Mountain ACA insurance rates to drop 7.4 percent
September 25, 2014
Objections from Garfield County officials and others in mountain resort areas earlier this year to high health insurance rates appear to be paying off under the new rates for 2015 announced Monday by the Colorado Division of Insurance.
The reconfigured western rating area, which includes most of the northwest segment of the state except Mesa County, will see an average premium decrease of 7.44 percent compared with this year for the various health insurance plans offered under the federal Patient Protection and Affordable Care Act (ACA).
In May, state insurance regulators agreed to realign the geographic areas in the state, consolidating the resort-area counties of Garfield, Eagle, Pitkin and Summit into the larger western rating area in an effort to reduce costs that for 2014 were as much as 30 percent higher for individual insurance plans than in other parts of the state.
The plan was ultimately approved by the U.S. Department of Health and Human Services, which approves rate plans for the states that have decided to set up their own health insurance exchanges under the ACA.
The move came after criticisms from Garfield County commissioners, who argued that the county should not be lumped in with its more-expensive neighboring counties to the east. At one point, Garfield County was prepared to sue the state and federal government over the rating system.
"I'm pleased, and this is the outcome we were trying to see," Garfield County Commissioner Tom Jankovsky said of the 2015 rates. "I do hope this helps everyone on their individual insurance."
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Officials in the other three resort counties also objected, saying they too should see some relief by drawing up a larger rate area where costs could be spread more evenly.
The resulting realignment reduced the number of rate areas in Colorado from 11 to nine. That change, however, led to a mix of decreases in regions including eastern and southern Colorado, but some increases in other parts of the state. Statewide, insurance rates will go up an average of 1.18 percent under the new rate structure for next year.
For individual ACA plans, the average increase will be about 0.71 percent, and for small group plans will result in an average increase of 2.54 percent, according to a Division of Insurance news release.
Premiums will still vary by plan type, known as bronze, silver, gold or platinum under the ACA, which is more commonly known as Obamacare.
Colorado Insurance Commissioner Marguerite Salazar said the combination of realigning the rate areas with the addition of new carriers in western Colorado helped to lower rates.
"This past year, the premiums in the mountain areas of Colorado have been a concern for many," Salazar said in the news release. "We are encouraged to see carriers such as Anthem and the Colorado Health-Op working with health-care providers in the mountain areas to develop more affordable insurance options for 2015."
Insurance regulators point out that the average insurance rates do not guarantee that every consumer will see a decrease in insurance rates.
"Consumers in these areas will need to look at the specific details for the plans available in their area," the division points out in a separate response to "frequently asked questions" that accompanied the Monday news release. "The geographic rating areas are only one variable in determining premiums, and the rates in the east and west areas are the product of many things, not just the area."
And, while the new insurance carriers were able to work with health-care providers and hospitals in some counties within the region, they weren't able to negotiate agreements with all of the providers, the division also explained.
The division reviewed and approved 1,072 health insurance plans from 20 carriers that offer coverage to individuals and small business groups in setting the new rates.
"We are pleased to see that our health insurance market is so competitive, especially compared to the other states that have released their 2015 rate information," Salazar said.
Open enrollment for new health plans begins on Nov. 15. Consumers must enroll by Dec. 15 if they want coverage to begin by Jan. 1, 2015. The open enrollment period lasts until Feb. 15.
Financial assistance via tax credits are also still available for those who qualify based on income, and those earning below the federal poverty level may still qualify for expanded Medicaid that was also part of ACA. For more information about health insurance options, visit http://www.connectforhealthco.com, or call 1-855-752-6749.