sign up for health insurance through the Affordable Care Act.
Kathryn Osler / The Denver Post

Tens of thousands of Coloradans who could be eligible for free or reduced-cost health insurance instead pay a fine every year for not having insurance at all, according to a new report from a nonpartisan health group.

The issue, for many, is the price of insurance. Especially in rural areas of the state, the cost of insurance — even if it is reduced by federal tax subsidies — can still be many times more than the cost of paying the fine, said Joe Hanel, the manager of public policy outreach at the Colorado Health Institute and the report’s author.

“The carrots and sticks are kind of misaligned,” Hanel said. “The tax incentives you get to buy coverage are not enough to make it more economically enticing to be insured than to pay the penalty.”

The penalty is meant to be a critical component of the Affordable Care Act, the national health care law also known as Obamacare. The law requires people to have insurance in the hopes of spreading the financial risk across the biggest possible group. Those who don’t have insurance are required to pay a fine, technically a tax, to the Internal Revenue Service.

This year, the penalty is either $695 per adult or 2.5 percent of a person’s income, whichever is greater. At that rate, the Congressional Budget Office has projected the federal government will collect $38 billion from the penalty between 2017 and 2026.

The Colorado Health Institute looked at how many people paid the penalty in Colorado in 2014 and 2015, when the tax was lower. Hanel’s report found more than 126,000 people who paid the penalty in 2015, nearly 5 percent of Coloradans who filed a tax return that year. According to the Congressional Research Service, payments in 2015 from Colorado alone totaled $60.6 million.

The highest rates of penalty payment came from people who make less than $50,000 a year, the Colorado Health Institute report found. Many in that group would be eligible under the Affordable Care Act for subsidies to help pay for insurance premiums, Hanel said, although the IRS data he used for his analysis make it difficult to say how many.

“People were just kind of leaving those tax credits on the table and paying the penalty,” Hanel said.

Mountain counties, such as Garfield, Lake and Grand, had the highest rates of penalty payment, and Hanel said that helps explain what is going on. Those areas also have some of the highest insurance costs in the state.

Read the full story here.


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