Rocky Mountain is leaving Colorado’s health-care exchange

Health-care options for Coloradoans in general and rural residents in particular who buy individual health-insurance plans through the Connect for Health Colorado exchange are set to decrease at the end of the year.

Rocky Mountain Health Plans, a small independent non-profit insurer based in Grand Junction, Colo., will exit the marketplace, leaving just one other insurer, Anthem Blue Cross/Blue Shield, available for exchange clients as of now in Southwest Colorado.

RMHP had been providing reasonably priced individual and group policies to West Slope residents for more than four decades.

In fact, President Obama traveled to Grand Junction in 2009, while campaigning for the Affordable Care Act, to praise RMPH as an example of what other health-care providers could and should be. The New England Journal of Medicine has also cited the company as a model of how to provide affordable care in rural areas.

But that’s now changing in two big ways.

First, RMHP President Steve Erker- Brack announced in late July that the company had begun the process of joining forces with the largest for-profit health-care firm in the state and nation, a merger that requires the expected approval of state officials.

“The partnership with UnitedHealthcare will offer significant enhancements for current and future RMHP members throughout Western and rural Colorado . . . and make health care more affordable and accessible,” he wrote in a colorful two-page brochure mailed to policy- holders, a message brimming with upbeat bullet points.

Erkenbrack assured his customers the company remained “committed to providing access to the high-quality health care our members and local communities deserve and expect.”

But hard on the heels of that rave review, RMHP members who are covered through individual or family plans under the Affordable Care Act, known as Obamacare, received notice in late August that their policies were being discontinued at year’s end.

“After careful consideration, RMHP has determined that we will no longer be able to offer our Members a competitive product in the Individual and Family Health Insurance Market,” states a letter from Michelle Walker, director of sales administration, which offers no further explanation of the cancellation. Members whose polices are being terminated are simply advised they “may begin shopping . . . immediately” for a replacement plan from another company.

Leanne Hart, RMHP director of marketing and communication, confirmed in a e-mail that approximately 3,100 members in Montezuma, Dolores and La Plata counties are having their polices cancelled.

Hart said the company will continue to offer individual and family coverage only in Mesa County (the Grand Junction area) through Monument Health, a coalition that includes St. Mary’s Hospital and primary-care doctors in that area.

“Monument Health builds on our past successful initiatives with providers and has proven, thus far, to be a more sustainable product compared to those offered in other service areas,” she wrote.

RMHP will continue to offer supplemental coverage for Medicare clients, as well as regular coverage through employer- based group plans.

Based on preliminary requests for rate increases – as much as 40 percent — submitted to the Colorado Division of Insurance, individual health-care-plan premiums are expected to jump significantly next year, while at the same time, consumers’ choices will become fewer.

UnitedHealth, RMPH’s new partner, will not be selling any individual plans next year in Colorado, nor will Humana, according to the Denver Post, and Anthem Blue Cross/Blue Shield, which has asked for a 26.8 percent rate increase, will discontinue its PPO individual plan and offer only an HMO statewide. Those changes will affect about 92,000 people in Colorado, or about 20 percent of the individual-plan market.

Close to a half-million Colorado residents buy insurance through individual plans – as opposed to small-group and other employer-based coverage – but in rural areas in particular there are few choices of providers, and premiums are markedly higher than in urban areas.

Of the nine regions used to determine rates in the state, Montezuma County is included in the most expensive one, according to Jamie Meier, a health coverage guide with the Piñon Project in Cortez. A proposal studied in the legislature that would provide a uniform rate throughout the state, lowering it by 20 percent in this area and increasing it 9 percent in the Denver area, appears to have no chance of passage, Meier said.

“It’s pretty much shot out of the water, unfortunately,” he said.

Meier said with tax credits available in the marketplace, the expected increases will be mitigated for some lower-income groups, and will have no effect on the third of Montezuma County residents on Medicaid.

“This is hurting the working families and individuals who are making a pretty good living – too much for the tax credit,” he explained, such as a couple whose combined income is $70,000. “I wish I had better answers for them.

“Rocky’s had such a good history in our area, it’s just kind of a bummer they’re pulling out,” he said, although RMPH will still be offering employer group plans here.

The Anthem HMO plan does have the advantage of being a statewide network, he said. A disadvantage is that care received in New Mexico or other places outside Colorado would not be covered unless the facility were part of the Anthem network.

A spokesperson for Southwest Memorial Hospital in Cortez said Anthem insurance is accepted there and by the physicians it employs.

From September 2016. Read similar stories about , .