The Temperature | A last-minute guide to buying health insurance

Hey there, Colorado, and welcome to another edition of The Temperature, the only climate and health newsletter out here to remind you — as my own child does every morning — that Santa Claus is WATCHING YOU. The jolly old elf of the surveillance state. Not creepy at all.

Let's check in on the sports world. The Colorado Rockies saw their most significant offseason acquisition in years when superstar baseball unicorn Shohei Ohtani signed for the division-rival Los Angeles Dodgers, thereby guaranteeing that fans will have a lot more reasons to go watch games at Coors Field this year no matter how terrible the Rockies are. That's the (Monfort) dream!

Let's also acknowledge Ohtani's truly ridiculous, record-setting $70 million-a-year deal, 97% of which he will defer until the mid-2030s. Who says the private-industry pension plan is dead?

We've got a packed newsletter for you today, including help for all you health insurance slackers out there, so let's get to it.

John Ingold

Reporter

TEMP CHECK

HEALTH

Your very (very) last-minute guide to buying health insurance

Dec. 15

The deadline to select coverage that kicks in Jan. 1

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Hey, you! If you buy health insurance on your own — or if you own a small business and are trying to pick a health plan for your employees — you have almost run out of time to get coverage for next year.

The deadline to select a plan that will kick in Jan. 1 is FRIDAY — Dec. 15. (Open enrollment continues until Jan. 15, but plans bought after Friday won't start until February.) If you are stuck in the throes of insurance indecision, do not fret, for we at The Temp have you, uh, covered.

Last week, we hosted a panel discussion with three health insurance experts to help you choose the plan that's best for you. Watch the whole thing here.

But, if you're just looking for the highlights, here are a few takeaways.

You better shop around: It can be so tempting to purchase the first plan that pops up on your search results. But that may not be the best choice.

"If you have a doctor that's important to you, you want to make sure that they're in the network of the plan that you're going to be choosing," said Michael Conway, Colorado's insurance commissioner. "You also want to make sure that if you have any prescriptions, that those prescriptions are covered by the plan that you're going to choose as well."

"The core point, folks, is to go shop," Conway added. "There's a ton of assistance for you both from the federal government and the state of Colorado to help you afford your health insurance premiums. And by shopping you might be able to just find a cheaper plan within the same metal level that you were in this year."

Claim what you are owed: Speaking of financial assistance, it's always a good idea to check whether you are getting everything you can. Colorado has new state-funded subsidies that can help lower-income individuals and families pay out-of-pocket costs. And, if you haven't checked in a couple of years, you may find that you are eligible for expanded federal subsidies that first kicked in during the pandemic.

"It doesn't hurt to check," said Kevin Patterson, the CEO of Connect for Health Colorado, the state's insurance exchange. "That has been the most stubborn data point I've seen. Everybody's like, 'Oh, I make too much for that.' And I say, 'Do you?'"

"If they've just been renewing in the same plan for a number of years, they may actually be eligible for subsidies that they're just leaving on the table," Conway said.

The only place you can apply for subsidies is through the Connect for Health Colorado website. Use the Quick Cost & Plan Finder to see if you are eligible for assistance and also see what plans are available in your area.

Look at the whole cost of coverage: The vast majority of people who purchase health insurance do so based on picking the least-expensive premium price. This is not the best way of doing things.

The reason is because plans with lower-priced premiums are more expensive when you actually have to use them — they come with higher deductibles.

"It's kind of like saying you own a car but you're only making the monthly payment — you don't have to get the oil changed or put new tires on it or put gas in it," Patterson said. "There's other expenses that come with the total cost of ownership. And I think you really have to think of health insurance in a very similar fashion."

So try to think about not just your monthly budget when buying insurance but also how likely you are to use it and how much you can afford to pay out-of-pocket at any given time. That will help you make a smarter decision that could save you money in the long run.

Be honest about your needs: OK, how do you estimate what your health care needs will be, especially if you don't have ongoing health conditions or planned procedures? You have to think like an actuary and come up with an honest prediction for the unexpected.

