Controversial health rating areas won’t change for 2015

By Katie Kerwin McCrimmon

Despite furor from members of Congress and residents in ski resort areas who face high health insurance costs, Colorado will not change its geographic ratings for 2015.

And Colorado’s Insurance Commissioner, Marguerite Salazar, said there is nothing she can immediately do to lower rates or alleviate sticker shock for residents from mountain communities in Summit, Garfield, Lake, Eagle and Pitkin Counties.

“It’s a really, really hard thing. I wish we could have come up with something,” said Salazar who plans to announce next week that her office has not proposed any changes to the geographic ratings.

“We kept going back to the drawing board,” Salazar said.

She and staff members modeled various impacts if they moved counties from one region to another. People in Garfield County have been especially angry because their historic costs are lower than nearby Pitkin, Eagle and Summit Counties, but they’re lumped in with the expensive resort counties for new insurance prices.

Had Colorado wanted to change its controversial map of 11 regions for 2015, Salazar would have had to notify federal officials by Jan. 1. She said she had no new data to warrant a change and therefore decided to stick with the 2014 geographic rating areas.

U.S. Rep. Jared Polis, D-Boulder, represents Summit County and last fall said he wanted Summit County grouped with lower-cost counties instead. Polis also wants waivers so people won’t be penalized if they skip buying costly health insurance this year. So far, no waivers have emerged for high-cost counties.

Salazar said she convened meetings with Congressional staffers along with insurance carriers, hospital representatives and cost experts to try to find a way to change the rating areas. But they are based on historic health costs. And costs in many mountain counties are much higher than those in urban areas along the Front Range. (Click here to read Remote care, monopolies and pricy injuries hike resort, rural health costs.)

Both Gov. John Hickenlooper and Commissioner Salazar also considered a single rating area for the entire state, but found that one rating area would have unfairly foisted higher costs on people who live in lower cost areas.

Salazar also feared that a single statewide rating area would have reduced competition among health insurance carriers in the state.

“Colorado could end up with two carriers and everybody else would fall by the wayside. Costs would start going up and everybody’s rates would increase,” Salazar said.

“The competition among all of these areas is much better than it ever was before,” Salazar said.

For the first time, however, people in expensive parts of the state are now able to see exactly how much more they are paying than those in lower-cost areas.

“It is the beauty of transparency. But it’s also making people really angry,” Salazar said.

She pointed out that the insurance companies set the costs and her agency has the right to review and approve or deny them, but does not determine exactly what people pay for insurance.

Hickenlooper asked Salazar to do a study on why health costs are so much higher in resort areas and other parts of Colorado. She plans to use money from a $3 million federal grant designed to strengthen insurance rate review in states. She said she hopes to complete the study by May.

“We just lack information on costs,” Salazar said. “Why are these costs so different? We’re on a mission to find this out.”




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