Rob Douglas: Sticker shock hits Ski Town USA

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A week ago, Steamboat Springs resident Leah Wolf Martin knocked on my door and asked if I was aware health insurance premiums for coverage mandated by the Affordable Care Act were far higher in Steamboat than in most other Colorado communities.

Rob Douglas

Rob Douglas' column appears Fridays in the Steamboat Today. He can be reached at rdouglas@SteamboatToday.com.

Find more columns by Douglas here.

As it turns out, Martin spotted an issue that has U.S. Rep. Jared Polis, D-Colo., asking the Obama administration to grant waivers from the health care law for his constituents in Summit County while simultaneously requesting that the Colorado Division of Insurance explain the extreme variations in health insurance premiums between Colorado’s 11 geographical rating areas.

Based on Martin’s experience shopping for health insurance that complies with the new law and my review of health insurance premiums available at www.connectforhealthco.com — the online health insurance exchange for Affordable Care Act compliant policies in Colorado — elected representatives serving Routt County should request waivers from the law for their constituents while determining why one of the healthiest counties in Colorado is facing some of the highest health insurance rates.

Martin and her husband are independent engineering consultants raising two children in Steamboat. Based on their income, the Martins are not eligible for a health insurance subsidy under the new law. Currently, the Martins have a family health insurance policy with a $1,500 per person deductible. During their annual renewal in August, the premium went from $700 to $900 per month. Recently, the Martins were notified that because of the new law, their insurance plan will be discontinued Jan. 1.

Due to the termination letter, Martin went to www.connectforhealthco.com and found a “silver” family policy that she thinks is the equivalent of her family’s current policy. It has the same deductible and is offered by the same company. The price is $1,098 per month. Even if the Martins increase their deductible to $6,000 per person, the premium drops to only $900 per month.

Concerned that the cost was increasing $4,776 per year over what it was just six months ago, Martin began researching what her family’s policy would cost in other Colorado counties. Although she found a few counties where the price is higher, she found many counties where the price is dramatically lower. In Jefferson County, for example, an equivalent policy costs 31 percent less than it does in Routt County.

Reinforcing Martin’s observations, Solutions — an online publication of the Buechner Institute for Governance at the School of Public Affairs at the University of Colorado Denver — published an article this week about the extreme health insurance price differentials between Colorado counties and the growing reality that, given those differentials, the Affordable Care Act may be unaffordable for many folks who work in Colorado’s ski towns.

In the article “Polis fights sky-high rates as ski town signups stall,” Solutions reports, “Health insurance rates are so high in Colorado’s mountain resort areas that U.S. Rep. Jared Polis plans to seek waivers from the federal government so people who skip buying insurance in 2014 won’t face financial penalties.”

While examining health insurance costs under the new law in Summit County, the article states:

“Rates … are up to three times higher in resort communities from Breckenridge to Vail and Aspen than in other parts of the state. For instance, a 40-year-old buying a mid-level silver plan in Greeley could pay as little as $232 per month while that same person in the resort communities could pay as much as $667 per month.”

Because of Colorado’s geographical rating system, the cost differential for Routt County — and Moffat County — is almost as high as Summit County. In Routt, that same 40-year-old could pay as much as $598 per month or about 2 1/2 times more than in Weld County where Greeley is located.

Martin thinks all Americans have a right to affordable health insurance and that no one should be denied coverage because of a preexisting condition. But under the new law, she thinks the cost of health insurance in Routt County may prove unaffordable and detrimental for middle-class families and small-business owners.

Unfortunately, Martin’s concerns probably will fall on deaf ears in Denver and Washington, D.C.

To reach Rob Douglas, email rdouglas@SteamboatToday.com.

Comments

Harvey Lyon 9 months ago

I do believe that when/if the internet sign up "glitches" (the term just cracks me up....Glitches) are resolved then folks will realize that Obamacare is truly a "Pig-In-A-Poke".

I think I read that 45% of the population pays no Income tax. That 45% is and has been the target vote for the Democratic Party for years. They wish to so financially enslave this population to Government handouts that they are Democratic Party voters for life...have no choice.

The population on food stamps has more than doubled under Obama and they have Government employees going door to door to sign people up. Heat/Energy subsidies the same. Medicaide, school lunch expansion, you name it. My guess is a "transportation assist" program where the Government will sponsor your car purchase next.

