The number of people without health insurance in Southwest Colorado has dropped by half since 2011, a statewide trend, according to a 2017 survey report released Tuesday by the Colorado Health Institute.
The Colorado Health Access survey has been tracking health insurance coverage, access to health care and use of health care services in the state since 2009. The Colorado Health Institute surveys more than 10,000 randomly selected households every other year, by landlines and cellphones, to evaluate and track impacts of health care policy.
Rural counties were grouped by region. Region 9, the Southwest Colorado region, is made up of Montezuma, Dolores, La Plata, Archuleta and San Juan counties.
According to the 2017 survey report, 10.6 percent of residents, about 9,958 people, in the five-county region did not have health insurance, down from 20.9 percent uninsured in 2011, and 17.9 percent uninsured in 2009. Since 2014, when the Affordable Care Act, known as Obamacare, began in force, about 4,000 people in Southwest Colorado gained health insurance.
Statewide in 2017, an average of 6.5 percent of residents were uninsured, the same as 2015, a historic low. In 2009, an average of 13.5 percent of residents were estimated to not have insurance in Colorado.
“Colorado has retained its historic level of health insurance coverage despite political uncertainty in the marketplace and rising insurance premiums,” the report says.
More than 5 million Coloradans, or 93.5 percent of the population, now have health insurance, according to the report. It’s the first time the state has topped the 5 million mark, the report says.
Of the estimated 84,063 insured residents in Southwest Colorado, 43 percent have employer-sponsored coverage, the same percentage found in 2009. Statewide, employer-sponsored coverage has dropped to 49.4 percent in 2017 from 57.7 percent in 2009.
In the five-county Region 9, the percentage of employers who offered health insurance plans to employees has gone up and down in the past six years, from 77 percent in 2009 to 65 percent in 2015 and to 81 percent in 2017.
In 2017, 37 percent of local insured residents in 2017 have public policies – Medicare, Medicaid or Child Health Plan Plus – up from 26 percent in 2009.
According to the report, fewer people are buying insurance on the individual private market in Southwest Colorado. This year, 8.7 percent gained coverage that way, compared with 12.6 percent in 2009. That number is expected to drop further because premiums for the individual market are expected to rise by 27 percent next year.
Despite its gains in health coverage, Southwest Colorado’s 10.7 percent uninsured rate is the fourth-highest in the state out of 21 statistical regions, according to the survey. Douglas County has the lowest uninsured rate, at 1.4 percent.
“The farther from Denver, the higher the uninsured rate due to fewer providers and less competition, and less income among the population,” Joe Hanel, public outreach coordinator for Colorado Health Institute, said during a presentation Tuesday at the Cortez Public Library.
Southwest Colorado’s attitude toward health insurance coverage has improved since 2009, according to the report.
An increased number of families reported that the current health care system was working for them. In 2017, 37 percent of families “strongly agreed” that the current system was meeting their needs, compared with 27 percent of families in 2011.
The report credits the Affordable Care Act, which mandates that people have insurance coverage and offers subsidized prices based on income, for the increase in health coverage. “Almost 600,000 more Coloradans have health insurance in 2017 than in 2013, just before the launch of the Affordable Care Act,” the report says.
But they also note that the “affordable” part of the Affordable Care Act is still elusive in Colorado.
“The high cost of insurance continues to be the No. 1 reason for not having health insurance, with 78.4 percent of the uninsured citing it as the reason,” the report states.
In an ironic twist, as the economy recovers, the number of uninsured residents who earn $25,000 to $35,000 has spiked, Hanel said, “probably because they no longer qualify for Medicaid, but do not have a job with health insurance or make enough to afford a plan on the private market.”
He added that the 19- to 29-year-old age group has the highest uninsured rate in Colorado, which needs to be addressed “because we need them insured because they have less health care demands and drive down prices,” Hanel said.
A bright spot is dental care: 15.8 percent said they skipped it in Colorado because it cost too much, down from 22.9 percent in 2011, before the Affordable Care Act.
In Southwest Colorado, 59.8 percent have dental insurance in 2017, compared with 48.6 percent in 2009.
The survey projects that one in seven Coloradoans don’t know how to get insurance, but Institute research analyst Ian Pelto noted, “It shows they also may not know that they qualify for benefit programs like Medicaid, so it is an opportunity to get them signed up.”
A concerning issue revealed by the survey is the projected amount of people who said they needed drug and alcohol abuse counseling in the state – about 67,000 – but weren’t getting it. The report said it is likely more need the service, but are not ready to seek it. Fifty-four percent said they were concerned about the cost of treatment, and 52 percent said the stigma about substance abuse kept them from receiving care.
“More outreach is needed to provide substance abuse services,” said Mary Ganir, a health advocate for the Piñon Project. “The problem is impacting local families, and leads to mental health issues as well.”
Hillary Cooper, a San Miguel County commissioner, added that improving broadband access to rural communities will translate to improved care by increasing access to telemedicine.
“A lot of us think lack of broadband is a public health issue,” she said. “I’d bet that a map of the areas with less broadband would overlap with the areas that have more uninsured.”
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