Health insurance

Data continues to show that where a person lives in Colorado plays a big role in dictating how much they pay for health insurance. That's because insurers use it to calculate premiums and in some regions it's unusually high. State lawmakers are aware of the problem – but are not sure what the solution is.

"I was seeing upwards of $500 a month," said Sam Higby, a Breckenridge outdoor gear shop employee. He's 35 and healthy, but said on his salary he simply can't afford healthcare.

"It does weigh on me as an active person, being concerned about what might happen out there."

Health insurance premiums can vary widely in Colorado depending on where you live — it's just one of the factors health insurance companies use to calculate prices. Mountain regions continue to have some of the highest premiums in the country. At the statehouse, House Bill 16-1336 [.pdf] would look at treating the entire state as one region, rather than continuing to group regions separately.

"Our current insurance payment of $1,508 a month is equivalent to our mortgage payment. We can't afford it," said Richard Backe, a Garfield County small-business owner. "There are numerous people in the mountain district with the same story. We are the healthiest counties in the state, and we have the highest insurance rates."

Colorado residents have vastly different health outcomes, based in part on where they live in the state. Rocky Mountain PBS News analyzed health data from the Robert Wood Johnson Foundation to rank each of the state's 64 counties based on a variety of health indicators from obesity, to amount of exercise, to smoking and premature deaths.

Butte is an old mining town, tucked away in the southwest corner of Montana with a population of about 34,000. Locals enjoy many things you can't find elsewhere — campgrounds a quick drive from downtown and gorgeous mountain ranges nearby. But in Butte, as in much of rural America, advanced medical care is absent.

People in Butte who experience serious trauma or need specialty care rely on air ambulance flights to get them the help they need.

Thousands of Americans are again searching for health insurance after losing it for 2016. That's partly because some large, low-cost insurers — health cooperatives, set up under the Affordable Care Act — are folding in a dozen states.

On Wednesday, the Census Bureau gave Obamacare some good news: the number of people without health insurance dropped to 10.4 percent in 2014, down from 13.3 percent in 2013.

Colorado may be doing even better. When the Affordable Care Act launched two years ago, about 1 in 7 of the state's residents, or 14 percent, were uninsured, according to the nonprofit, nonpartisan Colorado Health Institute. That figure is now 6.7 percent, according to the organization's latest data.

The number of Coloradans who don't have health insurance has dropped by about half since President Barack Obama's signature health care law went into effect. The state's uninsured rate fell from 14.3 percent in 2013 to 6.7 percent in 2015. Not only does the Colorado Access Health Survey say that the uninsured are at a record low, it also finds that more people have enrolled in Medicaid.

The states that set up their own insurance marketplaces have nothing to lose in King v. Burwell, the big Supreme Court case that will be decided by the end of June. But that doesn't mean those states are breathing easy.

With varying degrees of difficulty, all of the state-based exchanges are struggling to figure out how to become financially self-sufficient as the spigot of federal start-up money shuts off.

Dana Lam was insured under her parent's health plan until the end of 2014, thanks to a provision of the Affordable Care Act that allows young adults to stay on family health insurance until they turn 26.

The arrangement worked out well until she needed treatment for depression. Lam knew that if she used her parents' health plan to see a psychotherapist or psychiatrist, her visit would show up on their insurance statements.

She wasn't ready to talk to them about her mental health issues. "I was just so afraid of having that conversation with them," she says.

Frances Stevens could have been a contender. She was training to be a Golden Gloves boxer and working as a magazine publisher in 1997 when 1,000 copies of the latest issue arrived at her San Francisco office.

"I'd just turned 30. I was an athlete. I had a job that I loved, a life that I loved," she recalls. "And in a second my life changed."

Buying health care in America is like shopping blindfolded at Macy's and getting the bill months after you leave the store, Princeton economist Uwe Reinhardt likes to say.

But an online tool that went live Wednesday is supposed to help change that, giving patients in most parts of the country a small peek at the prices of medical tests and procedures before they open their wallets.

Got a sore knee? Having a baby? Need a primary-care doctor? Shopping for an MRI scan?

In health insurance prices, as in the weather, Alaska and the Sun Belt are extremes. This year Alaska is the most expensive health insurance market for people who do not get coverage through their employers, while Phoenix, Albuquerque, N.M., and Tucson, Ariz., are among the very cheapest.

A Shots post earlier this week by NPR's John Ydstie detailed the "family glitch" in the Affordable Care Act. That's where people who can't afford their insurance at work aren't eligible for help in the new insurance exchanges. Many of these Americans, most of whom make middling incomes, will remain uninsured.

That story got us wondering: Who else is getting left out by health law? And who is getting coverage?

Diabetes is an expensive disease to treat, costing the United States $244 billion in 2012, according to an analysis of the disease's economic burden.

When the loss of productivity due to illness and disability is added in, the bill comes to $322 billion, or $1,000 a year for each American, including those without diabetes. That's 48 percent higher than the same benchmark in 2007; not a healthy trend.

The increase is being driven by a growing and aging population, the report finds, as well as more common risk factors like obesity, and higher medical costs.