The conversation around health insurance has often been centered in politics, and it’s only gotten more screen time in the 14 months since President Donald Trump took office. The Republican-majority Congress attempted—and failed—to repeal the Affordable Care Act several times, although they did manage to remove a few of the law’s protections. Most notably, they killed the individual mandate, which required Americans to purchase health insurance or pay a fine—a decision that has resulted in even more uncertainty and could potentially lead to massive premium hikes in the next three years.
With all these changes and political battles, there’s probably never been a more important time to get to know your state insurance commissioner. Late last year, Gov. John Hickenlooper named Michael Conway the state’s interim insurance commissioner for the Colorado Department of Regulatory Agencies (DORA), so that the previous commissioner, Marguerite Salazar, could focus on her role as DORA’s executive director. Conway officially started on January 1, and he’s raring to clean up the mess that is our health insurance system. Here’s what you should know about him:
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He’s got a plan to reduce premiums. It’s called a reinsurance program, and it’s designed to cut costs for folks who purchase their own individual health insurance (think: freelancers and individual contractors) and rake in an income that’s above 400 percent of the poverty level, which means they don’t get any kind of tax credits to buy said insurance. (That threshold is $48,560 for one person and $100,400 for a family of four this year.) If you’re one of the 9 percent of Coloradans in that category, the reinsurance program would cough up the money for a portion of your claims, and the insurance company charges you less each month as a result. So far, seven other states have created or are developing reinsurance programs.
While a reinsurance bill hasn’t been introduced in the Colorado legislature yet, it looks like it’s coming soon (hopefully during this session). The major sticking point? Who should fund the program. Conway says it’s likely the federal government would provide 50 percent of the dollars needed, and negotiations are in motion to figure out who would cover the remaining half. Based on an analysis his office did in 2017, Conway thinks the program could reduce premiums by 21 percent statewide in 2019. For example, a 60-year-old married couple living in Denver could save close to $9,000. “These are the folks who call us,” Conway says. “These are the folks who are paying the same amount for their health insurance as they’re paying for their mortgage. They’re incredibly scared about what their next step is going to be, and this is something that we fundamentally believe we can do to help those folks.”
He suggests you don’t buy a short-term health insurance plan. Recently, the Trump administration announced it would likely let Americans buy short-term health insurance plans that would cover them for up to a year instead of just 90 days. This is the type of plan you might buy if you’ve recently switched jobs and your health insurance at your new company doesn’t kick in for a couple of months; it’s supposed to tide you over, not serve as your main coverage. Expanding those plans, though, means more people might rely on them full-time, especially since their low sticker price makes it seem like they’re a good deal. But the secret is: They’re cheap because they don’t cover preexisting conditions—including health issues as straightforward as asthma or diabetes. And if you develop one of those conditions after purchasing a short-term health plan and then try to renew it, your plan still won’t cover that illness or disease. (Here is a good explainer if you want more info.) “One of the things we’re going to be working on throughout this year is a lot of consumer education on that point,” Conway says, “so people really understand what it is they’re buying when they buy these plans.”
He thinks we could take a page out of other countries’ health insurance plans in order to solve America’s problems—but not in the way you think. “I don’t really have hobbies,” Conway says. “My hobby is essentially: I walk my dog around the lake and think about these things.” By these things, he means the future of health insurance—what the marketplace looks like in five, 10, 50 years. “Especially the more left-leaning part of this country always thinks that when you look at the rest of the developed world, it’s the single-payer idea, Medicare for all, however you want to phrase that part of the conversation,” Conway says. “But I think they’re missing the more fundamental thing that the rest of the world does that solves or at least helps address the problem.”
So far, he thinks the key to finding sustainable success is treating everyone the same, instead of creating different ways to buy health insurance depending on where you work and how you live. “We have things like short-term plans in the marketplace, a large-group market, we have a small-group market, individual market, and then we have self-insured,” Conway says. “Other countries don’t approach this issue the same way; they put everybody in the same pool and say, ‘Here’s the base product that you’re going to get. If you want to buy something else, that’s great, but this is the base product.’”
He’s a fan of the Affordable Care Act. “I literally have a bumper sticker on the front window of my front door at my house that reads something to the effect of ‘Obamacare saves lives,’” Conway says. “Because it did. Fundamentally, the Affordable Care Act stepped in in Colorado and took our uninsured rate down from 16 percent to six percent. [Ed note: Recent data lists that rate as seven percent.] That meant that people were getting coverage. That meant people were having their health issues addressed. That wouldn’t have happened without the Affordable Care Act. It was an incredibly important thing to get passed, and it’s incredibly important from my perspective that it’s continued to be defended.”
He wants to help you. Although Conway went to undergrad at the University of Colorado Boulder, he moved to Miami for law school—and almost immediately regretted it. The day after he graduated, he packed up his truck and moved back to Colorado, where he set about trying to find a job. (It was 2009, at the height of the Great Recession, so well-paid positions were rare.) Conway ended up working for Colorado Legal Services, a nonprofit that provides legal aid to low-income individuals, for a year for free before getting hired by the state as an assistant attorney general in the insurance division and then moving to the insurance division itself.
“Really the only thing I knew that I wanted to do was try to find a way to help people, and everything that we do here is about helping people,” Conway says. He points to the closed door of his corner office, located near the Civic Center Station. “Most of the people on the other side of that door could be out in the private sector making a lot more money than they’re making here, but they work their asses off here because they want to help people, and it’s inspiring.”