EAGLE COUNTY — We’re No. 1.
We pay the nation’s highest Obamacare premiums in Colorado’s Central Rockies resort region, according to a study released Monday from the Kaiser Family Foundation.
Obamacare is the most expensive in the country in Eagle, Pitkin and Garfield counties at $483 a month. Summit County residents get a slight price break at $462 a month.
That’s more expensive than the Connecticut suburbs of New York City and the rural regions of Georgia, Mississippi and Nevada. The top 10 most expensive regions also include Alaska, Vermont and large parts of Wisconsin and Wyoming.
The rankings are calculated on “silver” plan, the mid-level plan that the majority of consumers are selecting, the Kaiser study says.
It’s all about your market region and who’s in it, says Marguerite Salazar, Colorado Division of Insurance commissioner. In Colorado, 11 regions were established as part of the Obamacare package, the Affordable Care Act. Region 11 is Eagle, Garfield, Pitkin and Summit counties.
The Kaiser study found that the causes for high cost premiums vary from region to region, although limited access to hospitals and the overall health of a region’s population were contributing factors. The study also found that in Colorado’s Central Rockies resort region, the high cost of Obamacare stems from high medical prices.
No surprise here
No one should be surprised that Obamacare is expensive in this region, Salazar says.
“The mountain and resort communities have had higher premiums than the Front Range, on average, over the past 25 years,” Salazar said. “Data shows it costs more to provide services in those areas compared to other parts of Colorado.”
The two main factors impacting the cost of healthcare are direct costs — the price of services — and utilization — the frequency of use of the healthcare system.
Local insurance broker Keith Thom works with businesses in the Vail and Roaring Fork valleys. He confirmed Salazar’s assertion.
“Insurance rates are 30 percent more expensive up here than the Front Range,” Thom said. “Insurance companies can’t negotiate the same prices they can down in the Front Range.”
That leads to two other issues, Thom said.
First, patients don’t want to drive to Grand Junction or Denver to receive treatment, so local medical providers have a more captive market.
“If you live in a captive community, it makes it very difficult for insurance companies to negotiate,” Thom said.
Second, Thom said industry data indicates that patients in this region have a tendency to access their healthcare more often. Sometimes it’s the patients’ idea, but sometimes their doctors want their patients to come in more often, especially when compared to their peers in the Denver metro area.
Then there’s the cost of healthcare in the High Country. It’s by far the most expensive in Colorado, Thom said.
Avoid the exchange?
Thom suggested you don’t buy health insurance through the ACA’s exchanges if you don’t have to.
“The only reason people would go into the exchange is for some sort of premium assistance,” Thom said. “If they don’t qualify for that, they would be well served to look outside the exchange. They can find better and more affordable health insurance outside the exchange. If you go outside the exchange, you have lots of options.”
In the meantime, Salazar says Colorado’s Division of Insurance will study the issue of higher premiums in different parts of the state. The Division of Insurance will gather a diverse group of stakeholders, including representatives of hospitals, healthcare providers, insurance carriers and the pharmaceutical industry.
In the mountain region, Mili Vazquez is in charge of making sure residents in Eagle, Garfield and Pitkin counties get all of the information they need.
If you refuse to buy insurance, then it’ll cost each adult a $95 tax penalty in 2014, or up to 2 percent of your household income, Vazquez said.
Staff Writer Randy Wyrick can be reached at 970-748-2935 or firstname.lastname@example.org.