Website data reveals gap between health costs, premiums in Garfield County | PostIndependent.com
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Website data reveals gap between health costs, premiums in Garfield County

John Colson
jcolson@postindependent.com

GLENWOOD SPRINGS — A meeting between local residents and the state’s insurance-industry overseers, scheduled for tonight, has been postponed due to bad weather, according to the Colorado Department of Regulatory Agencies, the parent agency for the state’s Division of Insurance.

But local residents may still get a chance to ask state Insurance Commissioner Marguerite Salazar why Garfield County residents are paying the same health insurance rates as those living in the wealthier environs of Pitkin, Eagle and Summit counties. Or to ask how it is that residents of Garfield County, under the state’s interpretation of the federal Patient Protection and Affordable Care Act, will be expected to pay much higher monthly premiums than those living in other parts of the state, despite similarities in economic status and actual health care claims histories.

Officials said information regarding a web-based alternative to the meeting might be available on the Division’s website, http://www.dora.colorado.gov/healthinsurance, by 1 p.m. today. They also said attempts would be made to reschedule the meeting in Glenwood Springs, but they weren’t sure when that would be.



The Colorado version of the ACA is based on an arrangement of “metropolitan statistical areas” or MSAs, which covers the metropolitan areas in the state; the non-MSA or rural portions of the state; and a special category known as the Non-MSA-Resort Rating Area, which includes the ski-resort counties of Pitkin, Summit and Eagle counties, as well as Garfield County.

This rating system is not the same as was recommended by the federal managers of the ACA, who reportedly suggested the state be divided into MSAs for city-dwellers, and non-MSA for rural residents, one east and one west of the Continental Divide, which was meant to ensure that health care costs could be “averaged” among larger base populations within the state.



Instead, former Colorado Insurance Commissioner Jim Riesberg adopted a system that set up 11 rating areas for different parts of the state, seven of them MSAs encompassing the major cities in the state, three of them covering rural regions, and one for the resort counties.

Industry request

This arrangement was suggested to Riesberg by the managers of the Colorado Association of Health Plans, a health-industry lobbying group based in Denver.

According to a March 14 letter from CAHP’s Associate Director Marc Reece, the association urged Riesberg to adopt the same rating structure as is now in place, including the placement of Garfield County within the Resort Rating area, a rating zone the letter says needed to be created because of higher health care costs.

Reece’s memo claims that the recommendation is based, in part, on information available on the Colorado All Payer Claims Database, a statewide data site that reports on the actual health care costs incurred by patients. The data can be viewed on a county-by-county basis if desired.

According to an interactive map on the site, Garfield County residents spent an average of $2,954 per person for health-care treatment in 2011, only $30 more than residents of neighboring Mesa County, including Grand Junction.

But under the rate-setting system proposed by the CAHP and adopted by Riesberg, Garfield County residents will pay substantially higher monthly premiums than their Mesa County counterparts.

For example, a Garfield County 27-year-old with the Bronze Plan, the lowest cost plan available, would pay between $286 and $430 per month, while a 27-year-old resident of Mesa County would pay between $194 and $328 monthly for the same policy. Garfield County residents, with an actual health care cost history in 2011 about 1 percent higher than Mesa County, would be paying between 31 percent and 47 percent more than Mesa County residents for the same insurance.

Meanwhile, according to data on the website, Pitkin County residents during the same period paid an average of $4,010 per person. And, the interactive map shows nearly 20 counties around the state outside the resort area with higher medical claims costs in 2011 than Garfield County, yet ACA premiums in them are lower than in Garfield County.

Riesberg reportedly resigned his job in July as Colorado prepared to deal with the rollout of the public provisions of the ACA. He was not available for comment for this story.

Attempts to reach current insurance commissioner Marguerite Salazar were not successful on Tuesday.


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