"I'm looking at the family composition — if they've got littles, I'm just gonna say right now, they're accident prone," said Meagan Fearing, a health insurance broker and a past president of the brokers' group NABIP Colorado. "Beyond that, I'm also asking questions around how many times were you guys sick this year? How many times did you take off from work? … Do you have anything that's kind of been nagging at you?"

Look at prior years' health spending and use an average of that as a baseline. Then start doing the math: Does 12 months of a lower premium make sense if it means you're paying most of your annual medical bills out-of-pocket before you hit your deductible? Or could you save money by paying more per month in premiums if it means you reach your deductible earlier?

Know when you need help: Even in these final hours, health insurance brokers and Connect for Health assisters are available to help you navigate the system and make the best choice. Even better, they work at no cost to you.

Connect for Health has a broker lookup tool, as well as a neat scheduling tool for getting help at a certified assistance center.

John Ingold | Reporter

MORE HEALTH NEWS

* In rural southwestern Colorado, maternal health care access is at risk. When Southwest Memorial Hospital in Cortez earlier this year announced plans to close its birthing center, it sparked protests by community members and the hospital's OB-GYN staff. In the face of those protests, the hospital backed down. But the root problem remains: Southwest Memorial is struggling financially and, like in other rural hospitals, labor and delivery services are money-losers in communities where not a lot of residents means not a lot of babies being born. Meanwhile, the wounds from the fight to save Southwest Memorial's birthing center remain. So how do the hospital and the community move forward? As Sarah Tory reports, they're still figuring that out.

— The Colorado Trust

* A Colorado board won't cap the price of a cystic fibrosis drug that costs an average of $234,439 per patient per year. Trikafta, a breakthrough drug for cystic fibrosis, has been a godsend for people living with the disease and a nightmare for budget analysts trying to figure out how to pay for it. But last week, in its first major decision, Colorado's Prescription Drug Affordability Board declined to label Trikafta as unaffordable, a crucial step along the way of setting a price cap on the drug. The decision was a surprising outcome for a board created to reduce the costs of expensive medications, but it came as a relief to patients who worried they might lose access to the drug if the state limited what its manufacturer can charge.

— The Colorado Sun

* A Safe2Tell report after suicidal social media post saved a Colorado student's life. Colorado's hotline for reporting concerning behavior by youth, recorded its second-highest monthly volume ever in November. And, according to the Colorado Attorney General's Office, one of those reports saved the life of a student who was "actively attempting suicide" when officers responding to the report went to the student's home. Jennifer Brown has the story.

— The Colorado Sun

* Colorado blames Biden team and drugmakers for delaying Canadian imports. For years, Colorado officials have been working on a program to import prescription drugs from Canada to help provide lower-cost options to people here. But it hasn't come together, and a new report says pharmaceutical manufacturers' refusal to work with the state is a big reason why.

— KFF Health News

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CLIMATE/EVs

Early adoption? The state of our EV use

69%

Portion of surveyed Colorado renters who don't have access to a garage to plug in an EV

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Colorado's official state EV boosters are reporting great success for 2023. But there's also some disturbing equity and policy gaps revealed in their new survey of state residents.

On the plus side, Colorado is No. 5 nationally in the share of the new car market taken up now by electric vehicles or plug-in hybrid electric vehicles, which count the same for zero-emissions purposes. At 14.5% of the state market, EVs in Colorado are running well ahead of the 8.5% national average.

But national and local electrification drives are meant to be economically equitable and diverse. And there, a survey attached to the year-end statistics shows some challenging gaps.

Only 31% of low-income respondents to the survey were aware of the lucrative federal tax credits available to help buy an EV, compared with 51% of high-income residents. For even more lucrative state rebates and credits that escalate for lower-income buyers, only 17% of low-income residents were aware compared with 34% of high-income buyers.

And the renters' market could frankly be a looming disaster.

