Governor John Hickenlooper says he could get involved with bringing down health insurance prices. That could have a real impact for residents of the Roaring Fork Valley and other mountain towns. Garfield County asked the state's top official earlier this month to intervene with high premiums. The County believes Colorado officials did a sloppy job earlier this year when coming up with prices. But some experts say the state didn't make any mistakes.
Editor’s note: Click here to check out our previous story about Garfield County's concerns about premiums, which includes Roaring Fork Valley resident Amy Barr.She contacted Garfield County Commissioners over high premium prices. Click here for more of our conversation with Alan Weil, Executive Director of National Academy for State Health Policy in Washington, DC. He’s got questions about why medical costs are so high in the Roaring Fork Valley and other communities in the “resort” health care pricing area.
Below is a transcript of Reporter Elise Thatcher's story:
Garfield County Attorney Frank Hutfless: "What we're really concerned about is the excessive premiums, the discriminatory premiums, that our citizens have been singled out to pay."
Reporter: That’s Garfield County Attorney Frank Hutfless, who’s at the forefront of the county’s effort to tackle high health care prices for residents in the Roaring Fork Valley and nearby. Locals have higher premiums than elsewhere in the state, because they're part of a so-called "resort" pricing area. Governor Hickenlooper, speaking at a recent press conference, admits there is a problem.
Governor John Hickenlooper: “I think that we have clearly seen the discrepancies in the, what the costs are in the mountain towns and what the costs are in the rest of the state. And not everyone who lives in a mountain town has a three figure income, you know, a lot of people there work very hard, and aren’t highly compensated, and for them to have to pay a higher health insurance-- it’s not completely clear to me how that makes sense.”
Reporter: Under the Affordable Care Act, states like Colorado can set up healthcare marketplaces called exchanges. In Colorado that’s Connect for Health. The law also has states come up with insurance prices. Those rates affect all health insurance policies, not just plans offered through the statewide exchange. So far, prices have been set by the Colorado Division of Insurance… but the Governor or State Legislature could also do it. That’s what Garfield County wants-- because county commissioners believe the Division simply set prices according to the desires of the insurance industry. They claim that prices were decided not by regulators but instead by an industry trade group. Again, County Attorney Frank Hutfless.
Hutfless: "Simply put, the state took the letter from this lobbying group, put their letterhead on it and submitted it as the state’s proposal."
Reporter: In fact, the state insurance agencydidsubmit a pricing plan nearly identical to prices suggested by an insurance trade group. A Division of Insurance spokesman says that’s because of time constraints as the new healthcare law was rolling out in Colorado. The Division didn’t get consumer feedback, and Garfield County argues that’s a problem.
Alan Weil: "I’m unaware of any formal requirements for consumer input in the rating decisions."
Reporter: Alan Weil is Executive Director of the Washington, DC based National Academy for State Health Policy. The group is studying how states are implementing the Affordable Care Act. Weil confirms insurance officials had only one month to develop prices for insurance policies.
Reporter: He explains it's possible insurance officials could have gotten some consumer feedback before deciding on prices… but it could have been very tricky.
Weil: "You have to put this in the context of the dozens and dozens of decisions that the states were having to make on a weekly and monthly basis to get ready for implementation of the law. Most of the states that I’ve worked with found themselves waiting until they knew the final rules of the road before they made decisions, because there were so many decisions, they couldn’t afford to make them once, and then revisit them after final rules came out."
Reporter: Not everyone looking at pricing is critical. At CU Boulder, law professor Dayna Matthew is also tracking the rollout of Obamacare. She teaches health law and policy… and she doesn’t seen any problems with how the state set it up pricing.
Dayna Matthew: “The insurance premium rate review process looks for rates from the industry that are either excessive, inadequate, or unfairly discriminatory, and I think Colorado did pretty well at least as a starting point."
Reporter: Pitkin, Eagle, and Summit County also have higher premium prices compared to the rest of the state. Still, none have joined Garfield County's request for the Governor’s involvement. Eagle County is instead working with state lawmakers seeking to lower insurance rates. The question remains, whether residents of the Roaring Fork Valley could see lower policy costs. Earlier this month, Governor Hickenlooper pointed to one option; putting the Valley in the same insurance group as the Front Range.
Hickenlooper: “I know one possibility for the next year, we can’t do it this year, but would be to make sure we have a pool for the whole state, right? Except where specifically you can demonstrate that there is a higher hospital cost.”
Reporter: Until a resolution can be found, local residents will continue to see higher premiums than other Colorado residents.
