Northwest Colorado Visiting Nurse Association community and small-business insurance coordinator Erin Gleason, left, helps LIFT-UP of Routt County Assistant Thrift Store Manager Nancy Mayer shop for a new health insurance plan last year. A change in the state's insurance rating map could result in higher premiums on the marketplace for Routt County.

Scott Franz/file

Northwest Colorado Visiting Nurse Association community and small-business insurance coordinator Erin Gleason, left, helps LIFT-UP of Routt County Assistant Thrift Store Manager Nancy Mayer shop for a new health insurance plan last year. A change in the state's insurance rating map could result in higher premiums on the marketplace for Routt County.

Premiums could go up in Routt County under new health insurance map

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— Routt County residents who buy insurance on Colorado's new health exchange soon will find out how a change to the state's health insurance rating map will affect their premiums in 2015.

State regulators just got approval from the federal government to add Pitkin, Garfield, Eagle and Summit counties to the same 17-county health insurance area that Routt currently is in.

The move aims to lower the premium prices in those four counties where health insurance is most expensive by placing them in a larger risk pool.

Officials have acknowledged the move could end up raising premiums in places such as Northwest Colorado.

Colorado Insurance Commissioner Marguerite Salazar told NPR and Kaiser Health news that while the move could lower premiums in the four mountain resort counties, it also could raise them in some of the other rural counties in the region.

For the purposes of the health insurance map, Routt is considered a rural county and not a resort county.

"It is about fairness," Salazar told NPR. "When we put (the resort counties) together, we didn't know what the difference and disparity was going to be. We found out pretty quick."

The health insurance geographic regions help determine the cost of insurance under the Affordable Care Act on the state's new health exchange.

Officials won't know how redrawing the map will impact premiums across the region until insurance carriers provide 2015 rates and plans June 6.

Routt County Commissioner Steve Ivancie said the change to the map could end up being a "double-edged sword."

"It could be good, and it could balance out the premium prices, or it could raise them," he said. "The whole idea is to spread the risk. They feel this is the most equitable way."

Ivancie stressed the complexity of the issue and said places such as Routt County and other mountain resort areas are in a tougher position because of a lack of competition among providers.

State Rep. Diane Mitsch Bush, D-Steamboat Springs, said she is supportive of the change to the map.

"I think there are a lot of moving parts, but my expectation is that having a larger risk pool and having more competition and having the Division of Insurance being able to negotiate rates on our behalf will help us, and I may be wrong," Mitsch Bush said Thursday. "I had originally thought the whole state would be a risk pool, and there are a number of different reasons why it isn't, and some of it has to do with the Front Range. I guess we'll see what happens, and I will be very closely keeping my eye on this."

Mitsch Bush said that last year when the health exchange first launched, she researched the general price of insurance plans in Steamboat Springs, Edwards and Denver and was struck by the difference in prices.

She is in a unique position in that she represents two neighboring counties, Routt and Eagle, that have different insurance prices because of the different insurance areas they were included in.

The Kaiser Family Foundation recently found that Garfield, Eagle, Pitkin and Summit counties have the highest health care premiums in the country.

While Routt County also hosts a ski resort, it was not included in the smaller mountain resort insurance region when the map was drawn.

The move ended up being positive for Routt County as premiums here were lower than in the resort region but still higher than in the Front Range.

The Kaiser Family Foundation found the cost of the least expensive silver-level plan for a 40-year-old person was $483 in the Colorado Resort Region.

The cost for an equivalent plan in Steamboat Springs is $349.

Health insurance premiums generally are more expensive in places such as Edwards and Steamboat because there is less competition among a fewer number of insurance providers and because there are fewer medical providers.

In addition to geography, family size, income, age and tobacco use determine the cost of premiums.

To reach Scott Franz, call 970-871-4210, email scottfranz@SteamboatToday.com or follow him on Twitter @ScottFranz10

Comments

Thomss Steele 4 months, 1 week ago

"Its about fairness" there you go koolaid drinkers. Enjoy your mess.

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Dan Kuechenmeister 4 months, 1 week ago

Health care never has been, never will be "free". More participants + less providers = higher costs for all. Subsidize some and the costs for those that pay rise even more. Econ 101. Higher health care costs, higher energy costs, higher food costs and stagnant incomes are not a recipe for a strengthening economy. The middle and less then middle class are what are needed for this once great country to climb back up the mountain. As things stand now, all I can say is good luck to us.

