Colorado Lawmakers Passed A Complex Health Care Reform. We Break Down How It Changed After Months Of Debate
Colorado Democrats have passed a bill they say will eventually lead to lower prices on the individual health insurance market by sparking new competition in counties that only have one option.
But their proposal to create a new insurance option regulated by the state government changed dramatically after aggressive lobbying and opposition from hospitals and doctors.
And even some Democrats who voted to send the bill to Gov. Jared Polis are questioning whether the bill will actually do what supporters say it will.
What did the “Colorado option” end up as?
Lawmakers still need to sort out some amendments before the bill officially passes, and some details may get tweaked.
But in a nutshell, private insurance companies must start offering a new standardized plan that will also eventually have to be cheaper than other options. The state will determine the parameters of the plan, like what gets covered.
The state is telling insurance companies to achieve a 15% premium reduction over the next three years.
If that doesn’t happen, Colorado could set the rates.
Supporters, like Sen. Dominick Moreno, D-Commerce City, say this kind of intervention is needed because he is tired of seeing Coloradans starting fundraising pages to cover medical expenses they cannot afford.
He also tearfully told a story about a relative who went bankrupt 25 years ago due to hospital bills from caring for her child who eventually died of leukemia.
“People still go broke because they or their family member gets sick,” Moreno said. “It's not OK. We see it every day when people create GoFundMe pages for their medical bills. Something's wrong with our system when people have to do that.”
He said trying to spark competition on the insurance market to lower prices was a “step in the right direction.”
But even a Democrat who voted ‘yes’ is skeptical.
Sen. Joann Ginal, D-Fort Collins, questions whether the new policy will work.
“The bill promises consumers lower premiums, but it doesn't provide a viable avenue to obtain these reduction goals,” she said. “Nothing in this bill explains how it will actually save money for the people who need this the most.”
Is it still a “public option”?
Not exactly. The proposal originally would have created a state-controlled, nonprofit entity to offer an insurance plan to compete with private companies.
But that was nixed early in the process to try and gain the support of the health care industry.
Rep. Dylan Roberts, D-Avon, said he was willing to make significant concessions to get the bill to the governor.
“At the end of the day, my constituents don't completely care where or who is providing the insurance plan,” he said before agreeing to the amendments. “They care about the price of the insurance plan and the quality of the insurance plan. So whether that's coming from a nonprofit entity or a private carrier, as long as it's affordable and quality, that's what I feel I have an obligation to get done for my constituents.”
Republicans opposed the bill during all its hearings and votes. They said it could have unintended consequences and drive some doctors out of the state.
Roberts disagreed and said he wouldn’t sponsor a bill that risked hurting the health care industry.
How many people’s health care plans could be affected by this bill?
The bill only addresses insurance on the individual and small group markets, which represents about 15% of people who have health insurance in Colorado.
Supporters estimate about half of those people would utilize another insurance option.
Why was so much money spent on advertisements on this issue?
Roberts thinks the bill attracted lots of opposition and advertising campaigns because it could become a model for other states, one that could end up competing with more private insurance companies around the nation if it works.
“They are trying to prevent states from taking this step, because they know that if one state does it and shows that it is a successful and viable way forward, that it will start to trickle out across the United States and it will cut into their very lucrative status quo,” he said.
But opponents saw it as a threat to small business owners.
For example, the National Federation of Independent Businesses strongly opposed the bill. After it passed, the organization issued a statement saying it was a “slow march toward complete state control of all health-care decisions for its citizens.”
What else got changed?
The original proposal would have forced hospitals and doctors to accept the new standardized insurance option.
If they did not, they could be fined. But that drew lots of concern from some Democrats, especially those such as Rhonda Fields, D-Aurora. She represents a district with at least four major hospitals.
She said threatening health care providers with fines and punishments for not accepting a new insurance plan sends the wrong message at a time she says doctors should be praised as heroes for treating coronavirus patients.
So the bill was amended to drop provisions that could have punished health care providers.
Gov. Jared Polis has expressed support for the bill, and he is likely to sign it when it reaches his desk.