Garfield County prepares to sue over health insurance zone
February 11, 2014
GLENWOOD SPRINGS — Garfield County is preparing to take on the state and federal government over a Colorado health insurance rate structure that places the county in the most expensive rating area, not only in the state, but in the entire country.
Garfield commissioners have directed County Attorney Frank Hutfless to prepare a lawsuit against the Colorado Department of Regulatory Affairs and the Division of Insurance, which was responsible for setting up the rating areas under the federal Affordable Care Act (ACA).
The rating area system included Garfield County in the same zone as the more traditional resort counties of Pitkin, Eagle and Summit counties, which combined were determined to have the highest health care costs in the state, resulting in higher insurance premiums for the area.
A recent study by the Kaiser Family Foundation concluded that the rates in Colorado's resort area for people to insure themselves or their families through the state's ACA insurance exchange are the highest in the nation.
Prompting the county's move was also a recent announcement by Colorado Insurance Commissioner Marguerite Salazar that the state will not look to make changes to the rating system until 2016, after a detailed study of health care costs in the state is complete.
Garfield County commissioners recently requested a meeting with Gov. John Hickenlooper to discuss the situation and come up with a solution that might address insurance rates as soon as this year.
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"We are now prepared to file a lawsuit, probably sometime in April, if we cannot work out a resolution with the state that is satisfactory to the citizens of Garfield County," Hutfless said Tuesday.
That lawsuit is likely to be filed in federal court, and would probably name the governor's office and the U.S. Department of Health and Human Services, Hutfless said.
That's because the county believes Colorado's rate structures violate the ACA's provisions that health insurance rates not be discriminatory.
"It is the belief of Garfield County that the state has violated the federal Affordable Care Act and the Public Health Service Act," Hutfless said. "The state's actions were arbitrary and capricious, and it hasn't acted within the intent of the ACA to not discriminate in establishing these geographical rating areas."
Commissioner Tom Jankovsky said he has received numerous phone calls from individuals and businesses saying their insurance rates are going up anywhere from 100 percent to 300 percent under the new system.
"This is a discrimination case," Jankovsky said. "There is no compelling evidence that shows our health costs are any higher or our utilization any greater than anywhere else in the state.
"What it looks like is that we are being lumped in with these other counties to reduce their costs," he said.
Jankovsky points to the figures used by the state to come up with the rate zones that show costs in Garfield County alone are more in line with other rural counties, and in some cases are less than in the metropolitan areas.
He also noted that the state's All-Payer Claims Database ranks Garfield County 17th out of 63 counties, at $2,544 per individual for total health-care costs 2013. That's lower than the state average of $2,647.
"The state is discriminating against Garfield County, and they are breaking the law when it comes to the Affordable Care Act," Jankovsky said. "We just feel like we're not getting any satisfaction from the state to correct this, and our residents can't wait until 2016."
Jankovsky said he also worries that, as those rates extend to small businesses that will be required to provide employee insurance in two years, those businesses may choose to leave Garfield County.
A Colorado Department of Regulatory Affairs spokesman could not be reached Tuesday for comment on the threatened lawsuit.