Renters of multi-family units tend to have lower incomes than homeowners, so targeting charging units for apartment buildings is one key to providing equal opportunities in EVs and electrification. Yet 69% of Colorado's renters in the survey said they have no access to a garage, where an EV charging unit would most likely be installed.

Some other more positive stats have moved in EV advocates' favor. In the 2023 survey, the first since a 2020 version, only 16% of respondents said they had no plans to consider buying an EV for their next vehicle. That negative response was down sharply from the 31% of 2020 respondents who said they weren't considering one.

The new report by EV CO, set up by the state Energy Office as an advocate and clearinghouse for EV information, tries to underline what remains a remarkable number: Certain lower-income residents looking for a new car can pile up federal and state credits to get $18,500 knocked off the price of an EV in 2024. That's big.

Is it big enough to combat the consumer-friendly plummet in gasoline prices, now at $2.58 a gallon at some metro Denver stations? Plug in next week for more answers at ColoradoSun.com.

Michael Booth | Reporter

CLIMATE/TRANSIT

RTD lowers fares in relentless search for new riders

3 million

Number of monthly boardings that disappeared from RTD from the pandemic, even after trying free fares.

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Still well below pre-COVID ridership numbers — which were themselves well below healthy, sustainable transit crowds — RTD will in January try an across-the-board fare cut and simplification of its complex regional price structure to bolster customer use.

A standard three-hour ticket will cost $2.75 beginning Jan. 1, on either local or regional routes, a big difference from the current $3 for local rides and $5.25 for regional. The airport train will be $10, down from $10.50. The full-price monthly pass takes a big cut, from $114 local passes and $200 regional passes down to a uniform $88 for next year.

Can a big price adjustment improve the prospects for mass transit helping to cut the Front Range ozone problem and combat greenhouse gases from transportation?

Evidence so far is not terribly encouraging. RTD released its report on two months of fare-free transit in July and August — paid for with state backfilling grants — and found only a modest increase in ridership still far below pre-pandemic, full-fare levels.

RTD was seeing more than 9 million boardings a month in 2019. And even at those rates, the agency for 3 million metro residents had trouble hiring drivers and running a reliable system.

Ridership fell off a cliff during the pandemic's massacre of commuting habits. Boardings increased about 22% in the free July and August sessions of 2023, but RTD figures only about 12 percentage points of that is from free-fare seekers. The rest was from ongoing post-pandemic recovery, and a customary peaking of summer transit trips.

Even with the boost, boardings hit only 6.6 million in August, about 3 million below 2019. RTD reports a very modest contribution to cutting ozone-causing pollutants and total vehicle miles traveled.

The free months were a victory for riders with disabilities, as RTD saw demand for its two disability-focused services rise 7% and 25%, respectively. But those services are also some of RTD's most expensive to provide, per rider, and so a long-term stimulus in demand would need new sources of funding.

As it was, the fare-free program took $15.6 million from RTD in revenue losses and marketing costs, of which the state grant reimbursed $13.9 million.

One of RTD's surprising conclusions about the 2023 program is that customers seem to respond more elastically and enthusiastically to frequent, reliable service than they do to price changes. National transit research has echoed those results.

Despite some of the 2023 successes, RTD concluded, "the cost of eliminating fares must be weighed against the modest increase in ridership and small reduction in VMT for the Denver region."

We'll be talking to RTD chief Debra Johnson about the results, and their implications for Denver's transit future, and will bring that report to you next week at ColoradoSun.com.

Michael Booth | Reporter

MORE CLIMATE NEWS

* Long-term protection for major Thompson Divide acreage moves forward. While Colorado politicians and wildlands advocates push for larger carve-outs in the proposed CORE Act, they've managed to win federal protection from drilling and mining on 225,000 remote acres around Leadville. Jason Blevins reports on what the agreement proposed to protect, and how the public can comment.

— The Colorado Sun

* Should Colorado be the next home for the elusive wolverine? Now that the sharp-clawed member of the weasel family — weasel, not miniature bear — has official threatened status from federal agencies, a reintroduction into Colorado may be in order. State officials say they are studying it, Michael Booth reports, and wildlife advocates can't wait. Bring all your "Red Dawn" movie knowledge to this fact-based but extremely unserious Q&A.

