Colorado health insurance exchange 
will offer affordable alternatives

By Michael J. Pramenko

Are you one of the 800,000 uninsured Coloradans? Or maybe all you can afford is catastrophic insurance that offers no help in treating your hypertension or diabetes, leaving you underinsured and without preventive health screening. Is it possible that you are stuck in a dead-end job simply because it offers you health insurance?

The upcoming insurance exchange here in Colorado offers hope. My last column encouraged readers to look for themselves. Again, check out the new website, “Connect for Health Colorado.” Beginning Oct. 1, Coloradans can begin to purchase insurance off the new exchange for coverage starting Jan. 1.

Partisan detractors of health reform, ignoring the human element of this story, only focus on the fact that the federal government is requiring you to purchase insurance beginning in 2014. This is known as the individual mandate. Remember, it is the individual mandate that triggers the ability of insurance companies to offer guaranteed issue.

Guaranteed issue means that insurance companies cannot turn potential customers away based on their current health problems. In other words, you can’t be denied coverage based on your current health status. Currently, this occurs on a regular basis as insurance companies look to insure only the healthier people among us.

In effect, Oct. 1 represents a seismic metamorphosis in the health insurance marketplace. It offers greater access, transparency and competition for your health-care dollar. This is real change for thousands of Coloradans. In some cases, it can be life-saving.

But affordability remains the most important element. Here is how Connect for Health Colorado explains the tax credits that will make health insurance much more affordable for uninsured Coloradans: “The new kind of tax credits will generally be available to individuals earning between about $15,000 and $46,000 a year, couples earning between about $20,000 and $62,000 a year, and families of four earning between $31,000 and $94,000 a year.” Obviously, these income ranges include most of the individuals living here on the Western Slope.

And the subsidies are not chump change. A look at the calculator on the website reveals an estimated $1,000 monthly tax credit for a family of four with an annual income of $40,000.

Critical to this working for the average family is the ability to use the tax credit up front to reduce the cost of the monthly premium. The website indicates this will be the case. And remember, if you are unfortunate enough to make less than the listed amounts, you will be eligible for the newly expanded state Medicaid program. 

But politics have blinded many to this policy. Millions of dollars and countless partisan comments have effectively moved our health care conversation from important human elements to simple differences between red and blue, conservative and liberal, rights and responsibilities.

Many of the pages of the Affordable Care Act are devoted to the tax mechanisms designed to pay for these tax credits. Imagine that — a federal bill that actually has mechanisms built into it to pay for the new expenditures. You may not agree with the new taxes on the wealthier Americans, but this bill has gone to great lengths to pay for the new expenditures. And, according to the non-partisan Congressional Budget Office, Obamacare includes many of these “pay for” mechanisms and Obamacare will increase the solvency of Medicare.

That’s much more than can be said for federal expenditures over the last decade. Remember Medicare Part D, the Iraq War and the War in Afghanistan were all put on the federal “credit card.” No taxes were increased. On the contrary, during those years the federal government was actually cutting your taxes while we spent trillions of new dollars on federal endeavors. Imagine Obamacare’s new tax credits and affordable health insurance without any new methods to pay for those benefits. 

We, of course, will continue to argue over the politics behind the policy. We will prioritize punditry over people. In the face of this year’s health reform events, some conservatives are actually cranking up their rhetoric as they fear the possible success of some of these programs. But the fact remains, millions of Americans will soon benefit from better access to health insurance and health care.

Finally, this fall Coloradans will be able to see for themselves what health reform represents. For many, it represents the ability to buy health insurance for the first time. It represents health insurance costs that are actually less than your house payment. It will offer the ability to buy insurance even if you are ill. It represents proper disease management and disease prevention. For some, it represents life.

So, when the exchange opens this fall at “Connect for Health Colorado,” leave your politics at the door. It could save you a lot of money. It may improve your health.

Michael J. Pramenko M.D. is the executive director of Primary Care Partners. He serves on the Club 20 Health Care Reform Committee and is a past president of the Colorado Medical Society.


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