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The Leg takes a first step toward changing health care 

Public option?

click to enlarge The price of health insurance continues to increase. - VOLODYMYR MAKSYMCHUK / SHUTTERSTOCK.COM
  • Volodymyr Maksymchuk / Shutterstock.com
  • The price of health insurance continues to increase.

Due to steps taken since the 2009 passage of the Affordable Care Act, just 6.5 percent of Coloradans don’t have health insurance now, compared with 15.8 percent in 2013. The most notable change: the 2014 Colorado Medicaid coverage expansion, which allowed more adults and former foster children to be covered under the government plan.

But that expansion didn’t fix all the state’s health care woes, and many say it’s time for another big move: a public health insurance option. Why? Because widespread coverage doesn’t equal affordability — costs for coverage have been rising steeply. In 2016, a Colorado household with a median income spent 32 percent of its earnings on health care costs. 

During his campaign, Gov. Jared Polis touted a single-payer health insurance system as the solution. At one point, he told the Indy that such a system may even be possible through interstate compacts with several neighboring states, rather than a national system. (He says his administration continues to explore that angle.) 

In early April, Polis unveiled his “health roadmap” — a mix of bills in the Legislature and administrative steps by his office, with short-, mid- and long-term goals. Some of the legislation mentioned in the plan is already signed or close to passage. 

In fact, in a recent interview, when asked whether he was working on a major shuffle to the health care system this year, Polis said, “Many, many medium health care bills. I mean many of them are big ... so you got reinsurance, public option, prescription drug importation, pricing transparency, out-of-network billing.”

Polis said the reinsurance bill, which saves insurers money on expensive claims, was likely the most important. A report, he said, showed it would save those in the individual market an average of 23 percent. That bill passed the House and remains under consideration in the Senate.

But House Bill 1004 — a first step toward a long-term goal — may be the most impactful. It looks to set the groundwork for a public option for health insurance in Colorado. The hope: that a state-run health insurance option would drive down costs to consumers and give rural residents a solid option. 

The Associated Press notes, “Fourteen of Colorado’s 64 counties have just one insurer for the individual market, and monthly premiums there can be $500 higher than in metropolitan Denver.”

HB1004 simply directs the Department of Health Care Policy and Financing and the Division of Insurance in the Department of Regulatory Agencies to come up with a well-thought-out proposal and present it during the 2020 legislative session. 

As of this writing, the bill was awaiting Polis’ signature. In order for there to actually be a public option in Colorado, however, federal waivers would have to be granted and a new bill passed. 

Nevertheless, supporters sound hopeful. “This bill has the potential to more dramatically affect health care costs than anything else we’ve looked at,” Sen. Jeff Bridges, D-Greenwood Village, told the The Daily Sentinel.

In the meantime, however, Senate Bill 004, which awaited the governor’s signature as of this writing, presents a pilot public option (and thus does not require those federal waivers). It would create a one-year program in high-health-insurance-cost areas (Eagle and Garfield counties) allowing people in certain income brackets to buy into plans offered to state employees. 

The bill also “modernizes” laws on health care cooperatives, creating more consumer protections and allowing them to negotiate with providers for better prices.

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