Open enrollment for 2019 on Colorado's health insurance exchange begins Thursday, and while most areas of the state will see a decrease in premiums for those who qualify for subsidies, some Mesa County residents will not.

While the average increase in subsidies statewide is 24 percent, those who enroll for coverage through the Connect for Health Colorado marketplace in Mesa County will only see a 7 percent hike next year, the lowest of the state's nine rating areas.

But because the average premiums in the county are to increase next year, area residents who purchase certain plans through the marketplace and qualify for subsidies could see a 38 percent increase in their premiums, according to the Colorado Division of Insurance.

All other rating areas in the state will see increases in subsidies ranging from 16 percent to 31 percent. As a result, all of them will see after-subsidy savings ranging from decreases of 5 percent (Pueblo) to 37 percent (the west region of the state outside of Mesa County).

The amount of subsidies a policyholder can qualify for depends on their income level, and how far below the federal poverty rate they are.

Luke Clarke, spokesman for Connect for Health, said Mesa County's increase is a bit deceiving. He said the average increase is based on the second-lowest rate plan consumers can buy on the exchange, which actually decreased 2 percent.

He said the cheapest and most expensive plans went up more dramatically, skewing the overall average.

"It's a modest decrease for enrollees in the second-lowest cost silver plan who do not receive a tax credit and a good savings opportunity for those who are comfortable moving to a different plan," Clarke said. "But that's cold comfort for the tax-credit eligible enrollees who are seeing an average increase of $72 in net premiums."

Clarke said that underscores the need to shop around.

Kevin Patterson, chief executive officer for Connect for Health, said the nonprofit, state government-established marketplace has been trying to get area rates lowered by encouraging more competition between insurance carriers, so far, however, without much success.

As such, 14 counties only have one choice in carriers, while 19 others have two.

There are three insurance companies eligible to do business in Mesa County, only two of which — Rocky Mountain Health Plans and Anthem Blue Cross/Blue Shield — are operating on the marketplace in the county.

"When I'm talking to folks on either coast, but mostly the East Coast, they just don't get how far you guys are from the larger population centers, and how the dispersement of population drives costs ... how much you have to pay workers on the Western Slope and how much it costs to be in these communities," Patterson said. "They just don't quite get that because they can drive two hours and be in five different states."

Still, enrollees who don't qualify for subsidies in Grand Junction and the rest of the western region — which includes Garfield, Delta and Montrose counties — will see lower average increases in overall premiums compared to the rest of the state.

Without subsidies, plans in Mesa County purchased through the exchange can cost, on average, $569 a month. People who qualify for subsidies can see reductions in their monthly premiums of up to 80 percent.

The insurance division estimates that 77 percent of people who enroll through the exchange qualify for some sort of subsidy. The current threshold to qualify are individuals who earn less than $48,560 a year, and families of four that have a household income of $100,400 a year.

While enrollees in other areas of the Western Slope are expected to see a 37 percent decrease in after-subsidy premiums, they only will have a single choice in carriers.

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