Expert: Why Are Healthcare Prices So High in the "Resort" Area?

Dec 30, 2013

Alan Weil, Executive Director of National Academy for State Health Policy in Washington, DC.
Credit Rick Reinhard

  Healthcare premiums under the Affordable Care Act are more expensive in the Roaring Fork Valley than in many parts of the state. They’re high in other mountain counties, too. Governor John Hickenlooper may get involved in bringing down those prices. Garfield County has asked him to intervene, arguing state officials did a bad job earlier this year when coming up with rates. Aspen Public Radio asked a national healthcare expert if the state failed to follow the rules. Reporter Elise Thatcher spoke with Alan Weil. He’s Executive Director of the National Academy for State Health Policy in Washington, DC.

Editor’s note: We’ve got two previous stories in this series. One is about Roaring Fork Valley resident Amy Barr, who's concerned about high health care premiums. The other is about Governor John Hickenlooper, who says he's open to helping bring down premium rates.

Below is a transcript of our conversation with Alan Weil:  

Reporter: One of Garfield County’s main concerns is that Colorado officials didn’t get consumer input when they were coming up with premium prices. Alan Weil is closely watching how state’s put Obamacare in place… and he says the Division of Insurance didn’t have to. But the Colorado health exchange… known as Connect for Health… did have lots and lots of meetings with stakeholders, to get their feedback. So we were curious if that could have had an effect on premium prices.

Alan Weil: “When my organization which works with states around the country, had a webinar about gaining public input, we included Colorado as an exemplar state, because of all the work that went into gaining public input. But it is true that that input was focused on exchange issues and exchange operations. And the more technical insurance regulation provisions of the affordable Care Act, which were always planned to be implemented and enforced by the Division of Insurance, would not have been the focus of the exchanges public input, nor would you have expected it to be.”

Reporter: So all that feedback wouldn’t have had an effect on premium prices.

Weil: “Right and also, at some risk I will say I think the issue of fairness is a hard one in this context, because when you buy insurance, you’re paying for the expected cost of something that you hope won’t happen. Namely you get sick, or you get into a car accident or your house burns down. And part of insurance is pooling together people with some commonality in what their likely expenses are. So if health care costs are higher in the resort areas, one way of saying it is, your insurance costs should be tied to what the underlying health care costs are, and therefore you should pay more. The other way of saying it is it’s not our fault and the wages here are barely enough to live on, and so that should be more of a common expense. There’s no one way to answer that question.”

Reporter: Several procedures are actually cheaper in the Roaring Fork Valley, compared to the Front Range, but the state said it looked at other factors too. That’s for coming up with premium prices.

Weil: “I think it’s important there’s really two stories here. And I’m hoping you’re looking at both. So the first story is yes, you have these rating regions that cause the insurance prices to be higher for folks in your part of the state than in other parts of the state. The argument made by the insurance carriers is well, we’re paying more, our prices are higher, for care up here. And I think the second story that’s worth examination is why exactly is that. Why is health care so much more expensive in the resort areas than in the rest of the state. Now, you could come up with the arguments: you could say living costs are high so we have to pay more. You could say it’s remote. It may have something to do with the fact that a lot of people can pay those prices without complaint, and so its easy to get away with higher prices, but it doesn’t mean its inherit.”

Reporter: Thanks for talking with us.

Weil: “You’re welcome.”