By Katie Kerwin McCrimmon
Colorado ranks fifth among 14 states operating their own health exchanges for selling private health plans to the highest percentage of the state’s population.
But in Colorado and across the country, sign-up rates are still very low.
That’s not a surprise says John Stuart Hall, an emeritus professor of public affairs at Arizona State University, who helped conduct a study of health reform implementation throughout western states. The Rockefeller Institute of Government at the State University of New York and the Fels Institute of Government at the University of Pennsylvania led the study. Researchers at the Colorado Health Institute are teaming up with researchers across the country and conducted the Colorado portion of the analysis. (Click here to see the report.)
“The complexity of the Affordable Care Act is astounding,” Hall said. “There are so many actors at the federal, state and local level that have a stake in the outcome, to say nothing of the political dimension,” Hall said.
As of Monday, Colorado’s exchange, Connect for Health Colorado, had sold private health plans to 100,112 people. So far, about 24 percent of people signing up are ages 18 to 34 and about 58 percent of them are getting tax subsidies to lower the cost of health insurance. An additional 151,050 people have qualified for Medicaid, the public health insurance program for low-income people. Colorado’s exchange has not released data on ethnicity of those signing up. But, among Medicaid recipients, about 45 percent are Anglo and about 21 percent are Latino.
Connect for Health had hoped to sign up at least 134,000 people by the end of this month to hit its mid-level targets and had once predicted as many as 200,000 sign-ups for private health insurance by March 31.
Hall warned that sign-up numbers now don’t tell the whole story and that researchers won’t know the full effect of health reform for years.
For the moment, Colorado is one of the states that appeas to be on track, he said.
“Colorado is one of these western states that have had substantial experience thinking about health care reform,” he said. “This is not something that can be implemented instantly or that will be guaranteed to succeed in all ways based on the plan. There will be surprises. But, I think Colorado is doing well.”
Hall now splits his time among three western states: Washington, California and Arizona, and says in general, pragmatic politicians in Colorado and the rest of the West are embracing health reform. That doesn’t mean implementation has been perfect in Colorado or elsewhere. Even so, politicians generally are moving forward.
“Everyone’s had this debate over Obamacare. Fierce politics have played out in every state. The western states have what I call ‘cover.’ They’ve compromised on some of the political issues. That gives their public management teams cover to move forward and do their job,” Hall said.
Hall said a bipartisan history of health commissions that pressed for reform in Colorado made the state ripe to implement the Affordable Care Act.
“That’s an advantage that Colorado has. It’s not that there’s perfect political unanimity. But there’s some degree of consensus that this is the law and we’re going to move ahead with implementation,” he said.
Based on data that the federal government is collecting, California so far leads the nation in signing up the most people for private health plans. As of March 1, California’s exchange had signed up 900,000 people or 2.3 percent of its population for private health insurance. Vermont has a much smaller population and with nearly 24,000 private health plans sold by March 1, had reached nearly 4 percent of its population. Another small state, Rhode Island, has so far sold plans to 1.8 percent of its population, while Connecticut has sold plans to 1.6 percent of its 3.6 million residents. As of March 1, Colorado had enrolled 83,469 people in private health plans. That put Colorado fifth among states running their own exchanges. As of March 1, Colorado had reached 1.58 percent of the 5.3 million people who lived in the state in 2013, according to U.S. Census data.
“I think it’s going great,” said Patty Fontneau, Connect for Health’s CEO and executive director. “Our volume continues to be steady and strong.”
During the final days before the March 31 deadline to sign up for health insurance, Connect for Health has opened a walk-in sign-up center on Denver’s 16th Street Mall. Health enrollment guides also are available for appointments at King Soopers grocery stores and at enrollment centers across the state.
Fontneau said she’s pleased that out of about 1 million potential customers — including uninsured people who are eligible to buy on the exchange and people who had previously bought through the individual market — the exchange has now reached about 10 percent.
“To actually take 10 percent of that market in four months is a real achievement,” Fontneau said. “This is the first step in a long path.”