For the 27 percent of La Plata County adults who dont have health insurance and dozens of local small businesses that cant offer it to their employees, 2014 will bring big changes. Thats when many of the elements mandated by 2010s Affordable Care Act will start to take effect, including the requirement that every citizen have health insurance.
In the meantime, Colorado and 12 other states are getting a jump-start on another mandate of the law: health-insurance exchanges.
Though the exchange wont be up and running for a while (the first enrollment period will start in October, 2013) Joan Henneberry, the planning director with the Colorado Health Insurance Exchange, visited Durango last week to tell businesses and community members what to expect from the exchange and the new health-care law.
She also urged businesses to give feedback to work groups that continue to hash out the details of the insurance exchange.
We want to hear from small employers who will be customers of the exchange about what can make it easier and more affordable to provide coverage for employees, she said.
The health exchange will provide a virtual marketplace for individuals and small businesses to compare and purchase health-insurance plans.
Henneberry compared it to Travelocity or Orbitz for health insurance.
It is insurance companies opportunity to put their products on our virtual shelves while allowing customers to compare apples to apples on insurance plans, she said.
All health plans offered in the exchange have to offer a minimum set of federally mandated benefits that can be increased by states, she said.
Though everyone will be required to purchase health insurance, people who go through the exchange can qualify for a financial boost to help pay those bills. Families that earn between 133 percent and 400 percent of poverty level (between about $30,000 and $89,000 per year) will get a tax credit for their premiums on a sliding-fee scale.
There will be a standardized process based on income to determine if individuals qualify for Medicaid a big change in social policy, Henneberry said.
The act also addresses businesses, and starting in 2014 it mandates that employers with more than 50 employees must offer health coverage to workers. The government will offer tax credits to small employers who offer insurance to their employees.
The exchange aims to help those small businesses find affordable plans by pooling them together into larger risk pools. That component was one that business groups have been lobbying about for years said Tony Gagliardi, state director of the National Federation of Independent Businesses.
If everything works according to plan, as risk is spread further it puts downward pressure on premiums, Gagliardi said.
In La Plata County, where businesses with employees have an average of seven workers, providing health insurance is a stretch for many right now, said Joe Keck, director of the Southwest Colorado Small Business Development Center.
Many businesses simply cant afford it, said Jack Llewellyn, executive director of the Durango Chamber of Commerce.
Ive seen more businesses that have dropped health care than added it in last few years because it has become so expensive, Llewellyn said.
At this point, there is no exact count of how many local businesses in the county offer health insurance to their employees, but the Community Health Care Capacity Project hopes to produce a survey soon to get that information, said Jaynee Fontecchio-Spradling, the projects health-integration coordinator.
The grant-funded project works to improve access, integration, quality and efficiency of health care in the county.
The new Affordable Care Act and the insurance exchanges will bring some big changes that businesses should grasp before they happen, said Emily Burns, the executive director of Southwest Colorado Area Health Education Center.
One to two years down the road, people should know what they have to be prepared for. With a project like this with so much formative process, it helps to be aware of it all along, Burns said.