Colorado health insurance
Health status and the Affordable Care Act’s impact in the Centennial States
By Carla Anderson
August 5, 2014
Maybe you’re considering a move to “Colorful Colorado” and curious how health care reform is viewed in your potential new home. Or, maybe you’re an established resident wondering what goes into your state’s top third “healthiness” ratings.
Either way, this is the place for you. We take a look at how Colorado measures up against other states in several national studies and briefly summarize the Affordable Care Act’s reception and rollout in the state.
Colorado health ratings
Colorado ranks 15th on the Scorecard on State Health System Performance 2014. The scorecard ranks the 50 states and the District of Columbia on numerous health indicators, such as uninsured rates, the percentage of people receiving preventive screenings, childhood vaccination rates, and many other factors. Colorado was ranked among the Top 5 on four measures, helping the state climb three spots since 2009. See Colorado’s 2014 scorecard for the state’s ranking on individual measures.
Colorado receives an even higher score from America’s Health Rankings, which were completed in 2013. The state is boosted to an overall ranking of eighth based on low rates of obesity, physical inactivity, and diabetes. Colorado also has low air pollution and a low rate of preventable hospitalization. However, the state would likely improve if the rates of binge drinking and deaths due to drug use declined.
You can also check out the 2014 edition of Trust for America’s Health for a wide range of public health information; see Key Health Data About Colorado.
For a more focused snapshot, see the county-by-county health rankings for Colorado from the Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin.
Colorado legislators’ positions on the Affordable Care Act
In the 2010 vote on the Affordable Care Act, Colorado’s Sen. Mark Udall Christopher Dodd – both Democrats – voted yes. Colorado’s five Democratic House members also voted yes, while the other two representatives – both Republicans – voted “No.” Two of the five House Democrats who voted in favor of the ACA have since been replaced by Republicans. Since their election, both Rep. Scott Tipton and Rep. Cory Gardner have repeatedly voted to repeal the ACA. Rep. Gardner is challenging Sen. Udall in his 2014 re-election bid.
At the state level, Colorado was one of the only states that moved in a bipartisan manner to establish a state-run health insurance marketplace. Gov. John Hickenlooper, a Democrat, signed legislation authorizing the marketplace in 2011. The state marketplace has since been named Connect for Health Colorado.
How did the ACA help Colorado?
Colorado’s uninsured rate has dropped an estimated 7.52 percent, from 16.54 before the 2014 ACA open enrollment period to 9.02 percent after open enrollment. Colorado’s uninsured rate is below the national average, which a Gallup-Healthways poll and the Urban Institute’s Health Reform Monitoring Survey place in the 13-to-15 percent range.
The drop in Colorado’s uninsured rate is attributable to enrollment in qualified health plans and the state’s decision to expand Medicaid.
Colorado enrollment in QHPs
According the final 2014 enrollment report from the U.S. Department of Health and Human Services (HHS), 125,402 Colorado residents enrolled in QHP. Sixty percent of those enrolling in QHPs were eligible for premium subsidies.
At the beginning of the open enrollment period, the Kaiser Family Foundation estimated Connect for Health’s market size 501,000 Coloradans. Based on that estimate, 24 percent of eligible consumers took advantage of the state marketplace.
Ten insurers offered medical insurance policies through Connect for Health Colorado for the 2014 plan year. Preliminary fillings for the 2015 plan year suggest that premiums will rise modestly on average.
One of the insurers participating in Colorado’s marketplace is Colorado Health Insurance Cooperative. The nonprofit is a newly formed Consumer Operated and Oriented Plan (CO-OP), founded through a $72.3 million federal loan. CO-OPs are intended to increase competition in the individual and small-group insurance markets while providing consumers with affordable, high quality options. Colorado is one of 22 states that is home to an ACA CO-OP.
Colorado and Medicaid expansion
Colorado is among the 26 states and the District of Columbia that are expanding Medicaid under the ACA. The expansion extends Medicaid eligibility to most nonelderly adults at or below 138 percent of the federal poverty level.
Nearly 182,000 Colorado residents qualified for the state’s expanded Medicaid program during the ACA’s 2014 open enrollment period. Note that individuals can sign up for Medicaid – or lose coverage, if their eligibility changes – anytime throughout the year, so enrollment totals fluctuate each month.
Learn about Colorado’s Medicaid and Child Health Plan Plus (CHP+) programs.
Does Colorado have a high-risk pool?
Before the ACA reformed the individual health insurance market, coverage was underwritten in nearly every state, including Colorado. People with pre-existing conditions were often unable to purchase coverage in the private market, or were only eligible for policies that excluded their pre-existing conditions or charged them premiums that were significantly higher than the base rate.
CoverColorado was created in 1991 to provide an alternative for people who were not able to get comprehensive coverage in the private market because of their medical history.
One of the primary reforms ushered in by the ACA was guaranteed issue coverage in the individual market. An applicant’s medical history is no longer a factor in eligibility, which means that high risk pools are no longer necessary the way they once were.
CoverColorado stopped enrolling new applicants at the end of 2013, and encouraged all existing members to transition to a new plan by December 23, 2013 in order to have private coverage (or Medicaid, if eligible under the expanded guidelines in Colorado) by January 1. For those who were unable to secure new coverage by the beginning of 2014, CoverColorado plans remained in force until the end of March, at which point the program ceased operations.
Any members who were still covered by the plan at the end of March were eligible for a 60-day special enrollment period at that point, allowing them to select a new plan, on or off-exchange. The CoverColorado website now includes a touching Wordle comprised of compliments submitted by members during the final months the plan was operational.
Colorado health reform at the state level
Here’s what’s happening at the state level legislatively with healthcare reform in Colorado: