Colorado Health Exchange Premiums Roughly Equal to Those of High Risk Pool

iStock_000004795595LargeIn 2013, Rebecca Ryan of Fort Collins, Colorado, paid $375 a month to be insured by CoverColorado, the state’s plan for people who are uninsurable. When the state ended that plan on December 31, 2013, 14,000 people became uninsured and had to find ObamaCare plans.

Ms. Ryan went to the state exchange. The least expensive available option was a Kaiser-Permanente HMO that cost about $360 a month. Ms. Ryan says that it had a roughly similar deductible of $5,000 per person and total out-of-pocket costs of $6,350. Unlike Kaiser, however, CoverColorado allowed members to see any provider in the state.

The Kaiser plan did not include Ms. Ryan’s longtime physician. The only exchange plan that did that was a new, untested, Co-op plan that cost $526 a month. When asked, the exchange representative agreed that “they are going to penalize me because I want to keep my doctor.”

Keep in mind that CoverColorado charged individual premiums that were 137 percent of the “industry average,” calculated as weighted average of Colorado’s five largest individual health insurance carriers’ premiums, adjusted for benefit differences.

Ms. Ryan’s experience in the exchange suggests that ObamaCare may have raised Colorado’s average individual premiums by 37 percent.

Comments (24)

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  1. Heinz says:

    This shortage really undermines the efficiency of exchange plan.

  2. Devon Herrick says:

    Advocates for the Affordable Care Act are discovering that many uninsured people were (are) uninsured because they did not believe health coverage was a good value for the money spent. If you’re healthy; and have a reasonable expectation of remaining healthy, you may decide that insurance against medical bills is not a necessity.

    If you step back from all the rhetoric, it’s a little bit mind-boggling to imagine the lengths advocates will take to expand a financial service that the people they are tying to help often don’t want badly enough to purchase.

    • Lucas says:

      It’s like when Fox advertises all their new TV shows in front of the good ones. If we wanted it, we would get it.

  3. Cyrus says:

    I think we have to clarify that health insurance is for unexpected diseases. People could have a reasonable expectation of remaining healthy, but a healthy person may have some imperceptible health risks. Diseases or accidents come silently and suddenly. For this point, I prefer to keep my health insurance instead of being exposure of risks.

    • Trent says:

      This is a fair point, and an important idea to express to young healthy adults.

    • Susan says:

      I would agree with that if I could buy a policy just for this. I don’t want my policy to include maternity, contraceptives, routine care….

  4. Trent says:

    Maybe the state should put all their Marijuana tax dollars to healthcare instead.

  5. James V. says:

    they are going to penalize me because I want to keep my doctor.”

    Thanks, Obama!

  6. Bob Hertz says:

    Note to John Graham:

    I was in the Minnesota High Risk plan for 5 years. The plan was effectively run by Blue Cross and had the widest possible network.

    As John implies, we could have just maintained those pools in the 20+ states which had them, withiout all the distortions of the ACA.

    There would have to have been more federal dollars, since many of these pools were underfunded……and there would have to have been some coercion to create these pools in the stingy states.

    But still much less disruptive and wasteful than the ACA.

    Side issue:

    Cyrus says that health insurance should be for unexpected diseases. That is the classic “casualty insurance” approach to health care. You insure for house fires, not for shingling your roof.

    However there is a big hole in this philosophy. What do you do for persons who have a chronic illness like athsma and diabetes or kidney disease or lupus or severe depression?
    What do you when this kind of person leaves corporate employment at age 55 and has no continuing coverage?

    The ACA did at least address this problem. The hard core libertarians seem never to address it, I assume because no one they know has a chronic disease.

  7. Linda Gorman says:

    Bob, one of the reasons for creating CoverColorado was to provide coverage for people who had health conditions that made them uninsurable if they lost their employer coverage.

    It also covered people who didn’t have coverage and signed up only when they developed an eligible medical condition. There was a waiting period for those who didn’t have continuous coverage in order to create a disincentive to gaming the system.

    A society worried about people with chronic illnesses doesn’t have to nationalize health insurance. There are other alternatives. It could, for example, set up special programs to treat them as has been done with end-stage renal disease.

    It could also figure out how much more per year treatment for these diseases averages and make payments to individuals. People could use cash to pay for their medical care or payer higher premiums to insurers willing to fund it.

    The question is whether subsidizing high risk pools or the other possibilities mentioned above would have left people better off than the methods used by OCare.

  8. Bob Hertz says:

    All agreed, Linda, but for the most part it was blue states that actually created and funded high risk pools. (and some of them were funded very poorly, and had long waiting lists.)

    The Bush administration had eight years to put federal weight and money behind high risk pools in the other states, and did not do it. I realize that health policy was not well focused on either side of the aisle.

  9. Linda Gorman says:

    Bob, a list of 2011 states with high risk pools is at http://kff.org/other/state-indicator/high-risk-pool-enrollment/.

    Do you see a pattern in red/blue there? I don’t.

    And as I’m sure you know, the states that didn’t have high risk pools, like Ohio, had insurers of last resort. By federal law.