Colorado option bill clears its first Senate committee
Bill now heads to Appropriations Committee for consideration
House Bill 1232 cleared the Senate Health and Human Services Committee with a 4-3 party-line vote Wednesday, with the support of several Democrats who voiced concerns about the bill.
“I’m not even sure what to say, because this has been a difficult bill to keep up with, because we’ve made a lot of changes,” said Sen. Janet Buckner, D-Aurora. “I am going to be a yes today, but I believe we have a lot more work to do.”
Sponsored by Sen. Kerry Donovan, D-Vail, and Reps. Dylan Roberts, D-Avon, and Iman Jodeh, D-Aurora, the bill now heads to the Senate Appropriations Committee for consideration.
It passed the House early last week with a 40-23 party-line vote. Democrats hold a slimmer majority in the Senate.
House Bill 1232 aims to provide a lower-cost, higher-quality health insurance option for people buying coverage in the individual and small group markets on the Colorado exchange. The two markets account for about 15% of the state’s health insurance market.
It would direct the state’s insurance commissioner to work with stakeholders to develop a standardized health benefit plan — the Colorado option — and require carriers to offer the plan starting in 2023 in the markets where they operate, with premium reductions totaling 18% over three years.
Supporters argue the bill is needed to help more people and small businesses afford quality health insurance coverage and medical care — something that too many are struggling to pay for or going without, because of the cost. They also argue that Colorado’s health care industry can afford to lower costs, and that the bill has adequate protections for health care facilities with lower margins.
Others question where the 18% savings are supposed to come from, pointing to premium reductions that already total nearly 30% in the state, and argue that the bill will negatively impact health care providers and patients and make it harder to keep or recruit doctors in the state.
Wednesday’s hearing saw a number of proposed amendments, most of which failed. And much of the hearing focused on questions about the bill’s “backstops.”
Provisions would allow state officials to hold hearings and set reimbursement rates for health care providers in areas where providers and insurers fail to meet the required premium reductions or create adequate networks on their own. They also allow the state to fine doctors or hospitals that refuse to accept patients with the standard benefit plan.
The mandatory participation and fines have been repeatedly raised by opponents of the bill. They were also a concern for Sen. Rhonda Fields, D-Aurora, the chair of the Health and Human Services Committee, and Sen. Joann Ginal, D-Fort Collins, its vice chair.
Ginal said she has heard from many doctors who oppose the bill and its mandatory participation. “I know there are other concerns that I hope we have a chance to work on,” she said.
Fields said doctors could face a fine of up to $5,000 per year, while hospitals could be fined up to $10,000 per day, or up to $40,000 per day after a month, and also face possible license suspensions, revocations or conditions for refusing to participate. She called the measures punitive and said she does not like the tone or timing of the bill.
“I really appreciate the merit and the intent of this bill, but I really believe that it is sending the wrong message at the wrong time for the people I believe are heroes,” Fields said about health care workers and the penalties in the bill.
“What this bill does, it changes the course of how doctors are going to do business, and I don’t clearly understand what kind of impact that’s going to have long-term,“ Fields said. ”So I am going to be voting yes to get this bill out of this committee, so we can have a full debate on the floor, but those are my concerns, and those are going to be the issues I am going to be working on.“
Three Republicans on the committee — Barbara Kirkmeyer, R-Brighton, Cleave Simpson, R-Alamosa, and Jim Smallwood, R-Parker — all opposed the bill.
Simpson said he does not believe the bill can deliver what it intends to deliver, adding that “the risk of the unintended consequences are just too great for me to be supportive.”
Kirkmeyer said she asked the Colorado insurance commissioner and the bill sponsors for a guarantee or commitment the bill will not increase out-of-pocket costs for low-income residents or increase health insurance premiums in the state, but could get no guarantee.
“So if we can’t get a commitment out of that, then I would say I’m going to agree with what I heard in committee from the people testifying, that the bill is moving us in the wrong direction,” Kirkmeyer said.
Sen. Sonya Jaquez Lewis, D-Longmont, was far more supportive. She said she is “truly in awe” of what the state might be able to accomplish through the bill, and a “proud and honored” yes vote to move it along.
“For the first time we can really equalize access to health care in areas that have been so hard pressed, and we will make sure that we save some of these smaller health care facilities and hospitals, while at the same time balancing what is happening with many of our hospitals that are making too much money, the most profitable in the country,” Jaquez Lewis said.
Tom Lotshaw can be reached at firstname.lastname@example.org.