Garfield uninsured rate drops, but county still lags state rate
September 25, 2017
Far fewer people lack health insurance in Garfield County than before the federal Affordable Care Act went into full effect in 2013, but the region still lags far behind the statewide average when it comes to the uninsured.
According to the biennial Colorado Health Access Survey for 2017 released earlier this month by the Colorado Health Institute, the statewide uninsured rate fell again slightly over the past two years, from 6.7 percent in 2015 to 6.5 percent this year.
County by county, the number of residents who don't have health insurance ranges from a low of 1.4 percent in urban Douglas County to 13.1 percent in the sparsely populated northwest Colorado counties of Rio Blanco and Moffat.
Garfield County's uninsured rate sits at 10.2 percent. That's down from 11.7 percent two years ago, and dramatically lower than the 25 percent uninsured rate recorded in the 2011 survey.
Likewise, the eight-county health statistics region in which Garfield County is included along with neighboring Rio Blanco, Routt, Eagle and Pitkin counties, still has an uninsured rate of 10.2 percent, according to the latest survey.
Even though that number continues to drop, Ross Brooks, for one, says he's not celebrating.
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"I will celebrate if we get to zero percent," said Brooks, executive director for the Glenwood Springs-based Mountain Family Health Centers that serve Garfield, Eagle, Pitkin and Rio Blanco counties.
"The movement to get people insured, overall, is a good movement," Brooks said. "With a 10 percent uninsured rate, clearly, our work is not done."
The statewide survey does note that the farther removed from the Front Range population centers, the higher the uninsured rate.
A major point in the survey continues along the same lines as the theme coming Washington, D.C., where the Affordable Care Act, the signature health care law pushed forward by former President Barack Obama, remains under harsh criticism from the Trump administration and Republicans in Congress who want to see it repealed.
"The affordable part of the Affordable Care Act is still elusive in Colorado," the HCI report says among the key takeaways from the survey.
"The high cost of insurance continues to be the No. 1 reason for not having health insurance, with 78.4 percent of the uninsured citing it as the reason," the report says.
That number is down from previous surveys, when more than 82 percent of respondents said cost was the major reason they did not have insurance.
Especially in Colorado's rural mountain resort region, with higher health-care costs and higher cost of health insurance that's available on the individual market, cost is a major reason why the uninsured rate remains in double digits.
According to the survey, 15.6 percent of residents in the eight-county region that includes Garfield County are insured through the individual marketplace that was set up by the state after ACA became law.
Medicaid recipients make up a large percentage of the 18,500 patients who use the Mountain Family Health clinics for their primary care, Brooks said.
Still, about 6,200 of those clients are uninsured, he said.
Many of those people fall into the so-called "donut," Brooks said. They are gainfully employed to the point that they don't qualify under the low-income Medicaid guidelines, but they don't have employer-provided insurance and can't afford the high premiums charged by the individual market insurance carriers.
A portion of those uninsured patients are also undocumented workers who are barred from obtaining Medicaid or other government-subsidized insurance, and also can't afford private insurance, he said.
Lack of competition in the regional market, which now only has one carrier, is another problem, he acknowledged.
Those patients often come through the doors at Mountain Family because of its sliding fee scale. But those same patients are at immediate risk if Congress does not take action by the end of this week to extend funding for community health centers like Mountain Family.
U.S. Sens. Michael Bennet and Cory Gardner of Colorado are working on a bipartisan effort to keep that funding intact for the Community Health Center Fund.
That source of money accounts for about 20 percent of the Mountain Family Health Centers' funding; money that goes to cover its uninsured patients.
"Those 6,200 people who are not insured risk losing their health care if this funding cliff is not resolved," Brooks said.
As to the larger question of making health insurance more affordable in Garfield and other rural counties, Brooks points to solutions such as allowing Colorado residents to buy insurance across state lines and possibly finding a solution to the state's rating zone system that keeps insurance costs higher in the less-populated parts of the state.
State Rep. Bob Rankin, R-Carbondale, also spoke to the issue at a Glenwood Springs Chamber Resort Association event last week when he touted a single statewide health insurance rate. Such a rate might increase insurance rates by about 5 percent in Boulder and Denver, Rankin said at the event, but would result in a 25 percent decrease in Garfield and other Western Slope counties.
The 2017 Colorado Health Access Survey concluded that, for the first time ever, more than 5 million Coloradans have health insurance. Still, 350,000 individuals remain uninsured.
"In spite of the uncertainty in 2017, the Affordable Care Act gains first seen in the 2015 [survey] are holding," the report concludes. "And, many Coloradans are benefiting from the advances in coverage."
For instance, the percentage of Hispanic residents in Colorado without insurance has dropped to 10.4 percent from 21.8 percent two years ago.
The state's "young invincibles," those between 19 and 29 who are just starting their careers and often struggling to afford insurance, have seen their uninsured rate drop to 12.3 percent from 25.6 percent, according to the report.
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