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Fred Duckels 4 months, 1 week ago

Long term I think that this debacle has not been thought out and we are in for a big problem. The public sector has a nest ;on the ground and the rest are going to be sucking.

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mark hartless 4 months, 1 week ago

The engineers, PHD's, and other great minds were gathered around the crash site, trying to determine what exactly went wrong. The stench of burning flesh still lingered in the smokey air.

The question was on everyone's mind, but they dare not breath it aloud.

Why did the flight crash? After all the careful reasearch and planning what had they missed?

Could it be that those unlearned rednecks were right when they told the elite that lead was a poor choice for airplane skin??

"No clever arrangement of rotten eggs will make a good omelet." -C.S. Lewis

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Dan Kuechenmeister 4 months, 1 week ago

As Nancy Pelosi so adroitly stated. We have to pass the bill to find out what's in the bill. Hey Neil, just for you a Memorial Day link. http://www.nytimes.com/2014/05/26/us/irs-bars-employers-from-dumping-workers-into-health-exchanges.html?_r=2

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Michael Bird 4 months, 1 week ago

When there are no pre-existing condition exclusions and all have to have many more coverages compared to a broad coverage individual plan previously available, does any sane person really think insurance costs will go down especially with no decrease in medical care costs. Remember every word of the AFC pharma section was written by pharma lobbyists according to 20/20. States, by law, are prohibited from obtaining bids for medicaid pharma.so how can costs decrease. We haven't seen anything yet. Medical and pharma costs WILL sky rocket until mandatory cost controls are implemented. When the base costs are the same for all, there is no competition available so an insurance company has no pricing room - thus no competition. Why are there no Humana, Aetna,Unied Healthcare, etc Medicare Advantage plans on the western slope? Answer is preceding. Dream on Diane but hold onto your purse once you are off of the public emploees health plan that those who pay for your plan cannot afford to buy for themselves even with a subsidy, which again is tax money that could be kept by citizens. What about public employees having to pay for their health insurance as most taxpayers must ? Then we'd see constructive change

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Scott Wedel 4 months, 1 week ago

Basic issue is that people get medical care one way or another because uninsured people still get emergency medical care. In particular for pregnancies, the cost of doctor visits and monitored care is a fraction of the costs of showing up pregnant with severe medical issues in the emergency room.

The US spends far more per citizen for medical care and has among the worst outcomes of industrialized countries. Our system is broken at so many levels from expensive underutilized equipment, to drug costs, to overhead, to insured paying for uninsured and malpractice.

Health insurance is not insurance in the true sense of the word because it is far too predictable and not a group sharing the costs of random events such as a house fire.

That said, grouping Routt County with larger, higher cost resort counties is going to worsen the local situation. Colorado should be one region since we send emergency cases to Denver.

And Salazar should be fired for incompetence since there is no credible way they could have failed to know the impacts of how they grouped regions. And now the solution is to make neighboring "rural" counties pay more? It is no longer about "fairness". It is about CYA so that Colorado doesn't have the highest cost region in the US. And now the neighboring counties pay the price.

"It is about fairness," Salazar told NPR. "When we put (the resort counties) together, we didn't know what the difference and disparity was going to be. We found out pretty quick."

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Chris Hadlock 4 months, 1 week ago

As a two time cancer survivor (30 years now) my premiums are cheaper, my insurance is better and I am guaranteed to be able to afford coverage in the future. No, I make enough cash, mulah, dough that I do not qualify for any subsidies. Until the advent of the ACA, I was barred from the insurance market by the very companies that you claim are so benevolent.

There are many things I would have done differently with the ACA and I have discussed them at length in the past.

Go ahead and keeps spinning your wheels and spouting your negative opinions, but this law is here to stay unless you somehow convince the American people otherwise. Just because you have driven any moderates away from these forums with your vile personal attacks does not mean you have won. We will continue to vote our priorities at the polls and without the Gerrymandering that Republicans engaged in in 2010, Democrats would control the House right now. (almost 2 million more Dem votes than Rep votes in house districts nationwide)

For those that might listen: 1. No more Groups - SSN = in the group All citizens treated the same regardless of profession 2. Break the Employment tie. - Why should my insurance costs be different if I work for GM or IBM as opposed to self-employed. Forcing ALL individuals onto the open market should be a Republican ideal as it would bring self reliance and responsibility to the forefront. It would also make the health insurance market more like auto, life, or property instead of giving corporate america a break 3. No more pre-existing conditions 4 No more out of network exclusions - Insurance should pay what it has agreed to regardless of the provider. If you choose the cadillac provider you must make up the difference.

If you understand anything about the actuarial statistics that the Insurance companies use to set their rates, you will soon understand that the biggest problem is that the companies want to break us into ever smaller "groups" because that helps them set higher rates (ie higher profits) Simply put, the more people that are incorporated into the formula, the more the risk is spread out and the lower the premiums become. If the insurance companies were forced to treat ALL citizens of colorado as 1 big group, that would be more effective at setting affordable rates than any other single thing that could be done.

As long as we allow the insurance companies to break us into ever smaller groups, you will see increases in premiums as they successfully decide that your risk of health problems is higher because you live in a small community and if you would just move to Denver or get a job with a major employer, all of a sudden you find yourself paying reduced rates.

Disaster, no I do not think so.... More like a tempest in a teapot. (pun intended)

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Jeff Kibler 4 months ago

That's great, Chris. I'm glad you're doing well. I have a close friend in a similar situation. His insurance is now heavily subsidized. Don't forget the millions that now are disenfranchised due to ACA. It seems to be better for a few, yet much worse for the general population.

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Michael Bird 4 months ago

Regardless of what you wrote, premiums cannot be affordable until the base costs are greatly reduced. Insurance costs are a minor part. Insurance company rates are regulated and have a profit of less than 6% compared to the DOW or S&P500, which have been 10& over the last 10 yrs.Target the insurance companies because it is easy rather than than those creating the huge cost increases and who are not regulated. Have you noticed that over the decades you don't see insurance index or ETF funds recommened. Money, Kiplinger's, etc. financial magazines almost never suggest an insurance stock. Why? One reason --- 10%+ is so much better than insurance returns. Take a quick look at Pharma's profits. Are improvements needed -YES. If we had a single payer system, we could save $$$ but only if we had cost containment. If run by federal employees instead of private industry, we'd have to pay for benefits significantly higher than private industry such as defined pension, Lexus type dental/medical , holiday/vacation,accumulated sick days etc. plus not being able to promptly fire incompetant employees. Bidding on drugs must be permitted. Standardize medical proceures and costs. Ex: MRI should cost the same everywhere.

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Chris Hadlock 4 months ago

I agree with much of what you say here Michael. The ACA is about the "Insurance" part of the problem and much work needs to be done with cost control and torte reform. Both are serious issues that are driving up the costs without giving benefit. The political problem here is that both sides have so poisoned the issue that there are no discussions or debate and even when there is agreement to compromise, nothing ever gets pushed forward due to the extreme elements on both sides.

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mark hartless 4 months ago

People met at the town hall. They were upset. It seems the rats were getting into their cheese all too frequently and it had become a problem for them.

Down below, in the crawl-space of the town hall the rats were having a meeting of their own.

While the townsfolk were interested in "improving" the problem by stopping the rats, the rats were discussing how to "improve" their problem of not having enough of the people's cheese.

Until the American Electorate realizes that politicians (rats) are not interested in improving the people's circumstances, only in "improving" THEIR circumstances, things will continue down hill.

Politicians across the spectrum do NOT define improvement the same as the naive voters do. They see improvement as them having more control over the suckers, and with those suckers' help they are well on their way to absolute control.

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Chris Hadlock 4 months ago

Is there even one single Gov't program or expense that you agree with Mark/Fred? Come on try hard! Name just one.

