Garfield County exploring health insurance cooperative in hopes of lower coverage costs | PostIndependent.com

Garfield County exploring health insurance cooperative in hopes of lower coverage costs

Peak Health Alliance CEO Tamara Pogue-Drangstveit speaks at the Keystone Lodge in Keystone, Colo. on Sept. 9, 2019, during an event officially launching Peak Health.
Liz Copan/Summit Daily file photo

A nonprofit health insurance cooperative that has served to lower health insurance costs in Summit and several rural western Colorado counties could do the same in Garfield County.

Garfield County commissioners have allocated $25,000 to work with Peak Health Alliance in the coming months to explore the potential for the county to join the expanding cooperative.

Begun in Summit County, the first-of-its-kind consumer cooperative works with insurers and health-care providers to negotiate individual, family and small group pricing for health insurance coverage.

In combination with Colorado’s reinsurance legislation that went into effect for the current Connect for Health open enrollment period, Summit County expects to see an overall 41.5% reduction in costs for health insurance purchased through the state marketplace, according to Peak Health’s projections earlier this fall.

The cooperative has grown to include affiliates in six other counties for 2020 — Archuleta, Dolores, Grand, LaPlata, Montezuma and San Juan. 

The soonest Garfield County could join would be 2021, but a lot of information must be compiled by April of next year in order to proceed, County Commissioner Tom Jankovsky said.

“There is a lot of work to get this done, but we’ll come up with some numbers and take a look to see if it makes sense to move forward,” Jankovsky said.

If the county can enlist between 2,000 and 6,000 individuals to join the cooperative, it could make sense, he said. Especially for small businesses, it could be a pathway to more affordable health insurance for their employees, he added.

A committee is being formed to pull together raw county-level data, including the number of claims filed by county residents and cost of care provided both within and outside the county.

Armed with that information, the county would negotiate pricing with providers and insurance carriers and issue a request for proposals from insurance companies to represent the county, Jankovsky explained.

Even another 10–15% rate reduction for the county could make a big difference, especially for small employers (50 workers or less) that make up the bulk of Garfield County businesses, he said.

Thanks to the reinsurance program, Garfield County has already seen, on average, a 28.6% reduction in the cost of 2020 health insurance purchased through the marketplace compared to this year’s rates, according to Colorado Division of Insurance data.

Still, at more than $700 per month for an individual to buy a basic bronze-level insurance plan, without financial assistance based on income, that continues to be a deterrent, Jankovsky noted.

“If somebody’s making $17 to $20 an hour, that’s still a lot of money,” he said. “So, if you’re healthy, you don’t buy insurance, which creates a conundrum.”

About 20% of Garfield County residents are not insured, according to Division of Insurance statistics. And, Mountain Family Health Centers, which has clinics in Garfield, Eagle and Pitkin counties, reports that about 40% of the patients coming through their doors are not insured.

Health insurance rate comparison

Basic 2020 Bronze-level Anthem health insurance plan for a healthy, 55-year-old male in Glenwood Springs vs. Lakewood, Colo. 

Glenwood Springs

Premium — $758.32/mo

Lakewood

Premium — $640.39/mo

Difference — 18.4% 

Source: Connect for Health Colorado 2020 plan explorer

 

The mountain resort region of Colorado and rural western Colorado counties continue to see health insurance rates anywhere from 18-30% higher than the Denver area, depending on the type of plan.

While rates have gone down statewide via the reinsurance program, that disparity is something Western Slope interests are working to address, said Steve Reynolds, co-chairman of the health policy committee for Club 20, a Western Slope business and government advocacy group.

“One thing to remember is that the majority of people who get their insurance through the exchange are getting a tax credit,” he said. “As the premiums go down, that tax credit also goes down, so the actual out of pocket might not change that much.”

The vast majority of insured Coloradans get coverage through their employers, or they’re on Medicare or Medicaid depending on their age and income.

The Colorado Legislature this coming session is also expected to take up consideration of a public option bill that could further lower insurance costs by creating a publicly funded insurance option.

“It’s something that has apparent support, and it will be interesting to watch that through the next legislative session,” Reynolds said. “The main message I see coming out of the off session work is that people are continuing to become more and more educated about health care and why it’s so expensive.”

That education is important to finding solutions such as reinsurance and the potential for local cooperatives, he said.

jstroud@postindependent.com


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