Health insurance set to soar next year on Western Slope
October 28, 2015
WESTERN COLORADO — If you're an individual buying your own health insurance in western Colorado, you'll pay an average of 26 percent more next year.
Colorado's Division of Insurance approved increases in health insurance costs for both individuals and small groups in Eagle County and the rest of western Colorado. Statewide, the average increase is 9.84 percent for individuals and 3.17 percent for small groups.
In 2014, Colorado's Rocky Mountain Resort Region — Eagle, Summit, Pitkin and Garfield counties — had the nation's highest health insurance costs. Federal officials addressed that not by studying the cost of health care in the region but by increasing the coverage area to include most of Colorado's Western Slope.
Who'll pay this?
The rates pertain to the individual market – for people who do not get insurance from their employer, but buy their own insurance – and the small group market – small businesses with 2-100 employees said Vincent Plymell, communications manager with Colorado's Division of Insurance.
For both markets, the rates apply to plans sold both on the exchange – Connect for Health Colorado – and off of the exchange.
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Right now, the individual market in Colorado makes up about 8 percent of the market, and the small group about 4 percent.
This does not apply to the large group market, employers with more than 100 employees. The large group market comprises a little over half of the health insurance market in Colorado, Plymell said.
Some jump more than others
Rocky Mountain Health Plan was awarded a 31 percent increase, and Anthem Blue Cross is taking an 8 percent increase for individual policies. Along with other health increases for 2016, the average increase for individual health insurance plans in our area is 26 percent.
How much more you pay depends on what company you select and what you buy, said Bethe Wright, who owns and operates Wright Insurance in Eagle County.
"None of their premiums have gone down and benefits have been pulled away, so you're going to pay more and get less in benefits," Wright said.
Take Anthem Blue Cross, for example, one of four companies still offering insurance in Eagle County, along with Kaiser, Rocky Mountain Health Plan and Cigna.
If you're a 40-year-old non-smoker living in Edwards and you bought a silver level plan last year, you paid $402 a month. That same plan will cost $445 in 2016.
Rates reflect Cost of health care
"Rates reflect the cost of healthcare, and the DOI has verified that information," said Marguerite Salazar, commissioner of Colorado's Division of Insurance. "The division doesn't regulate the cost of health care, but everyone involved in health care in Colorado needs to work on bringing these costs down."
Open enrollment begins Sunday, only the third one under the Affordable Care Act, and this is the first time health insurance companies have had a full year of data on which to base their rates, Salazar said.
"They are still trying to figure out what consumers want in terms of plans, deductible levels and services at a price that attracts enrollment but allows the carrier to keep the lights on and pay their bills," Salazar said.
Federal and state regulators removed one of Colorado's major low-cost health insurance players last week when they banned Colorado HealthOP from selling policies on the Affordable Care Act's state health insurance exchange, saying it did not have enough reserve funds.
A quick walk through that state exchange data finds that under Anthem Blue Cross's gold plan, the maximum deductible for an individual will be $6,850 in 2016 and $13,700 for a family. The Colorado HealthOP gold level policy maximum deduction was $2,000. After that, everything was covered.
Summit County harder hit
Individuals in Summit County will take a harder hit, said Wright, who handles dozens of Summit County clients.
Colorado HealthOP was popular in Summit County because of its low cost, achieved by negotiating lower rates with a smaller number of doctors, in exchange for bringing those doctors more of the co-op's clients.
If you were with HealthOP last year, you have to find new insurance because the co-op is banned from renewing policies for next year. Some HealthOP members in Summit County could pay 100 percent more for individual insurance next year than they did this year, Wright said.
Across the state, premiums will increase over 2015 premiums by 7 percent, on average, with individual policies rising an average of 9.84 percent, and 3.17 percent for small group plans, which are purchased by small employers, ones with 2-99 employees.
Political backlash from both sides
Eagle County's two congressional representatives, Republican Scott Tipton and Democrat Jared Polis, both blistered the higher health insurance rates.
"The big government Obamacare model continues to fail, and unfortunately it's hardworking Americans who are suffering," Tipton said. "We're seeing Obamacare's legacy in Colorado, where the largest insurer on the Colorado exchange just collapsed, insurance rates are skyrocketing and access to care is declining.
"We can do better, which is why I am working to do everything possible to repeal, defund and replace this law," Tipton said. "We must have an alternative, and I believe that market-based alternatives that empower patients and doctors, enact tort reform, allow for greater flexibility, portability and cost savings, and provide coverage for pre-existing conditions show great promise, and need to be at the core of Congress' focus to replace this law."
Polis called the increase "outrageous."
"This outrageous increase on top of already high rates is really jeopardizing access to health insurance in our mountain communities," Polis said. "The state must make sure residents of our mountain and western counties can actually purchase affordable healthcare and that the Affordable Care Act is implemented in a way that achieves the goal of providing affordable access to quality health care for all individuals. This kind of increase simply doesn't work for our community and will cause people to drop their healthcare because they can't afford it."
Staff Writer Randy Wyrick can be reached at 970-748-2935 or email@example.com.
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