Giving Thought: How healthy is Colorado’s health care system?

Tamara Tormohlen
Giving Thought

The politics of health care continue to dominate headlines from Washington, D.C., but what is happening in Colorado?

For seven years, former Roaring Fork Valley resident Michele Lueck has led the Denver-based Colorado Health Institute, which provides timely and relevant information to policymakers. Colorado Health Institute recently completed its 2017 Colorado Health Access Survey (CHAS), so we asked Michele for a summary.

ACF: Please give us an overview of the Colorado Health Access Survey and its findings.

ML: Many of us were surprised by the CHAS results. They reveal that 93.5 percent of Coloradans have health insurance. And the new uninsured rate is 6.5 percent. These rates match historic gains that Colorado achieved in 2015. So we have held on to those big improvements — even with the political uncertainty around the Affordable Care Act and rising insurance premiums, particularly in Colorado’s rural and mountain communities.

This is the first time Colorado has ever had more than 5 million residents with health insurance. Not so long ago, there weren’t even 5 million people in the state. So that’s quite an achievement.

Another notable finding is that just 3 percent of Colorado kids are uninsured. That matches our record low and it’s great news about our kids.

Finally, we also found that the state’s health care system is handling this big influx of insured people pretty well. We added a new question about wait times to see a doctor, and we found that the average is just two days.

ACF: You also discovered some problem areas, though.

ML: Yes, we did. The CHAS showed that people who were vulnerable before the Affordable Care Act are still vulnerable in many respects. For instance, the uninsured rate among Hispanics is 10.4 percent, nearly double the 5.4 percent uninsured rate of white Coloradans. Still, it’s an improvement. In 2013, the Hispanic uninsured rate stood at 21.8 percent.

Affordability of both insurance and health care continues to be elusive for many Coloradans. Cost continues to be the primary reason for not having health insurance. And one of 10 Coloradans couldn’t get medical care because it cost too much.

Finally, as the state struggles with the opioid epidemic, a new CHAS question asks whether Colorado is adequately caring for people misusing alcohol or drugs. The answer is no — 67,000 Coloradans say they needed alcohol or drug services but didn’t get them.

ACF: Do Pitkin and Garfield counties reflect the statewide trends?

ML: The region including Pitkin, Garfield, Eagle and Summit counties has an uninsured rate of 10.2 percent, nearly four percentage points above the statewide rate. Still, it’s heading in the right direction. In 2011, the uninsured rate was 25 percent.

What’s striking about this region is that 15.6 percent of residents buy their insurance on the individual market, which has the highest rates in the state. This compares with a statewide rate of 8.7 percent. Prices on the individual market are rising the fastest. It’s also the market where people can get tax credits through Connect for Health Colorado if their income is below 400 percent of the federal poverty level, or $98,400 for a family of four. Many families earn more than that, but still struggle in an expensive area like the Roaring Fork Valley.

ACF: Are there systemic tweaks or solutions in the works?

ML: There are three main places where those changes can happen — at the national, state and local levels.

Who knows what will happen at the national level? If the latest attempt at repeal and replace (the Graham-Cassidy bill) passes, we will see a major recalibration of our insurance markets, with fewer Coloradans covered by Medicaid and an increase in charity care. If Graham-Cassidy doesn’t pass, we expect more business as usual. Even so, significant challenges remain, including stabilizing the insurance markets and enforcing the individual mandate, under which everyone needs to have coverage.

At the state level, we’ve seen interesting ideas emerge. They were defeated in the last legislative session, but I think these ideas will be refreshed in 2018. We’ll see efforts to strengthen state purchasing power and bring relief to insurance purchasers in rural and resort communities.

Finally, at the local level, I am optimistic about community partnerships, such as the Health Alliance in the Roaring Fork Valley, and strengthening purchasing power through the Valley Health Partnership. These are great vehicles for innovative solutions.

Tamara Tormohlen is executive director of the Aspen Community Foundation and the Aspen to Parachute Cradle to Career Initiative.