The Democratic Party passes so many regulations one needs to get the Government's permission to wipe their fannies. Which is exactly what they want. They want you and everybody else to be beholding to their Party, afraid to speak out for fear of retribution. And there's really good evidence that if you do speak out...you get hammered.

Did you really think that Obama care was going to make your insurance more affordable? If so then you're either in that 45% not paying income taxes or you purchased that "Pig-In-A-Poke".

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Pat West 9 months ago

Harvey, please show us where you get your figures? I can easily say 95% of posts to this forum are pure BS, but without referencing my sources, that stat is as reliable as yours.

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Scott Wedel 9 months ago

But it is far from true that voting follows that split of income and paying taxes. The poorest states that receive the most government aid per citizen are strongly Republican states.

While most of the wealthiest states vote Democratic.

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John Fielding 9 months ago

Even if Rep. Jared Polis is able to obtain waivers for the penalty that will not help with the cancellations of policies. Can he get exception to the requirement that all policies conform with Obamacare standards?

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Rob Douglas 9 months ago

A quick addendum. The Denver Post's Allison Sherry is reporting, "Colorado's state-run health insurance site Connect for Health Colorado has reported about 226 individuals signing up for new coverage so far." See: Sens. Mark Udall, Michael Bennet ask Obama for more time on health care enrollment deadline

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Melanie Turek 9 months ago

Seems like the issue is with how Colorado is pricing plans based on location in state, presumably relating costs to some kind of mean or average income/wealth calculation. Would be helpful if Rob could explain how that is structured.

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Michael Bird 9 months ago

There was a long stretch of time where we at Alpine Insurance were by far the largest seller of individual health insurance. During those years, the insurance companies repeatedly entered and left Steamboat and other ski resort markets due solely to an inability to operate at a profit due to the claims mainly arising from ski accidents. ACLs were as common as a cold but at thousands of dollars companies were forced to depart. Years ago State Farm stopped selling health insurace. Allstate, Geico,Travelers, Farmers, Hartford - and the list goes on and on - do not sell health insurance.Some due sell other company's health insurance products. The bottom line is that ski area claim experiences are far higher than metro areas. Way higher.

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Scott Wedel 9 months ago

But a heart attack can easily result in $100,000 in healthcare costs. And generally, the chronic conditions of diabetes and so on that result from obesity cost a lot more than a healthy person's occasional injury.

So it is not clear that our healthcare needs is why our rates are higher.

The article stated that the costs of providing the same healthcare services are far higher in the mountains than the Front Range.

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Michael Bird 8 months, 3 weeks ago

Scott, It isn't the amount per claim. It is the frequency. A $100,000 heart attack is less expensive than multiple and repeated ski injuries. Again, if a business - any business - cannot make a profit it will cease a non-profitable activity or go out of business. Overall, the reason the above mentioned insurance companies, plus most others, do not sell health insurance is a lack of profit. If it were profitable enough, they would have been in that market. Health costs are high for one reason. Health providers charge high amounts. Insurance companies,including exchanges, will pay high costs. Eliminating pre-existing conditions will insrease the cost of health insurance even accounting for more enrollees. Remember the old adage " We lose on each sale but we make it up with volume" ? Health costs will increase so Insurance costs will INCREASE. One can investigae costs, or form a commission, or take it to City Council but don't expect a single change. Why is our gas so much higher than Denver when the transport cost is far less than the difference in cost between SB and Denver ? Because they can. Remember the pharma industry wrote every single word of the Pharma section of Obamacare (Dateline) and backed the law preventing Colorado (or any other State) from obtaining bids on its Medicaid pharma and Colorado cannot buy drugs from Canada. Maine tried it and was closed down by the Feds.

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Scott Wedel 9 months ago

http://www.healthpolicysolutions.org/2013/10/23/congressman-fights-sky-high-rates-as-ski-town-signups-stall/

The pricing differential is based upon the costs of providing healthcare in the area, not the area's income or wealth.

So the interesting thing is that apparently there is no dispute that the healthcare costs are that much higher up here. Article cited that a MRI costs $500 in Denver vs $3,000 in Summit County.

