A First Glimpse: Estimating Health Reform's Impact in Colorado

Jonathan Gruber knows more about health insurance exchanges than most people in this country. That’s because he helped design the Massachusetts insurance exchange, he sits on the board of that exchange (known as the Connector), and he is an accomplished economist with a specialized system of health care data modeling.

Gruber, a professor at the Massachusetts Institute of Technology, presented new data on September 16 to the Board of the Directors of the Colorado Health Benefit Exchange about what he expects to happen to the uninsured in Colorado as a result of health care reform. The report provides a wealth of information based on his analysis of data from the U.S. Census Bureau and the 2008-09 Colorado Household Survey.

First, Gruber presented a picture of insurance coverage today in Colorado, which shows that 63 percent of Coloradans are insured through their employers, about 10 percent have public insurance and about seven percent buy individual insurance. Just over 20 percent of Coloradans are currently uninsured, compared to a national average of 18 percent. The vast majority of uninsured Coloradans are poor, with 59 percent earning up to twice the federal poverty level. And 59 percent of the uninsured are employed full-time.

Gruber provided a host of projections about what he expects to see in 2016, after health care reform is implemented, and if health care were not implemented. He predicts that most people with employer-sponsored insurance will not be affected, that more people will sign up for public insurance, and that most Coloradans will benefit financially from health care reform.

Gruber predicts that at least 590,000 Coloradans will obtain health insurance through the Exchange, and he said that number could grow to more than 1.1 million depending on how many small employers use the Exchange.

However, he projects that about 350,000 Coloradans will remain uninsured. Of that population, 39 percent are undocumented, 22 percent will choose not to get insurance in spite of the mandate, and that 29 percent are legally here but not subject to the mandate because of low income and not being able to afford existing plans.

Gruber cautions that his numbers are estimates, and that the actual outcome of health care reform may be much different depending on how the regulations and systems are developed between now and 2014, when the changes take effect.

“This is a model. This is not the truth. This is our best projections based on the best information that we have,” Gruber cautioned.

Gruber’s entire presentation can be downloaded here.