If you are buying health coverage in the Colorado ski resort towns, the Connecticut suburbs of New York City or a bunch of otherwise low-cost rural regions of Georgia, Mississippi and Nevada, you have the misfortune of living in the most expensive insurance marketplaces under the new health law.
The 10 most expensive regions also include all of Alaska and Vermont and large parts of Wisconsin and Wyoming. The ranking is based on the lowest price "silver" plan, which is the mid-level plan that the majority of consumers are choosing.
These regions, created as part of the health law, range in size from a state to a single county. While many people in these places will receive government subsidies to help pay for premiums, the portion that they pay will still be higher than they would have to foot in many other places.
The cause of the stratospheric premiums varies from region to region, although a recurring theme is that in some areas the limited number of hospitals and specialists allows them to demand high prices from insurers.
In southwestern Georgia, one hospital system dominates the area and beat back an effort by federal antitrust regulators to loosen its grip on the market. High individual insurance rates also reflect the extra costs that come when locals tend to be in poor health and where large numbers of people lack employer-sponsored insurance, leaving providers with more charity cases and lower-reimbursed Medicare patients.
A sicker population doesn't explain the most expensive region in the country: four mountain counties around Aspen and Vail. People here are generally healthy, but medical prices and the use of medical services are both high.
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