2016 Election Night

In this era of partisanship, there’s one issue that unites both Democrats and Republicans representing my community in western Colorado — the exorbitant price of health insurance premiums for plans purchased on the state insurance exchange. Health insurance premiums can cost as much as 50 percent more in Colorado’s resort communities and rural western areas compared to the state’s urban areas. The higher costs are the result of higher fees charged by providers, who have less competition than providers in urban areas. I know firsthand: I live in Delta County, a rural area of western Colorado, and the monthly premiums on my ACA plan are rising 48 percent next year, making them more costly than my mortgage. About 85 percent of people who buy their own ACA plans receive subsidies, but for many of those who don’t, the cost is quickly climbing out of reach. I’ve talked to a lot of self-insured people in my community who are opting out because they can’t afford the premiums. There are no solutions in sight. A study released by the Colorado Division of Insurance in August concluded that insurance costs in the state’s most expensive regions could fall by about 20 percent if the state was consolidated into a single insurance region. But if that happened, people in the more populous urban areas of Denver and Boulder would see their rates climb by around 9 percent, making the idea politically unfeasible. The problem of rising premiums isn’t unique to Colorado. The Kaiser Family Foundation has found that premiums next year are rising as much as 145 percent in some areas.

Major cities with the biggest increases in ACA monthly premiums

CITY	% INCREASE	2016 PRICE	2017 PRICE
Phoenix	145	$207	$507
Birmingham, Ala.	71	288	492
Oklahoma City	67	295	493

What makes premiums so expensive in certain areas? A lack of competition for services and insurance providers. That problem is only getting worse.

Percentage of ACA enrollees with a choice of insurance providers

YEAR	3 OR MORE INSURERS	2 OR MORE	SINGLE INSURER
2016	85	12	2
2017	57	22	21

In our “New Bellwethers” series, we’re examining select counties in key states where Clinton and Trump are polling very close to how they are in the U.S. overall. Our second stop? Berks County, Pennsylvania. If you’re just joining us, the first episode of “The New Bellwethers” video series — Gaston County, North Carolina — can be viewed here. And Clare’s article on Berks is here.

Unemployment rate (September): 5.8 percent (U.S.: 5 percent) Median income (2015): $52,431 (U.S.: $55,775) Poverty rate (2015): 14.7 percent (U.S.: 14.7 percent) College share (2015): 23.6 percent (U.S.: 30.6 percent) The real-estate bubble was at its bubbliest in Nevada, which meant the state also experienced one of the country’s worst slumps when the bubble burst. Unemployment neared 14 percent in the state at the peak of the crisis, and it would have been worse if many construction workers hadn’t abandoned the state when jobs dried up. Even today, more than seven years after the recession officially ended, the state still suffers from relatively high unemployment and has a larger share of “underwater” homes (homes that are worth less than their owners owe on their mortgages) than any other state.