A bill aiming to create a lower-cost, high-quality option for individuals and small businesses buying health insurance on Colorado’s exchange was tabled Monday night by a state Senate committee, after lawmakers heard seven-plus hours of testimony.
Sen. Kerry Donovan, D-Vail, asked the Health and Human Services Committee to table House Bill 1232 at around 10:30 p.m., predicting more negotiations between lawmakers and the health care industry Tuesday.
“This bill has been marked by remarkable compromise,” Donovan told the committee. “I think we have the potential to keep that going, with each side of these complicated conversations making concessions.”
In the lengthy hearing, dozens spoke strongly in support of the bill while others strongly opposed it. The committee is scheduled to take the bill back up for amendments and consideration Wednesday.
Perspectives varied widely over seven-plus hours of testimony. Some called the bill a needed measure to provide an affordable, high-quality option for individuals and small businesses struggling to pay for health insurance and medical care, or going without it.
That group included Ross Brooks, CEO and patient at Mount Family Health Centers, which serves 21,000 people in Garfield, Eagle and Pitkin counties. More than a third of those patients — about 7,500 people — have no insurance. “Not crappy, high-deductible health insurance, no health insurance,” Brooks said.
Brooks said he and the Colorado Community Health Network, which represents health centers serving more than 800,000 people across the state, are both strong supporters of the bill. He predicted its standard benefit plan with 18% premium reductions over three years would allow half of the uninsured patients at Mountain Family Health to buy insurance.
“That’s why I’m such a strong supporter of the legislation, to get people access to affordable health insurance and care,” Brooks said.
Others opposing the bill predicted it would place significant burdens on hospitals and doctors, reduce innovation, lower reimbursement rates, make it more difficult to recruit medical professionals to Colorado, and, ultimately, threaten community care and services. They also took issue with parts of the bill that would mandate providers to serve patients with the new standard benefit plan and determine how much they are paid for that care.
At several points, testimony touched on the ability of the health care industry to meet the 18% premium reductions that would be required over three years for the new standardized plan, the sustainability of the bill’s reimbursement rates, and the prices and profitability of the state’s hospitals.
Some pointed to studies finding Colorado’s hospitals are among the most profitable in the country. Others argued their margins are significantly lower, pointed to the extent that health insurance premiums have already declined by about 28% in Colorado — to where they are now among the lowest in the country — and predicted the bill would have “dire consequence” for the state’s health care industry.
Not so, countered Tamara Pogue, a Summit County commissioner and former CEO of Peak Health Alliance. The nonprofit insurance purchasing collaborative formed to address Summit County’s high health insurance costs and has since expanded to six other Western Slope counties. Pogue said the alliance decreased premiums by at least 20% while expanding benefits, decreasing deductibles, and increasing coverage of preventative care.
“And we somehow managed to do all this without closing a rural hospital, without closing a practice,” Pogue told the committee. She encouraged the lawmakers to adopt the bill without additional amendments. “Make no mistake, I believe in a free market approach to solving this problem. But I have also learned this is not an industry that can or will self correct or self regulate without encouragement from the government,” Pogue said.
House Bill 1232 saw a complete rewrite before passing out of the House Health and Insurance Committee to end the opposition of major industry groups like the Colorado Hospital Association and Colorado Association of Health Plans. The bill cleared the House with a 40-23 party-line vote early last week.
The previous version also called for the creation of a new standard benefit plan for the individual and small group insurance markets, encouraging carriers to reduce premiums by 20% over two years. Yet it would have authorized state officials to create a quasi-governmental authority to offer that standard plan as a competing “Colorado public option” if those premium reduction targets were not met.
The amended bill would direct Colorado’s insurance commissioner to work with stakeholders to create a standardized health benefit plan, and insurance carriers would have to offer that standardized plan — now being called the Colorado option — in the counties where they currently offer coverage, with premium reductions totaling 18% over three years. The bill includes a process for the state to set reimbursement rates for care providers in areas that fail to create adequate networks or meet the premium reductions.
Tom Lotshaw can be reached at [email protected]