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Why are health insurance premiums higher in the healthiest areas?

(FINANCE) Rising health insurance costs are a perplexing mystery in some of the nation’s healthiest places to live, but why?

health insurance

You would never guess it by the fit people, the Whole Foods Markets, the abundance of cycling and snow sports, but some of the highest insurance costs can be found in some of the county’s with the nation’s lowest mortality rates.

Counties home to famous mountain towns like Breckenridge, Aspen, and Vail are home to some of the highest insurance costs for individuals and families purchasing insurance in the marketplaces created by the Affordable Care Act.

According to research done by FiveThirtyEight, premiums in Summit County, home of Breckenridge, have gone up 32 percent for 2018 over the previous year. Summit County has the lowest mortality rate in the nation, yet still is home to some of the highest premiums provided by the ACA. This problem has even gotten itself some statewide recognition, being dubbed the “Summit County Paradox.”

Its not just Summit County. With the second and third lowest mortality rates in the country, Pitkin and Eagle counties are facing the same problem. Despite low rates of smoking and obesity, the unsubsidized lowest-cost bronze premium for a 40 year old in Summit, Eagle, and Pitkin counties (Eagle home to Vail and Pitkin home to Aspen) is above the 95th percentile when compared to the rest of the nation.

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Generally, when rates are rising for insurance, it is due to the high cost of insuring sick people. But these counties show that this is not always the rule. Being healthy doesn’t always mean paying less for insurance.

Summit County officials are baffled by the high costs and are left searching for answers, “It’s something we’re scratching our head about,” Summit County Commissioner Dan Gibbs said. “It’s a crisis situation for many working families who can’t afford health insurance now.”

As one of the states that created its own ACA health insurance exchange, Colorado government has been very hands-on when it comes to managing insurance in their state, and their constituents have let them know that that something has gone awry here.

Two big reasons found for this spike in insurance cost are availability of services and residents of these counties’ needs for more thorough, and subsequently more expensive, services. In an area with so few people yet such high cost of living, convincing health care workers to move permanently to the area is difficult, without paying them through the roof.

While there are extra hospital wings open to treat ski injuries through peak seasons, the availability of services is extremely low compared to a big city.

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Also, residents seem to be requiring MRI and other imaging services at a much higher rate than the rest of the nation, and not just looking for bone breaks and tendon tears, but for cancer and other problems as well.

With multiple reasons for this spike in cost, there is no simple solution. However, recent studies and reports are teaching us a lesson regarding overall healthcare costs. Not only do we need to worry about getting people healthy, it is also extremely important to make the best use of expensive care and overuse of expensive testing.

Written By

Will hails from Northern California, earned a B.A. in English from Texas A&M University, and now calls Austin, Texas home where he works at a tech startup. He likes riding his bike an ungodly amount of miles and his favorite aesthetic is an open road. If you see him around he'll likely be reading a classic American novel and drinking a Topo Chico.

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