As more people in Montezuma County sign up for insurance under the new federal health care law, Southwest Memorial Hospital may take on far less bad debt. Southwest Health System said patients were unable to pay about $4.6 million in medical bills during the 12 months leading up to October 2012.

The hospital also found through a survey that not having insurance was the No. 1 health concern for the community.

The Colorado Health Institute estimates about 20 percent of the people in Montezuma County are uninsured.

In preparation for Obamacare, the hospital became certified in the fall to sign people up for Medicaid and other forms of insurance.

The hope is that people will seek out preventative care and make fewer trips to the emergency room when they have insurance, said Kent Helwig, CEO of Southwest Memorial Hospital .

"We want to be one-stop shop for all the patients that come through here, even on the financial side," Helwid said.

Medicaid was recently expanded in Colorado to cover those who make 133 percent of the poverty level. This equates to $15,000 a year for an individual or about $30,000 a year for a family of four, according to the state. Everyone is required to submit information to see if they qualify for Medicaid before signing up for the state health exchange.

The first deadline to sign up for the Medicaid expansion or health insurance through the state health care exchange, known as Connect for Health Colorado, was Dec. 24.

People who remain uninsured through March 31 will face a fine of $95 or 1 percent of their income, whichever is higher, on their taxes.

Local agencies including, The Piñon Project, were busy during the days leading up to the first deadline helping people find the right policy.

A majority of people signing up through The Piñon Project qualified for Medicaid, said David Hart, the health care program director.

Across the state, more people have qualified for Medicaid than have signed up for the state exchange. As of mid-December 114,192 people had enrolled in Medicaid and 42,771 people had signed up for insurance through the state exchange.

Computer glitches in October meant people often waited days to find whether they qualified for Medicaid, said Jon Parker, the health coverage guide with The Piñon Project. Now, applicants often find out immediately, he said.

Many people come with a negative attitude toward health care reform and uncertain about the details, Parker said. But he said about three-fourths of the people leave with a better deal than they expected.

"I was pleasantly surprised with how many people are pleased," he said.

Despite the federal penalties, the Colorado Health Institute estimates that about 2,500 people in Montezuma County will remain uninsured in 2016. This number was derived from a state estimate and includes those who are undocumented and do not qualify for insurance.