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jerry carlton 4 months ago

Chris I agree with all 4 of your suggestions. I also survived a malignant melanoma 30 years ago. I still say Obamacare and the US Healthcare system is a disaster. Multiple reasons, including greedy Insurance Executives, Greedy Pharma, Greedy for profit hospitals, Greedy Doctors, Greedy Dentists, Greedy Psychiatrists, and Greedy consumers. Everybody needs a knee replacement, a hip replacement, a heart transplant, a liver transplant, an abortion, birth control pills, Viagra, etc. God did not design people to live forever no matter what modern medical science says. You did not ask me but I agree with Social Security. I and my employers paid into the system 51 years and I think we Americans deserve our money back. I do not think our money should be given to Egypt or Israel or Iraq or Afghanistan or the Congressional pension plans or Mexico or what ever the cause of the day is.

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mark hartless 4 months ago

The Tenth Amendment was intended to confirm the understanding of the people at the time the Constitution was adopted, that powers not granted to the United States were reserved to the States or to the people. The constitution is a "thou shalt not" list directed at the federal government.

The 10th Amendment was specifically placed in the U.S. Constitution to remind the federal government of these enumerated powers and that it has no authority in any area not specifically described in the U.S. Constitution. The Founding Fathers feared (and boy were they right) that federal agencies would try to usurp powers reserved for the states or the people.

Here is something to remember, as said by George Washington, “Government is not reason; it is not eloquence; it is force! Like fire, it is a dangerous servant and a fearful master.”

We, the people, should be aware that an out-of-control government can be very destructive but in its proper place, it is a very useful servant.

Government has escaped the confines of the constitution, due in no small part to the constitutional ignorance and apathy of the electorate.

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jerry carlton 4 months ago

I agree completely Mark. That mule is out of the barn and not coming back.

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mark hartless 4 months ago

I wonder if any of these geniuses understand that we already have a great example of the kind of healthcare they want for all americans right down at the VA hospitals where many vets are dying due to lack of care.

The VA IS government/single-payer healthcare.

Don't any of these nitwits keep up with the daily news about what is happening at the VA???

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rhys jones 4 months ago

Don't dis the VA. They serve a LOT of vets.

They are my primary caregiver, thank God for that, ACA-approved. I've got FULL coverage, for everything, no deductibles, at their facility in Grand Junction (or anywhere) and my contact for that is the tele-climic in Craig, where they can zap pics to my personal physician in the Junction, who then schedules the appropriate visit, specialists if necessary...

Emergency procedures are 100% covered, wherever encountered, including transportation if necessary.

Despite the aging VA facilities, the equipment and care is first-rate... unlike private practice, they have little interest in return business, would rather fix you up now... they are ALWAYS most courteous, respectful, and accommodating.

A van leaves Craig, every day a regional veteran has an appointment there, one just has to transport oneself to Craig... and I'm gonna have to show up three hours early Monday, because there's another guy with an earlier appointment.

Am I complaining? Hell no!!

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mark hartless 4 months ago

Yeah??

From the recent news it seems they DIS-serve a hell of a lot of 'em too. Of course THOSE guys ain't complaining either... caues the're DEAD!

Did you see where the vet in California was beaten to death by security for trying to leave the VA hospital???

Government provided healthcare for all to see.

Suckers.

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mark hartless 4 months ago

If government provided stuff is such a grand 'ole thing then why isn't everybody clammering to use public housing or public toilets?? And ya think public medicine is gonna be the exception????

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Chris Hadlock 4 months ago

We all know how much you hate the Gov't Mark. You cannot or will not even name even one single thing they do that is postive. Surely though, even you can tell the difference between the ACA and the VA. Just in case your advanced age has made you even more single minded than it appears I will explain the basics for you.

ACA = Private Insurance companies mandated to provide coverage levels and individuals mandated to purchase private insurance. Come on, you remember you have railed on and on about the mandate.

VA = Government owned and operated healthcare facilities, doctors, nurses and janitors employed by the federal Government.

Even a diehard such as yourself should be able to tell the difference but then I guess when you have a hard core talking point, the truth takes a backseat.

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jerry carlton 4 months ago

Rhys I am glad VA healthcare is working well for you. During one of my periods of unemployment or employment with no benefits, I applied for Va healthcare. They told me that I had too much money and was not eligible. It did not bother me much at the time. However now I hear that Va executives are being paid bonuses? McCain has a bunch more money than I do and I bet he gets all the VA healthcare he wants. Everybody in Congress has more money than me and they get gold plate healthcare paid for by the taxpayers. Just another example of what a load of crap the federal government is.

