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.
"We're one of the first states in the country to unveil post Affordable Care Act findings," said Michele Lueck, president of the Colorado Health Institute, a policy think tank in Denver. "Whether or not you agree or disagree, like or dislike the Affordable Care Act, the central charge was to get more Americans insured. In some ways at a very basic level, we can say mission accomplished."
The Affordable Care Act expanded the income threshold for Medicaid allowing more low-income people to qualify for the program. In Colorado, Lueck said that has been a big driver in getting more people health insurance coverage.
"We've moved from 1-in-4 Coloradans being insured by a public plan to 1-in-3 Coloradans."
But the survey of 10,000 people from across the state also indicates that the number of underinsured is rising. That means people have health insurance, but pay a lot of money out of pocket for medical expenses.
"We don't want to set up a system where individuals are vulnerable in terms of the financial risks associated with their medical products," said Lueck.
Colorado's Health Insurance Commissioner Marguerite Salazar said she thinks a lot of consumers don't understand what paying a lower monthly premium means for their overall health insurance benefits.
"We hear a lot of complaints about high co-pays, high co-insurance. When they buy the lowest cost plan, they're not buying the richest benefits. I see people are still buying based on price," said Salazar.
For some, the cheapest monthly premium may be all they can afford. The health access survey shows that fewer employees get health insurance from their employer, especially those who work for small businesses. Lueck said cost is still one of the main reasons why people say they don't have health insurance.
"The jury is still out on whether the Affordable Care Act is providing affordable health insurance," Lueck said. "The health insurance premiums are the highest in the country in our ski resort areas so we are keeping our eye on this."
Connect for Health Colorado, the state's health exchange for individuals purchasing health insurance, said it's looking at putting a new out of pocket indicator on its website when people sign up for individual plans. Kevin Patterson, the CEO of Connect for Health, said he hopes more people will also start to take preventative measures to look after their own health.
"It's kind of like you want your car to last, you have to think about how you really maintain your own health," said Patterson. "Getting more people covered means there's more people we can talk to about moving that continuum to help them understand how health insurance and the health system work, because those are two different things."
Half of the uninsured in the state are between the ages of 19 and 39. About 20% of people without insurance said they don't need coverage, either because they don't agree with Obamacare or they are healthy and don't expect it to change.
Despite some of the mixed results, Dr. Ned Calonge, head of the Colorado Trust which funded the survey, said increased access to health care is just the first step in real reform.
"The rest of the parts are to fix the system, to make it affordable for the government and individuals," he said. "To make it work better, and those next pieces need the coverage piece to happen first."
Rural western Colorado has the highest rates of uninsured, specifically the north and southwest parts of the state. Hispanics are also more likely to lack health insurance compared to whites, blacks and Asians. In 2015, the tax penalty for not having health insurance will jump to $325 per person, or 2 percent of your household taxable income, whichever is higher.