State Rep. Dylan Roberts (D-Avon) represents two counties on Colorado's Western Slope that face some of the highest health insurance costs in the state. So for his first two years in office, Roberts has been a key player on some of the biggest health care proposals coming out of the Capitol. His latest, which has bipartisan support, would create a new health insurance plan.
The so-called "public option" would be governed by the state, but still use private insurance companies. But the state would set reimbursement rates for hospitals and dictate how much the insurance companies must spend on patient care.
Capitol Coverage reporter Scott Franz recently sat down with Rep. Roberts in Denver to talk more about the proposal and why he thinks it will lower premiums.
Scott Franz: Why are YOU sponsoring this bill?
Rep. Roberts: My district demands action on health care costs. Ever since I got here two years ago, the number one issue I've heard from my constituents is the rising cost of health care and, specifically, how much it costs per month to be insured. We have a lot of people in my district in Eagle County and Routt County, that are self-employed, unemployed, own their own business who buy insurance on the individual market, probably a higher percentage than the rest of the state, and they are the ones being hit disproportionately by these price increases… I wanted to do something that would increase choice and lower prices.
How does a public option actually lower prices?
Right now there is a profit motive in the industry, and we're not removing that profit motive in this public option, but we're starting to rein in some of the profit motives behind health care.
We have an incredibly bloated hospital system in Colorado. It's the second highest hospital profits in the whole country. We have insurance companies not spending a large enough percentage of the money they're taking in on actually serving care to their customers.
So this plan puts some limits to how much hospitals can charge under the plan. It raises the amount of money per dollar that insurance companies have to spend on your actual care… It requires that pharmaceutical companies and drug middlemen actually pass rebates down all the way to the customers… and it takes a look at our health care system as a whole and says "we need to rein in some of the profit motives and give people more choice by bringing in more insurance options to all regions of the state."
What do you see as the greatest benefit of a public option?
If we can do this successfully in Colorado, we can show that when you take a hard look at the profit motive in health care and try to do some things that reasonably rein those in, then you can deliver the exact same quality of care and the exact same amount of care at a lower price and that's something worthy to do because people are dying, going bankrupt and losing significant parts of their life because they don't have insurance coverage. And we can make it more affordable.
On the flip side, what do you see as the greatest risk of a public option?
Since we are leading the nation in this way, we don't have examples to work off of… We don't have the examples to take a look at to make sure there aren't unintended consequences. But I think we've put forward a really reasonable proposal that limits the unintended consequences that lowers prices and gets more people covered.
The Colorado Hospital Association has raised concerns about this proposal. They're taking issue with the fact the state will set hospital reimbursement rates. They are also concerned a public option could "destabilize" the insurance market. How do you respond to those concerns?
We're not trying to put any hospitals out of business, and we're going to do whatever we can legislatively to make this as equitable as possible… We're going to make the reimbursement formula fair so that the hospitals that are already seeing immense profits are going to have to play in this plan as well, but the hospitals operating on a razor's edge are going to be recognized for their work and not be punished in any way under this plan.
What impact do you hope this plan has?
This is simply just a choice for consumers who are on the individual market and want another option. In 22 counties in Colorado that's going to be a big deal, because in 22 counties in Colorado there's only one (insurance option). We're going to see savings on this public insurance option of between 9 to 18% of what is currently offered for monthly premiums.