GLENWOOD SPRINGS — A lot of people in the tri-county rural resort region who qualify for subsidized health insurance under the federal Affordable Care Act haven’t even explored that option, because they don’t necessarily consider themselves poor, according to one area health care official.
The ACA provides that persons earning under 400 percent of the federal poverty level should not pay more than 9.5 percent of their adjusted gross income on health insurance premiums, points out Ross Brooks, CEO for the Mountain Family Health Centers (MFHC), which operates low-income health clinics in Garfield, Eagle and Pitkin counties.
Translated, at the top end of that 400 percent level, that’s an individual earning $46,680 per year, or a family of four that brings in $95,400, Brooks said.
Those people can qualify for what’s called an Advanced Premium Tax Credit, which is essentially a monthly subsidy offered under the ACA that helps consumers keep their insurance payments to that 9.5 percent-of-income level, Brooks explained.
“The important thing to know is, even though we are seeing much higher insurance rates out here, this is an option for a lot of people to be able to bring that monthly premium cost down,” he said in reference to the more-expensive resort rating area under Colorado’s health insurance exchange, also known as Connect for Health Colorado.
The Connect for Health website (www.connectforhealthco.com) does advise, however, “It is possible, depending on the cost of health insurance in your community and the amount you are expected to contribute to pay for insurance, to not be eligible for a tax credit even if you are in the eligible income range.”
Besides the tax-credit subsidy, those earning 138 percent of the poverty level or less qualify for expanded Medicaid coverage under the ACA.
According to the latest data cited by Brooks, that has resulted in approximately 3,000 new people in Garfield, Eagle and Pitkin counties, including 1,453 in Garfield County alone, enrolling in Medicaid between Oct. 1, 2013, when expanded enrollments began, through Jan. 31 of this year.
Combined with the approximately 2,000 people in the tri-county area — 837 in Garfield County — who had signed up for health insurance through the state exchange as of mid-February, that’s 5,000 individuals or families in the region who have benefited from health care reform, Brooks observed.
Brooks was among those who spoke at a public forum on Feb. 21 sponsored by the Garfield County commissioners as they gather information to make a case with state insurance officials that the county should be removed from the more-expensive resort rating area.
The resort rating area, which includes Garfield, Eagle, Pitkin and Summit counties, is reported to have the highest health insurance rates not only in Colorado, but in the entire country, due to the often high cost of health care services in the mountain resort region.
Taken alone, though, Garfield County officials argue that health care costs here are more in line with similar-sized rural counties, and are even competitive with the metro areas.
One after another at the Feb. 21 forum, county residents and business owners told their stories of insurance rates doubling under the new system.
Garfield County has threatened to sue the state if some type of relief is not granted to county residents and small businesses attempting to buy health insurance.
“This really is an attack on the middle class, and we need to get this taken care of for all of our citizens,” county Commissioner Tom Jankovsky said during the meeting.
Brooks acknowledged that anyone who does earn over that 400 percent level “is in tough shape right now.”
“That’s one of the things we are in discussions with state officials about, is to possibly look at changing that to 500 or 600 percent for our area,” Brooks said.
He said he is currently awaiting data from the state to see how many people in the tri-county area might qualify for the tax credit if that change were made.
However, the subsidies that are built into the ACA could have the unintended consequence of encouraging people to forgo employment in order to remain qualified for the tax credit or for Medicaid, Tricia Murray, economic division manager for the Garfield County Department of Human Services, warned at the commissioners’ forum.
“With health care reform, our case load has increased,” she said, noting that the county recently had to hire two new caseworker positions to keep up with the expanded Medicaid rolls.
Murray also oversees the department’s self-sufficiency programs, which help individuals and families get themselves back on their feet and off of government assistance, she said.
“We have individuals who work very hard at doing this, but when they do get more income they lose eligibility for assistance,” Murray said. “Now, with the added high cost of insurance, I am concerned that people will cut their [work] hours so that they can re-qualify.”