Commission working to reduce health insurance costs
December 3, 2016
EDWARDS — No one is sure what will happen to the federal Affordable Care Act — Obamacare — but a group tackling high health insurance costs in the high country isn't waiting to find out.
Local, regional and state officials met through October and November — in Edwards, Summit County and Denver — in what was called the "Lt. Governor's Health Cost Commission." They came up with a 20 proposals that they hope will help reduce the nation's highest health insurance rates, which is what the high country has.
They've been encouraging urgency, said Dan Gibbs, Summit County commissioner.
"We cannot wait for what the federal government may or may not do," Gibbs said. "The high cost of health insurance in Colorado is creating a breaking point for many families, especially since the cost of living in this area is already so high."
The group's objective was to develop recommendations on how Colorado can address high health care service costs in the state and in parts of the state with disproportionately high health care service costs, said Colorado Lt. Gov. Donna Lynne.
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Those 20 solutions fall into three basic categories:
They range from dealing with local issues such as housing and transportation, making the entire state one coverage area, providing additional subsidies and encouraging use of non-Affordable Care Act-compliant plans in high cost areas such as the mountains.
The commission is also taking a look at Maryland's Health Authority, which sets some rates hospitals can charge.
Local hospitals helping
At that Denver meeting, the Colorado Hospital Association proposed things such as local hospitals creating discounts for locals and local businesses in mountain communities, said Vince Plymell, public information officer with Colorado's Division of Insurance.
Doris Kirchner, Vail Valley Medical Center CEO, said the local hospital's initiatives include:
• Finalizing a new medical discount policy that allows 75 percent off urgent care visits to "ease the burden for uninsured Eagle County residents."
• Offering an enhanced Financial Assistance Policy, making it easier to qualify for federal poverty guidelines.
"It has been great to work with other leaders across the state on this important issue," Kirchner said.
Kirchner also said the medical center has increased prices less than 3 percent annually throughout the past three years as compared to the national average of 4 to 7 percent.
Time and money
Some of the commission's proposals target long-term solutions to an immediate problem, while others could cost tens of millions, money that Colorado state Sen. Kerry Donovan said the state does not have.
Among them: Health insurance subsidies for Coloradans earning between 400-500 percent of the federal poverty level — which the Department of Health and Human Services puts at $11,880 for an individual and $24,300 for a family of four.
That one won't get far in the foreseeable future, Donovan said, with Colorado's lawmakers facing their annual budget problems.
"If you want to do big ideas that help citizens, you need money," Donovan said.
The price is not right
If you're an individual buying health insurance, then your 2017 rates will increase by as much as 20 percent next year, especially if you live in the mountains.
Eagle, Pitkin, Garfield and Summit counties already have notoriously high insurance rates, the nation's highest a few short years ago. Those rates stabilized, but only after the Division of Insurance expanded our zone — Zone 9 — to include most of Western Colorado.
In the commission's Edwards meeting, Lynne, a former Kaiser Permanente executive, blamed such expensive insurance rates on high health care service costs.
"As health care service costs are the largest component (more than 80 percent) of health insurance premiums, containing health care service costs is integral to ensuring health insurance premiums are affordable for Coloradans," Lynne said.
Solutions, not policy
Donovan, a Democrat from Vail, was a vocal participant in all three meetings. When they started all this last month, Donovan said the goal was to create solutions, not just create policy that has no impact.
"The goal was to find solutions that lower prices" Donovan said. "I am very proud of what the group did together. It's how government should work, and it did."
Gibbs said health insurance costs are now increasing on the Eastern Plains as fast as they are in the mountains, and the group is seeking allies across the state.
"No solution is easy, and while the status quo is great for several industries, it's not great for consumers," Gibbs said.
It's not just us
It's not just us, Colorado's Insurance Commissioner Marguerite Salazar said when 2017 insurance rates were released this fall.
"The recent EpiPen scandal is a prime example. The drug maker raised prices stating it did not expect consumers to pay the increases but rather their health insurance plans. However, when insurance plans must pay those increased costs, it will show up in consumers' health insurance premiums," Salazar said.
According to the financial statements of insurance carriers, for every dollar they collect, they spend $1.13, Salazar said.
"People cannot sustain this, and we cannot continue to blame the insurance companies because they're trying to keep their bills paid," Salazar said.
Staff Writer Randy Wyrick can be reached at 970-748-2935 and firstname.lastname@example.org.
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