Garfield County moves forward with lawsuit over rates

By Katie Kerwin McCrimmon

Garfield County’s commissioners on Monday authorized their attorney to sue Colorado officials for placing them in the state’s resort region, which has the highest health insurance prices in the nation. (Click here to read Colorado ski towns priciest in nation for insurance, no help from the feds.)

County Attorney Frank Hutfless plans to file the lawsuit in U.S. District Court by April.

“The Division of Insurance has violated federal law in establishing these geographic rating areas,” Hutfless said. “The rating areas should not discriminate against people. The rating areas should, to the extent possible, make (health) insurance affordable. People shouldn’t be deprived of the benefits that are intended to be conferred upon them by the Affordable Care Act.”

Health News Colorado first reported last week that the county was considering suing. (Click here to read Garfield County may sue, accuses state of rubberstamping insurance lobbyists’ plan.)

Colorado has 11 geographic rating areas that mirror pricing zones proposed by the health insurance industry’s lobbying group, the Colorado Association of Health Plans.

Garfield County officials have supplied data to regulators at the DOI showing that their historic health costs are lower than neighboring resort communities including Aspen and Vail. The most recent data available from Colorado’s All Payer Claims Database show that in 2012 Garfield County ranked 18th most expensive in the state for average per-person health costs while Pitkin ranked fifth, Summit ranked ninth and Eagle ranked 11th. People in some other counties where total costs are higher nonetheless can pay less for health insurance through Colorado’s exchange, Connect for Health Colorado.

Hutfless said he has never received any explanation from DOI officials why they were placed with resort counties. And Gov. John Hickenlooper did not respond to a request for a meeting with county officials.

“Everything we have submitted shows that costs are lower here,” Hutfless said.

Colorado Insurance Commissioner Marguerite Salazar has said previously that the newest data do not support changing Colorado’s geographic rating system and she plans to keep it in place both for this year and next. (Click here to read Controversial health rating areas won’t change for 2015.)

Late last year, Salazar held meetings around the state to try to allay concerns from people in high-cost areas including Garfield and Summit counties.

When consumers complained about health insurance prices that were significantly higher in resort areas, Salazar explained that prices have long been higher in resort and rural areas of the state. For the first time because of new transparency under the Affordable Care Act, people can log in to the exchange website and see exactly how much they would pay if they lived in a less expensive area.

Salazar has repeatedly said that she does not set the health insurance rates and she is undertaking a study, at Hickenlooper’s request, to determine why costs are higher in resort areas and if the state can help drive costs down. Figuring out why costs are higher in some parts of the state will be a complex task.  (Click here to read Remote care, monopolies, pricey injuries hike resort, rural health costs.)

Hutfless said the state has been “consistently inconsistent” in its arguments. On the one hand, state officials say they included Garfield County in the resort region based on higher costs and usage for patients who live there. On the other hand, they say they can’t remove Garfield County from the resort pricing zone because doing so would dramatically hike costs for people in areas like Pitkin, Eagle and Summit counties.

“It’s just nuts,” Hutfless said. “Wow. Lucky us. Now we’re the most expensive in the entire country, not just in the state.”

Print Friendly

Leave a Reply