— The Colorado Sun

* How northern Colorado is making the clean energy transition. Platte River Power Authority made bold greenhouse gas promises to Fort Collins, Longmont and more, but is now facing a controversy over a big, expensive natural gas power plant. The authority says it needs reliable gas energy to make the full transition to wind, solar and batteries. Environmental groups think it's an outdated and expensive strategy, Michael Booth reports.

— The Colorado Sun

* Top water task force recommendations to save the Colorado River. Spending more state money for homeowner turf buybacks is one of the top ideas approved for further study by a state advisory group, Jerd Smith reports. Other proposals for preserving the West's most important river from drought include leaving more water rights in the river for natural stream flows if industry or agriculture doesn't need it immediately.

— The Colorado Sun

CHART OF THE WEEK

Flu and RSV are surging, so get vaccinated

There's a classic good news/bad news situation going on with respiratory viruses in Colorado.

The good: Cases of COVID-19 appear to be declining, along with hospitalizations.

The bad: Influenza and RSV (respiratory syncytial virus) appear to be increasing. While COVID hospitalizations remain higher, there's been a notable jump in hospitalizations due to flu and RSV — and there's also been a sharp uptick in the number of people showing up at hospital emergency departments with symptoms of flu.

This is fairly typical for respiratory virus season, which hits Colorado during late fall to early spring. But it's also kind of astonishing because it doesn't really have to be this way. All three of these viruses are things you can vaccinate against.

According to the federal Centers for Disease Control and Prevention, Colorado is doing better than the national average at vaccinating adults against the flu — and is also outpacing tallies from the two most recent years. But, with a coverage level below 50%, Colorado is still well off the goal of 70% of the state's adult population receiving a flu shot.

So, get the stick to avoid the sick. (™ The Temperature — We're claiming that line.)

John Ingold | Reporter

HEAT MAP

CLIMATE

* Teslas are running full autopilot where it's not allowed. Our future of flying cars is still grounded in facts of messy driving software.

— WaPo

* Massachusetts takes big step against natural gas. In a fight that could come to Colorado, utilities can no longer expand natural gas networks for homes. .

— Inside Climate News

* Should some carbon be parked under national forests? Though they don't usually consider permanent uses of federal land, officials may consider a capture and storage policy.

— HCN

* China rakes in California squid, then ships it back. We're all complicit. The world's bottomless appetite for seafood creates an eight-armed environmental monster.

— Inside Climate News

HEALTH

* The depression that lies beyond the finish line. For some athletes, the euphoria of accomplishment is followed by empty sadness. So some coaches are starting to include post-event plans in their training programs, Dan England reports.

— The Colorado Sun

* Abortion wait times increase. Wait times for abortions at Planned Parenthood clinics in the Rocky Mountain region typically exceed two weeks, part of a national trend of lengthening delays for abortion care as a result of abortion bans and restrictions adopted by conservative states.

— The Associated Press

* That Cigna-Humana wedding is OFF. The megamerger between health insurance giants we told you about last week has apparently collapsed.

— Becker's Payer Issues

* When gun buybacks don't take guns off the street. Some companies are taking firearms surrendered at buybacks and flipping them into parts kits that can be bought and reassembled into ghost guns. (Note: This doesn't apply to the gun buybacks we've written about, where Sun reporters witnessed guns being destroyed.)

— The New York Times

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Hey, we may not have $70 million a year, but at least we have each other. (And if you do have $70 million a year, might I suggest a tax-deductible donation to the newly nonprofit Colorado Sun?)

Thanks for reading and thanks for supporting local journalism in Colorado. When it comes to creating community, we're all in this together — which is why we would never snitch on you to Santa.

Stay warm and we'll see you back here next week.

— John & Michael

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Corrections & Clarifications

Notice something wrong? The Colorado Sun has an ethical responsibility to fix all factual errors. Request a correction by emailing [email protected].