By Caitlin Switzer MONTROSE—(May 15) Fortune favors the fearless. It is a phrase Linda Gann shares with her presentation audiences, and uses to remind herself of the importance of her work.
After all, she could be playing tennis. Only recently retired after years of managing communications for the Montrose County Re-1J School District, Gann has instead taken on an even more challenging role. As Western Slope Outreach Coordinator for Connect for Health Colorado, a non-profit funded through the Affordable Care Act (ACA), Gann spends her days traveling throughout the region, presenting real information about the changes that citizens can expect as the Act takes effect.
“What I am trying to do is just simplify a very complicated, large program,” Gann said. “Here in Colorado we are moving forward; this is our story, and our plan.”
When the Affordable Care Act was signed into law, Colorado already had a plan that had been initiated in 2006, when state lawmakers saw health care costs spiraling out of control. Despite a fiscally conservative governor and its status as the healthiest state in the U.S., Colorado’s costs for health insurance at that time were the nation’s 13th highest.
In response, 27 commissioners across the state were appointed and charged with creating recommendations and curbing escalating health care costs, Gann said.
“They came up with a report in 2008, ten months before the presidential election,” Gann said. “Their key finding was that coverage is key; the document they created was a vision for change, a roadmap for health care reform.”
And despite the controversial nature of the subject, 24 of the 27 state commissioners signed the recommendations, she said, which included findings that individuals are responsible for their own health and wellness, and that eligibility for insurance should be expanded with health care plans that cover everyone.
“The plan was shelved,” Gann said. “But several years later, there was an opportunity to fund Colorado’s plan. At the national level, after a very heated and divisive discussion, we passed the Affordable Care Act.”
Colorado is one of just 16 states that has created its own health insurance exchange under the ACA, she noted.
“Our state applied for a planning grant, so in 2011, we applied for and received funding,” she said. “We will open the marketplace here in October; carriers will have a variety of plans and consumers can shop—there will be no denials.
“And when insurance companies compete for your dollars, you win.”
Gann has presented information about the insurance exchange, which opens in October, across the region since February. Although she is currently the only representative on the Western Slope, she expects to see “more boots on the ground” soon. Federal funding for the program will continue through the implementation phase and year one, and by 2015, Colorado’s program is expected to sustain itself.
“This is not a government program, although there is legislative oversight,” Gann said. “There is no funding for abortion, and there won’t be. This system will not replace the current market, or brokers. We are making a huge investment now, but in a few years all markets will be in place, and we will be able to compare which models work best—this will no longer be theoretical.”
Expect a few bumps along the road, as those involved work the kinks out of the system, she said.
“Colorado’s exchange will work like a farm market, and any insurer can sell,” she said. “There is so much to learn, but we should be proud of our effort.”
Gann, who includes a history of health care in America as part of her presentation, came to the work with the perspective of a consumer; she and husband David have operated small agricultural businesses over the years, and tried to purchase health care for their own workers years ago. The Ganns were astounded to learn that when it came to obtaining coverage, good health was less of a factor than the purchasing power of large groups. With 75 percent of insured Americans receiving health care through their employers, and Coloradoans spending on average 20 percent of their income on health care, she knows how badly change is needed.
“The birth of my first child cost just $600 in 1976,” Gann said. “Today costs are so astronomical that many people are priced out of the market.”
After Congress passed the Emergency Medical Treatment Act in 1986, costs really began to skyrocket, she said, with many of the associated charges passed on to the insured.
“There was no reimbursement provision in that act,” Gann said, noting that the Federal government is funding the launch of the Affordable Care Act. “We have all been paying for the uninsured (under the current system), many of whom have access to health care only through the emergency room—which is the most expensive option. There is no prevention and wellness care—and yet we know that many diseases are much easier to treat in the early stages.”
Gann will speak at the Heidi’s Deli Forum on May 22, she said, and those who have questions about the new system should plan to attend. Anyone who would like to schedule a presentation for other groups is encouraged to call her at 970-417-7119. A web site with information is also live, at http://www.connectforhealthco.com.
“There will be a tax credit available for Coloradoans,’ she said, “and our market is the only place to access those advanced tax credits. This is a free market web site, and the 800,000 uninsured Colorado residents will now be one big group. The big need right now is to get as many Coloradoans insured as possible, to bring down the spiraling costs. In October, you will be able to shop, and coverage begins Jan. 1. Then we will see if Colorado has come up with a plan that is part of the solution.”
The program now lists 10 essential benefits, and offers a series of “tiers” based on co-pay and deductible amounts.
“The next few months are so important, as we work to get good, real information out to the people,” Gann said. “Hopefully, through education we can move forward. And it will be interesting to see if Coloradoans take personal responsibility for their health.
“I am not intimidated by hostile groups,” Gann said. “And I believe it is important to honor people where they are coming from, and approach this subject through our own history. Once we are through the first evolution, I can go back to playing tennis with my kids and grandkids.”