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Dan Shores 4 months ago

Thank you Chris for reminding us all of the good that is done by the ACA. It is an imperfect piece of legislation as we all agree, but it is also a necessary piece of legislation. A just society cannot continue on while ignoring the millions of Americans who were excluded from the health insurance market place, and let's not forget that premiums were rising at an unsustainable rate before the ACA. Chris and I were both excluded prior to the ACA. The cost of health insurance is a huge issue and not affordable in mountain communities and this issue still must be addressed. Our state legislators are well aware of the problem and are working toward solving the problem. I would urge everyone to contact your state legislators and keep the pressure on to find a solution to the affordability issue. The ACA is the law, it is not going away, so it seems that the best course would be to work to find solutions to the problems rather than just being negative and complaining.

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Michael Bird 4 months ago

Dan, the ACA does nothing to reduce the rate at which premiums increase. It subsidizes these increases with our taxes based on one's income. In some cases, some will pay less but the costs haven't been decreased and the federal govt pays the difference. Prior to ACA Colorado offered guaranteed issue health plans excluding only pregnant women and those with renal kidney disease so neither you nor Chris were excluded unless you were not Colorado residents. Colorado Colorado had a 6 month pre=existing exclusion and its successor had none. Affordability is a word that needs to be defined. Affordable by whom ? The insured? The tax payer paying for others' insurance ? Until medical costs are reduced, nothing can be reduced. Lest we forget insurance costs are a minor part of this equation. Delete insurance costs and our medical costs are still sky high. Affordability can only occur when these costs arre greatly reduced.

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Chris Hadlock 4 months ago

The only problem with Colorado's Guaranteed Issue plans is that you had to prove you had been denied coverage. Once you actually force any insurance company to actually deny coverage, that is a black mark on your health record that can NEVER be erased and you are forevermore un-insurable. Most of us with these kinds of health histories chose other avenues than getting denied. In my case, we have used my wife's employment to provide spousal coverage.

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Fred Duckels 4 months ago

The VA is a union cesspool, 80% signatory, need I say more?

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Chris Hadlock 4 months ago

I agree with you Michael. It is health care costs that are driving health insurance costs. The ACA did little or nothing to control those costs, and Congress has specifically forbidden Medicare from doing just that in the Pharmacy market.

Prior to the ACA, all health care recipients were subsidizing the free care provided to those that could not or would not pay. Forcing everyone to have insurance is supposed to allocate those costs away from the Hospital/Doctor/Patient and into the entire insurance pool. The jury is still out here, but that was "supposed" to help drive down costs.

I do not have a good answer for these cost drivers, what do you propose? Some suggestions I agree with from the far right.

Tort Reform - Lawsuits remain a serious cost driver for Hospitals and Doctors.

Making everyone pay for routine maintenance while providing health insurance for major issues would put the Dr/Patient relationship squarely on the market and the individual. Look at the costs for things that normal insurance does not pay for like lasiks or Chiro and you see much different cost structures while fully insured procedures and drugs are through the roof.

Hospitals are forced to treat "anyone" that walks thru the door. What does this equation do to hospital costs? Can it be changed, should it be changed?

Google the Hepatitus c drug named Solvadi.
http://www.washingtonpost.com/blogs/wonkblog/wp/2014/05/29/how-an-84000-drug-is-sparking-a-new-health-care-debate/?tid=pm_business_pop

Is it right to charge $84000 for this treatment in the US. $57000 in Britain, and only $900 in Egypt. What should be done about this

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Dan Shores 4 months ago

Michael, you are correct that Chris and I could have gotten health coverage thru the state program that existed before the ACA. The problem was that it was even more outrageously expensive than insurance under the ACA. More than double in fact for me and that's double the ridiculously expensive premiums we have in mountain towns now. It doesn't do any good to have access to insurance if it is completely unaffordable. That's why the word "affordable" is part of ACA. Let's not forget that the specific issue I am addressing is the cost of insurance, and particularly the cost in mountain towns. While insurance is now available to all, it is by no means affordable and this is a central issue that must be addressed by our law makers.

