Residents not putting off their medical care needs despite costs, survey says

Despite the rising cost of health care insurance in recent years, fewer Western Slope residents are putting off seeing a doctor or buying the medications they need than in years past, according to a new survey on access to health care.

The 2017 Colorado Heath Access Survey, taken every two years by the Denver-based Colorado Health Institute, shows that while a number of patients had trouble paying their medical bills last year, they didn’t put off seeing a doctor or specialist as much as they did in 2009, before the federal Affordable Care Act was enacted.

In the four regions that make up much of the Western Slope, about 15 percent of residents said they had trouble or were unable to pay for health care for themselves or their families, down from about 25 percent in 2009, the first year of the study.

The study, which is taken by cellphone and land-line telephone of more than 10,000 Colorado households, showed that in Mesa County, 13 percent put off seeing a doctor because of costs, compared to 16 percent in 2009.

The survey asks a variety of questions, from how affordable health care costs are to how often patients visit their doctors.

Overall, the study found that more Coloradans are covered by some sort of health insurance — 6.7 percent of the more than 5 million residents are uninsured — than at any other time. That’s only 0.02 percentage points higher than in 2015, the first study done after the ACA, also known as Obamacare, became law.

“The survey results show the Affordable Care Act’s coverage expansions worked, as far as they went,” said Joe Hanel, a spokesman for the institute. “Coverage improvements seem to be a lot more durable than some people had expected.”

Hanel said the survey also can be a tool for policymakers to determine how they can improve the system, particularly in rural parts of the state that are seeing double-digit increases in health care premiums.

“The survey also points out some populations that are starting to slide in coverage,” Hanel said. “People who make fairly low wages but too much to qualify for Medicaid, people over 40, and, of course, a lot of people in rural Colorado. These are some of the groups that would benefit the most from future policies to boost coverage and access to care.”

That uninsured rate is a statewide average, but it doesn’t hold up on the Western Slope, which ranged from 7.9 percent in the Montrose-Delta area to as high as 13.1 percent for residents in Rio Blanco and Moffat counties.

Mesa County’s rate was 10.2 percent, down from 14.7 percent in 2009.

“The one thing the survey shows is the farther you get away from Denver, the higher your uninsured rate is likely to be,” Hanel said. “Northwest Colorado continues to have the highest uninsured rate in the state, at 13.1 percent, and it’s been like that in northwest Colorado for several iterations of the survey now.”

Jeff Bontrager, the institute’s director of research on coverage and access, said one of the things that likely is contributing to higher costs in certain areas of the state is the use of emergency rooms.

Bontrager, project director of the survey, said that increased use of emergency rooms helps drive costs because that’s one of the most expensive parts of any hospital.

While the average statewide rate went up only nominally, 7.7 percent to 8.6 percent from 2015 to 2017, it was more dramatic on the Western Slope, going from as low as 6 percent to as high as 10 percent during that same period.


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