Romer: Public option not the pragmatic answer to our health insurance challenges
We have no desire to add to the urban-rural, right-left, old-young, black-white, rich-poor noise that espouses much of today’s dialogue (frankly, it is tiresome and not productive). If we are partisan at all, it is in a pro-economy and pro-problem solving manner, rather than partisan on traditional political issues. We’re interested in meaningful solutions to the challenges facing our community and that value pragmatism and working together. Health care and insurance costs are an example.
Last week, Rep. Dylan Roberts, Rep. Iman Jodeh (D-Aurora) and Sen. Kerry Donovan introduced House Bill 1232, also known as the “Standardized Health Benefit Plan Colorado Option.” The legislation requires that health insurance carriers reduce premiums for individual and small business market plans by 20% by the end of 2024. If the commissioner of insurance believes that the carriers failed to meet that goal, a public health insurance option designed by an elected board would be authorized in Colorado.
Health care is too expensive. We know this and agree. We share the goal of lowering costs, decreasing the number of uninsured, and creating meaningful competition to drive prices down. We have (a lot) more work to do, but Colorado is on the right track pursuing market-based innovation and public-private partnership solutions to address this issue. However, the public option mandate is not the pragmatic solution we need to address this problem.
Consider: the benchmark silver premiums in Eagle and Routt counties of $424.47 is 4.7% above the Colorado median benchmark premium and is 7.5% below the national median based on Kaiser Family Foundation analysis of state average benchmark premiums. Eagle County had an uninsured rate of 12.5% in 2018 based on estimates from the U.S. Census Bureau for all people under the age of 65. This is slightly above the statewide median of 10.6%, but still places Eagle County in the top 75% of all Colorado counties. The uninsured rate in Eagle County has declined from 22.4% in 2013 to 12.5% in 2018 (Source: U.S. Census Bureau, 2008-2018 Small Area Health Insurance Estimates using the American Community Survey).
Coloradans in the individual market have experienced meaningful reductions in insurance premiums, expanded product choice, and increased competition in the private market in recent years. Colorado has seen larger reductions on a percentage basis in the Affordable Care Act’s average benchmark health insurance premiums than Washington, the first state to establish a public option two years ago. Since 2018, Colorado’s benchmark premiums have fallen by 25.3%, compared to 15.5% increase in Washington State.
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None of this is to indicate that we don’t need to focus on the challenge of health care and health insurance costs to our community, because we do. However, this legislation includes a provision that requires health care providers to accept all patients enrolled in health plans offered by the the state authority at the reimbursement rates set by the authority. Neither Medicaid nor Medicare — the two major national public insurance plans — include such an onerous requirement of providers. Failure to participate in the government-run plan is punishable by disciplinary action against the health care provider, including loss of license. This isn’t a public option, it is a public mandate.
Imagine the government stepping in to set prices for your business and then to remove your license to operate if you don’t cooperate. We would not accept this in any other industry and we should not accept it here. We are committed to solving the problem through market driven, public-private partnerships. The public option, as currently written, does not meet this criteria.