Routt County health insurance costs tempered by regional grouping
February 11, 2014
Steamboat Springs — Steamboat Springs might be one of the top ski resorts in Colorado, but for the purpose of the Affordable Care Act, Routt County is not a resort region.
That's a significant difference when it comes to how health insurance premiums are calculated under the landmark legislation. The Affordable Care Act allows insurers to calculate premiums based on age, tobacco use, family size and geography.
When designing the structure of Colorado's health insurance system, officials with the state Division of Insurance had three choices: treat the whole state as one geographic region, use federally-defined metropolitan statistical areas and throw everywhere else into one group or design its own map. The department chose the latter.
The resort region — which encompasses Garfield, Pitkin, Eagle and Summit counties — has been cited as having the most expensive premiums in the nation, according to the Kaiser Family Foundation.
The Kaiser Family Foundation looked at the cost of the least expensive silver-level plan for a 40-year-old person. The cost was $483 in the Colorado Resort Region.
The cost for the same silver-level plan from Rocky Mountain Health for a 40-year-old person in Steamboat Springs is $349.
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The difference between those two costs is that Routt County was grouped with all the Western Colorado counties not part of a metropolitan statistical area. The amount individuals actually pay could be lower, depending on what subsidies they qualify for.
The Western Region includes 17 counties in both the northwest and southwest corners of the state while skipping the Interstate 70 corridor, which is made up of the Grand Junction MSA and the Resort Region.
Routt County's health costs are above the state average in most categories, according to the Colorado All Payer Claims Database, but the county is included in a region with lower-cost counties such as Archuleta, Hinsdale, Ouray and San Juan.
Residents of Garfield County, which is part of the Resort Region, have objected to the way the regions are drawn. Members of the public there have argued that their health costs are different enough from the other counties to warrant being placed in a different region.
The Department of Insurance has announced in a news release that it will not change the regions for 2015 but will "launch a study of healthcare costs, which is the key driver of premiums in Colorado."
"We looked at a variety of different options, but any changes for 2015 would have to be based on new data so we could justify them to the U.S. Department of Health and Human Services," Department of Insurance Commissioner Marguerite Salazar said in the release. "Because there is no new data available, we could not recommend changes for next year."