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Enrollment in the state health exchange is strong regionally and statewide, despite federal efforts in 2017 to roll back the Affordable Care Act, including the recent elimination of a tax penalty assessed to uninsured individuals.

“It seemed like the prospect of losing the Affordable Care Act actually got people more interested in buying Affordable Care Act coverage,” said Joe Hanel, a spokesman for the Colorado Health Institute.

The rush to sign up for insurance through Connect for Health Colorado happened mainly before the mid-December deadline for those who wanted insurance to become effective Jan. 1, said Luke Clarke, a spokesman for the exchange. The open enrollment period for Connect for Health closes Jan. 12.

By mid-December, more than 149,000 Coloradans signed up for health insurance through the exchange, representing a 7 percent increase compared with the same period last year, according to Connect for Health. The early birds represent the bulk of enrollment, Clarke said.

Residents are still enrolling daily at the Piñon Project Family Resource Center in Cortez and the nonprofit has been busy, said Dave Hart, the health program director at the center.

“To stay within the law ... people wanted to be signed up,” he said.

For those who qualified for tax credits, insurance was cheaper than last year, he said.

“There was such a huge difference between the people who were eligible for credits and those who were not,” he said.

Insurance prices on the state health exchange increased more than 30 percent in Montezuma and La Plata counties in 2018, according to the Division of Insurance.

The most recent change to the Affordable Care Act – the elimination of a tax penalty to the uninsured – could also increase prices. But it’s unclear how it might play out.

The penalty was eliminated in December as part of the tax overhaul, and it was touted by President Donald Trump as a way to roll back the Affordable Care Act. But it will not take effect immediately.

The penalty remains in place through 2018, so those without coverage during the coming year would still have the penalty assessed when paying their income taxes in April 2019, Clarke said. The fine for going without insurance for a year is 2.5 percent of an individual’s annual income or $695 for an adult and $347.50 for a child. Individuals pay whatever is higher. The fine is capped at about $2,000.

So far, San Juan Basin Public Health has not received many questions about the elimination of the penalty assessed against the uninsured, said Kevin O’Connor, health insurance literacy program lead.

“Between now and next January, there could be many other changes to insurance law that could be more important than the elimination of the individual mandate, so it is too soon to speculate on the effect of that change in the law,” O’Connor said.

However, modeling has shown that the elimination of the mandate could increase premiums by 10 percent in 2019, Hanel said.

The Congressional Budget Office estimates insurance premiums would go up 10 percent annually for most years in the decade after the elimination of the mandate.

Mandating everyone purchase insurance or be subject to a penalty was meant to help keep prices down by encouraging younger, healthier people to purchase insurance, Hanel said. But it is not clear how much of an effect it will have on insurance enrollment in the coming years nor is it clear how many people might drop insurance in 2019, he added.

Hanel also said as the tax penalty increased, it did not seem to be a driving factor for residents choosing to purchase insurance or not.

In 2014, about 145,000 Coloradans paid the penalty, and in 2015, about 126,000 residents paid it, Colorado Health Institute reported.

Connect for Health Colorado doesn’t emphasize the tax penalty, choosing instead to focus on the need for health insurance.

“The real penalty for not having health insurance is experiencing the need for it,” Clarke said.

mshinn@durangoherald.com