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Dan Kuechenmeister 4 months ago

Hey Dan S., Dan K. here. I am a bit confused by your last post. Is the ACA "affordable" or not. You seem to say it is but then say it isn't. Maybe it should be the AACA - Almost affordable Care Act. Also why would you state that you and Chris were excluded when apparently now according to you in your most recent post you were not. That would be like me saying I am excluded from buying a Lamborghini when in reality I choose not to be able to "afford" one.

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Chris Hadlock 4 months ago

I was excluded. Why should the cost of my health insurance be tied to my wifes employment? Only by gaming the system was I able to keep continuous coverage. I tried several times to get insurance for my employees only to be turned away or offered exorbitant rates because I was a cancer survivor. Most of my employees at the time we less than 35 and my company was unable to offer them insurance because the insurance companies insisted that I had to be covered by the policy and that the rates for these young healthy employees would be over $1000 a month (in 1992-1995) because the owner was a cancer survivor.

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Chris Hadlock 4 months ago

PS. I still have the letters from the insurance company saying "Oh, we are sorry, the state says we are not allowed to raise your premiums by 500%. The max is only 40% per year" They then laid out 7 years of 40% increases.

This happened only 3 months after I had basic follow up checks done to see if there had been any recurrence of the cancer. This was about 15 years after the original cancer and I have been symptom free since the original treatment

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Dan Shores 4 months ago

I was excluded from the traditional free market, for profit insurance companies that we are all familiar with. The only possible option for me was the state run program and as I said was impossible to afford. Premiums well over $1,200 per month. If you think that's affordable Dan K. "tu salud." What I am saying is that one of the main purposes of the ACA is to provide access to affordable insurance for everyone. One can debate that the word "affordable" is impossible to define, but I think reasonable people can agree on some percentage of income as "affordable". The point is that health insurance is still not "affordable" by any measure in mountain towns, if you don't qualify for the subsidy. This problem is unique to mountain towns and is an issue that must be addressed by our state representatives and is the point of the story in the Pilot. Buying a Lamborghini just because you want one has no relationship whatsoever to buying health insurance that you need to continue living a healthy life and continue to contribute to society, without having to worry about going broke should you get sick.

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Dan Kuechenmeister 4 months ago

So if I am reading the posts correctly both Chris and Dan have had access to health care prior to the ACA. The issue was the cost. The hope then is that the ACA truly becomes affordable. Me thinks it will take a lot more than the 7 - 8 million who reportedly have signed up. As I have suggested previously. More demand (more on the dole for free or subsidized health care) plus less supply (doctors retiring or refusing new patients) equals higher prices for those who are deemed to be able to "afford" to pay. Not looking so good for the home team.

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Dan Kuechenmeister 4 months ago

Dan S, If health care is a necessity yet "unaffordable" what should a person do. Yes there are those who cannot afford health care and they should be helped. How ever there are many who choose not to afford health care because they don't want to make sacrifices. How many cell phones, ipads, ipods, computers, TV's, cars and I could go on do people really need. For the most part those are not necessities, they are modern conveniences. Turn up the thermostat in the summer, turn down the thermostat in the winter. Find a way to pay for health care. My monthly premium is well north of the $1200 figure you posted so "tu salud" to you. I don't whine or cry about it. Is it affordable? As you say, what is the definition of affordable. Doesn't matter. I believe my wife and I need health care so we pay it. It goes up 8 - 10% annually. That certainly doesn't make it any more affordable. O well, it is what it is. We choose to make changes to our life style so we can continue to pay the bill regardless of the cost. Part of continuing to "contribute to society" is taking responsibility for your own life. Now before you get your undies in a bunch I am not implying that you do not take responsibility for your own life. Best I can tell from past comments you have made, you do take responsibility.I am saying that there are millions upon tens of millions in this country that have their hand out for more from the government even while enjoying the modern conveniences available. Unfortunately that number continues to grow and until that stops, my guess is health care will not be "affordable" to those of us who pay for it.

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mark hartless 4 months ago

Chris,

I'm affraid you are correct; I refuse to name even one positive thing government does, mainly because the few things that might fit into that category are so ridiculously outnumbered by the absolute mess they make of all the rest.

To me that question is like asking if there was anything "positive" about Charles Manson. I guess you could say "he didn't kill us all" or maybe he gave blood while in prison, or maybe he presses some real fine liscense plates...

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