Steamboat Springs — More than 40 people on Friday night showed up at the Bud Werner Memorial Library in Steamboat Springs to attend a town meeting hosted by Democratic state Rep. Diane Mitsch Bush, where the cost of obtaining health insurance through Colorado’s exchange, Connect for Health, was on the minds of her constituents.

“I have a couple of friends here who are paying more for health insurance through the exchange,” Tom Kelly told Mitsch Bush. “Can you tell me what is going on with health care insurance costs in Routt County?”

Kelly’s timing could not have been much better. Mitsch Bush, who lives in Steamboat, voted among the majority on the House Health, Insurance and Environment Committee on Thursday in a 7-6 vote to kill a bill that would have repealed Connect for Health.

She told Kelly that some people are experiencing high premiums here because of the lack of competition among health care providers and insurance companies. But she knows from talking to her constituents that based on their personal situations, others are paying less through the exchange.

Had the House bill sponsored by state Rep. Janak Joshi, R-Colorado Springs, passed out of committee and ultimately become law, it would not have ended the overturned reform law here most often referred to as Obamacare. Instead, it would have ceded management of the program to the federal government in Washington, D.C.

Mitsch Bush reminded her audience that the primary goal of the health care reform has been to extend insurance to people who previously have been unable to qualify. However, she added that she has met with Colorado Health Insurance Commissioner Marguerite Salazar to impress upon her the disconnect between the perceived wealth of the state’s mountain resort towns and the actual wages earned by working families.

Insurance premiums are reviewed by the commissioner based on cost of care in a region (typically higher in mountain towns where the only hospital in town doesn’t have competition) and on rates of utilization of insurance benefits, she said.

“I tried to impress upon her that although in mountain communities, census based incomes look high, in fact, our wages are not,” Mitsch Bush said. “Wages here are lower than in Denver. Hospitals (in mountain towns) don’t have the opportunity to negotiate with insurance companies for discount rates. … One of the keys is competition among carriers. What we can change is the number of insurance carriers.”

Mitsch Bush said when she researched the number of insurance carriers in Steamboat and Eagle County’s town of Edwards, then contrasted them with Denver, she saw little competition here, but 20 carriers offering policies “at every rate you can imagine” in Denver, albeit with widely ranging benefits.

Mitsch Bush did have one piece of good news from Salazar, who said she thinks Kaiser Permanente, one of the least expensive health insurance carriers in the Denver metro area, intends to move west along Interstate 70 and begin serving communities on the Western Slope.

Other questions and concerns fielded by Mitsch Bush included constituents concerned about how the Yampa River might be impacted by the state’s new water plan to be finalized in December.

She told her audience that rivers like the Yampa are critical to the Colorado lifestyle that attracts employers in tech industries to the Front Range.

“The Western Slope, particularly the mountain communities, have the agriculture, beauty, ski industry and public lands that are critical to the state economy,” she said. “One of the reasons we have such a robust tourism industry is because of our free flowing rivers.”

To reach Tom Ross, call 970-871-4205, email tross@SteamboatToday.com or follow him on Twitter @ThomasSRoss1