For this are to have a strong economic future, we need to figure out why our healthcare costs are so high and figure out how to reduce them. I'd suggest that should be a top 3 economic concern for the city. That the city should have a commission to figure this out and how city policies affect it.

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Harvey Lyon 9 months ago

Scott, I agree with you totally. There are numerous articles by reputable writers showing how US health care costs are way out of line with other Countries. From prescription drugs to what are now routine operations. Reasons range from tort law to R&D to "because we can". Pressuring insurance companies to control health care costs is like pressuring you to get your neighbor to mow his lawn....not much leverage.

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Melanie Turek 9 months ago

Hi Scott. Thanks for the link. But it would seem that this approach contradicts the underlying philosophy and economics behind the ACA, which is based on the idea that, if you get everyone--young and old, healthy and sick, couch potatoes and extreme skiers--into the pool, then rates effectively level out across the board. They come down for some and increase for others compared to pre-ACA pricing, but no one is paying a higher or lower rate going forward (with the exception of smokers). So, it seems as though the Colorado approach is poor. Unless I am misreading your analysis...

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Scott Wedel 9 months ago

Melanie,

Well, since the population of the Front Range is so much greater than the mountain resort towns then the ACA could lower costs overall for Coloradoans even as it increase costs for us.

Though, at these rates, a local family could afford to travel to Denver for doctor visits and medical procedures and still save a lot of money.

That is why I think it is important to have a public commission to research and report on local healthcare costs. If MRIs cost $2500 less in Denver then it is not economically viable to have non emergency medical procedures performed up here. And healthcare is like a sixth of the local economy and there would be serious economic consequences if most of it is too expensive to be done locally.

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Melanie Turek 9 months ago

But there are two separate issues here: The cost of providing care, and the likely need to provide care. I am still not clear on which of those CO is basing its ACA program pricing. If it's the second, that would seem to run counter to the economics behind the ACA. If it's the first, then I'm not clear on why costs are increasing so much, since those factors should presumably have influenced costs before the ACA.

Why medical care is so expensive in mountain towns--and how people can work to reduce those costs--is a separate, though important, issue.

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Harvey Lyon 9 months ago

I guess the latest numbers indicate a huge signup for the expanded Medicaid but not so much for real pay-for-it insurance.

And, please correct me if I'm wrong here, the plan is to pay for the expanded medicaid by reducing medicare which is being termed "finding increased efficiencies" by the White House Spokesman.

Okay, but I'm going to have to play Missiourian on that one...."Show Me"....LOL

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jerry carlton 9 months ago

I voted for Obama his first term. I did not vote for him the second time. My wife and I are healthy and on Medicare with no supplement or prescription drug policy. You liberals enjoy life under Obama and next Hillary Clinton.

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Harvey Lyon 9 months ago

"The Business of the United States is Business: Calvin Coolidge 1924.

A short Bio: John Calvin Coolidge, Jr. (July 4, 1872 – January 5, 1933) was the 30th President of the United States (1923–1929). A Republican lawyer from Vermont, Coolidge worked his way up the ladder of Massachusetts state politics, eventually becoming governor of that state. His conduct during the Boston Police Strike of 1919 thrust him into the national spotlight and gave him a reputation as a man of decisive action. Soon after, he was elected as the 29th Vice President in 1920 and succeeded to the Presidency upon the sudden death of Warren G. Harding in 1923. Elected in his own right in 1924, he gained a reputation as a small-government conservative, and also as a man who said very little.

Coolidge restored public confidence in the White House after the scandals of his predecessor's administration, and left office with considerable popularity.[1] As a Coolidge biographer put it, "He embodied the spirit and hopes of the middle class, could interpret their longings and express their opinions. That he did represent the genius of the average is the most convincing proof of his strength."[2] Some later criticized Coolidge as part of a general criticism of laissez-faire government.[3] His reputation underwent a renaissance during the Ronald Reagan Administration, but the ultimate assessment of his presidency is still divided between those who approve of his reduction of the size of government programs and those who believe the federal government should be more involved in regulating and controlling the economy.

The problem today is, while we are wealthier than most, we're not a hugely wealthy Country. And "wealth" is what it takes to provide a great quality of life. The current administration wants to "cut to the chase" and spend like we were wealthy. The problem is....we're not wealthy. Sure there are some who are very wealthy, but not enough to make significant difference.

