State considers plan to eliminate resort insurance rate zone
May 2, 2014
State health insurance regulators said Friday that they may adopt a revised plan for geographic rating areas in Colorado that would eliminate the more expensive resort rate zone that includes Garfield County in favor of one that would take in a much broader cross-section of western Colorado.
The result could be a reduction in insurance premiums of about 4 to 8 percent in Garfield, Pitkin, Eagle and Summit counties, although some other Western Slope counties could see an equivalent increase in their premiums.
Mesa County would remain as one of the state's seven "Metropolitan Statistical Area" zones by itself, under the proposed new plan.
If approved, following a public comment period that closes May 7, and sent by Colorado Insurance Commissioner Marguerite Salazar to the U.S. Department of Health and Human Services for approval, as anticipated, the new rating areas would come into effect in January of next year.
That's a year sooner than officials from Garfield and the other affected resort-area counties had previously been told any changes were likely to be made in the state's geographic rate zones. The rating areas were set up last year to implement the federal Patient Protection and Affordable Care Act (ACA) in Colorado.
"I'm pleased if this happens and we don't have to go to a lawsuit to make our case. It looks like we are being listened to," said Garfield County Commissioner Tom Jankovsky, who attended a state Division of Insurance Healthcare Cost Study Group meeting in Denver Friday where the new rate zone options were presented.
The four mountain counties that had been included in the resort zone, which ended up with the highest health insurance premiums in the country under the ACA, have pressed the state to rethink the zones.
"We truly felt like we were being included in that group to subsidize the costs for the other three counties," Jankovsky said, adding a rural designation with more comparable counties such as Rio Blanco, Gunnison and Delta made more sense.
County commissioners from all four counties attended the Friday meeting.
"The status quo is killing our middle class," said Summit County Commissioner Dan Gibbs, who also lobbied for changes to the rate system. "Doing nothing is a non-option for us."
State Sen. Gail Schwartz of Snowmass Village, who has also been pushing for a change in the rate zones, applauded Salazar for listening to the concerns and moving toward the adoption of the new map that would include a second non-MSA rating area taking in most of the rural eastern Colorado counties.
"High insurance premiums that have been in place since the beginning of the year have had a crippling impact on working families and individuals in these four counties," Schwartz said in a prepared statement.
The new plan will "provide the necessary relief to mountain communities, and end the disparity in costs that they have been facing," she said.
Under the current configuration of 11 health insurance rating areas in the sate, the resort area offered a mid-level health plan for $483 per month, compared to $280 per month for the same plan in Denver.
The Colorado Division of Insurance will accept public comments on the new proposed rating zones through May 7, at DORA_georatings@state.co.us, and announce a plan next week.
Salazar called the move "increasing the risk pool."
"I can't say today whether premiums are going to go up or down," Salazar said. "We'll find out."
Also Friday, health insurer Kaiser Permanente announced it is considering offering plans for mountain communities along Interstate 70 by 2016. The company didn't elaborate on how it would make its decisions or what premiums might be.
In addition, Colorado regulators announced that they'll give health insurers another year to offer plans that don't meet new federal requirements and will revise geographic rating zones that have led to high premiums in some mountain counties.
The Division of Insurance said it would give insurers until the end of 2015 to continue offering health coverage that is skimpier than current federal law allows. They said they don't know how many insurers will take up the offer, or how many consumers will sign up to extend non-compliant plans.
About 100,000 of the 335,000 Coloradans who got cancellation notices have already extended their plans. Salazar said those people can now keep those plans for longer.
— Associated Press writer Kristen Wyatt contributed to this report.