With enhanced Affordable Care Act subsidies set to expire at the end of the year, some small businesses and health care advocates in Durango are worried about the prospect of increasing insurance premiums.
Ashleigh Tucker, managing partner of 4Corners Riversports, an outdoor recreation retail store and paddle school in Durango, doesn’t know if she will be able to continue providing health care to her employees.
The small business currently offers an injury rider plan for full-time employees, which is separate from the ACA, and AFLAC supplemental insurance for any employees. If an employee decides to use AFLAC, the company covers half of the monthly price and employees cover the rest.
Tucker said 4Corners will try to find a way to keep offering insurance to employees. The biggest thing the company wants is affordable health care for all so employees don’t have to be in fear of getting hurt and not having insurance, Tucker said.
“We’re a small business so it’s hard for us too,” Tucker said. “(Premium increases are) a big thing to take on but obviously we want to keep our employees, so it’s a nice benefit to give them, but we have to make sure it’s feasible for us too.”
For Tucker personally, she pays $97 a month. Her premium with credits would be going up to $230, but without tax credits, it would be $650.
“That’s a lot of money,” Tucker said. “If it’s $650 a month, I might not have health insurance.”
Tucker said she has gone through phases in her life with and without insurance, but mostly with it. During times of being uninsured, she came across problems and wound up with huge medical bills.
“It’s like gambling. It’s rolling the dice if you’re not going to have insurance, and that’s not always the best thing to do,” she said.
Doug McCarthy, CEO of Local First La Plata, advocates for affordable health care options by partnering with Peak Health Alliance to bring greater competition to the health insurance market.
“Western Colorado has had some of the highest health insurance rates in the country, which is a paradox because we also have a very healthy population,” McCarthy said. “That was a puzzle to us.”
In 2017, residents and community leaders in Summit County created a task force, which led to the creation of Peak Health Alliance in 2019. It serves as a community organizing group that works with local providers to help residents access affordable health care. There are now nine counties in western Colorado, including La Plata, that are served by Peak Health Alliance.
Johns Hopkins University published a study earlier this year and found that health insurance premiums in counties served by Peak Health Alliance are 13% to 17% lower for those who purchase individual and family coverage compared to Colorado counties not served by Peak.
McCarthy said people benefit from having greater market competition, and one problem nationwide is the consolidation of health care providers, which don’t have as much sensitivity to offering the best prices they could.
Small businesses are already at a disadvantage to big businesses, McCarthy said. On top of health care costs, they have been faced with increasing tariffs and inflation rates this year.
“(Small businesses) want to do the right thing. They want to be able to provide for their employees and they want a healthy workforce,” McCarthy said. “The government needs to help businesses to be able to do that and so it’s really important for main streets in our communities to be just as strong as the wall streets and our national economy.”
Sen. John Hickenlooper, along with other Democrats, have been working during the government shutdown to extend ACA subsidies and wants Coloradans to “hang in there.”
“I’m hopeful that the Republicans are going to come to their senses and recognize they’re going to lose elections if they don’t find a remedy,” Hickenlooper said in an interview with The Durango Herald. “They’re not willing to walk back at least a part of all these cuts. They’re trying to take $1 trillion out of health care over the next 10 years. You can’t do that without causing some serious damage to the public health care system.”
Hickenlooper said there are roughly 35 million small businesses in the U.S. and 10 million individuals will be severely impacted if the federal government gets rid of tax subsidies on exchanges. This is a “horrendous” problem for small businesses, Hickenlooper said.
“When people lose their health care coverage, in most cases they no longer have a medical home so they don’t go in and get a checkup,” he said. “They don’t get a scan if they got something serious like cancer. They don’t find out about it until sometimes it’s too late.”
If cuts to Medicaid continue, Colorado could lose six to eight rural hospitals and clinics, Hickenlooper said.
McCarthy said the Big, Beautiful Bill will make it “very difficult” for some rural hospitals to stay open because of the reduction in funding for Medicaid, which makes up a large percentage of their revenue with their patient base. He referenced the Southwest Health System in Cortez and the Pagosa Spring Medical Center. Both are classified as “critical access hospitals.” They are small and it’s hard for them to stay in business, McCarthy said.
“We’re really concerned,” McCarthy said. “A lot of those hospitals were built back in the day through special programs that offered rural communities the ability to have health care, and so we need to look at other ways we can support our rural hospitals because it’s really important for people to have medical care where they live.”
According to a study from the Small Business Majority, small business owners worry about changes to health care coverage for themselves and their employees, citing financial stress due to higher costs (73%), having to provide private coverage to employees (44%) and challenges recruiting and retaining employees without coverage (43%). Nearly three-quarters (74%) of small business owners support extending the enhanced Premium Tax Credits.
“Having the enhancements are really important but we don’t want to stop there,” McCarthy said. “What this whole episode has shown us is that health care costs are just unaffordable for many people. … It’s just going to be kind of a slow train wreck for our communities when we have so many people who are not going to get the health care they need.”
As a parent, Tucker also worries about health care for her children. Her child has heart problems and is on the Child Health Plan Plus, which may be undergoing changes after guidance from the Trump administration. She said she doesn’t know what she would do if her child wasn’t on CHP+.
Tucker hopes the tax credits can continue.
“They’re huge for our employees to have insurance and just live their lives and live in this beautiful town and enjoy everything that it has to offer without being in fear of going into massive debt,” Tucker said. “… Health care shouldn’t be a question, it should be for all.”
Abigail Hatting is an intern for The Durango Herald and The Journal in Cortez and a senior at American University in Washington, D.C. She can be reached at ahatting@durangoherald.com.