If you want wealth and you want health care for all then you need to take care of business first. And this may mean not getting as much renewable energy as you desire, bike lanes may not be built in your life time and construction may happen on a previously open space you find attractive. Get over it and remember.....the Business of the United States is Business"!

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mark hartless 9 months ago

You're wrong, Harvey.

The business of the US used to be business. Not any more. Today far too many of the American people are becoming adept at living off the system until its emminent collapse which even Hellen Keller could see is comming, while the dwindeling number pulling the wagon are starting to ask themselves why continue being the patsy for the freeloaders. This spells doom for the gubbamints revenue stream while demands for the omnipotent state to be all things to all people increase exponentially.

Government healthcare is merely a symptom of a society that wants to ride in the wagon and not pull it. It will collapse the system or render a pitifully unimpressive version of "healthcare". No other outcome is mathematically possible.

"The State is that great fiction by which everyone tries to live at the expense of everyone else."-Bastiat

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Harvey Lyon 9 months ago

Damn Mark, I do hope you're wrong. I harbor this belief that folks still believe in the good old USA and are willing to put out for it.

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Scott Wedel 9 months ago

US is not a wealthy county? Right now we are the world's second largest oil producer just behind Saudi Arabia. We will be the world's largest oil producer by 2015.

We have large forests and huge regions of farmland.

We are so wealthy that we can spend on much on defense as just about the rest of the world combined and can pay far more per citizen for healthcare than any other country. We waste more money than average per capita income of most of the world. The trouble is that we are so wealthy that our politicians can afford to be ideologues and political opportunists giving money to their constituents instead of seriously reforming to a cost effective government.

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John St Pierre 9 months ago

Seems to me if your going to come to play your going to have to pay.... I would very curious to know what our local hospital and physician collection rates are on the many ski accidents here.... especially in the 18 -30 bracket.

Many of those who staff our seasonal business's get no health coverage from their employers and when they get hurt .... who pays????

The higher rates are like flood prone areas... high crime areas.... you pay more for insurance in those areas....why is that so hard to understand??? Why should someone in Weld or Jefferson county pay for people to play in the mountains??? Would we not get mad if our flood insurance rates went up to cover losses in Weld county from their floods????

Insurance has always been a bet .... to make money for the insurance companies.... Obama Care is a bet to cover the millions without who cost us all when they don't pay or don't have the $ to pay......

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mark hartless 9 months ago

Our apparent wealth (or our current use of it) is not an indication of the current condition.

We are living off the prosperity that was created in the previous generation when people actually worked.

Our credit, prosperity, longevity, whatever, is a function of the PAST, when we uesd to be accountable.

None of that applies going forward. We're eating our seed corn.

Sorry Harvey; I believe there are a lot of good people but the coasters have tilted the scoreboard and it will not correct itself without muc h tumult.

People with no skin in this american game get to vote. Only lunatics believe that can end well...

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jerry carlton 9 months ago

Mark The "lunatics" are the ruling elite running the asylum [country}. ' ' '

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mark hartless 9 months ago

No, Jerry. I'm sorry. They are NOT the lunatics. The increasingly reliable ignorance of the American people keeps these people you call "the lunatics" in positions of power where they, their families, and their friends become wealthy, powerful and influential. Hardly makes them the lunatics. I think they are quite intelligent.

The lunatics are the electorate which has the power to remove those in power that are doing the harm, but who choose to continually re-elect them instead.

The lunatics are the ones that talk of term limits because they can't get it done at the ballot box.

The lunatics know the gubbamint can't make the post office or Amtrak work but because of their own laziness put that same gubbamint in charge of their heart operations.

The lunatics expect the gubbamint, which purchases power with the taxes of the people, to refrain from "spreading the wealth" and to instead reign itself in.

The lunatics think Washington DC is populated with well-meaning lambs rather than the wolves they are.

The lunatics are the American people who naievely believe the lunatics reside in the cesspool on the Potomac, rather than understanding that the true lunatics are right there in their mirror.

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Dan Kuechenmeister 8 months, 4 weeks ago

"If you like your doctor, you can keep your doctor. If you like your plan, you can keep your plan." Awe shucks. I was just kidding.

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