Colorado state-backed health insurance bill nears approval
DENVER – The Colorado Senate on Wednesday passed the bill that would create a state-backed health insurance plan after several amendments were made to the measure on Tuesday to try to appease insurance groups, doctors and some Democrats who have reservations about the bill.
The Senate voted mostly on party lines, 19-16, to send HB21-1232 back to the House for approval with the Senate amendments, where it is expected to pass again and be sent to the governor’s office.
Senator Rachel Zenzinger, D-Arvada, was the only Democrat to vote against the bill on Wednesday. Senator Rhonda Fields, D-Aurora and Senator Joann Ginal, D-Fort Collins, had shared their concerns about the so-called “Colorado Option” but voted in favor of its passage.
Fields said she felt the bill had become less about health equity and more of an insurance bill than it was in its initial version, when it included a real public option. , before being rewritten earlier this month. She and Ginal also previously expressed concerns the state would require providers to accept patients on the standard plan when they are not to accept Medicaid or Medicare, with Ginal saying she didn’t think it was ethical.
As a result of the rewrite, the bill faced even more pressure from Republicans, some Democrats, and lobbyists for insurance groups and doctors, with the latter two trying to get the Sponsors of the measure include protections for their industries surrounding the penalties of doctors or insurers who do not want to accept the standardized plan, the power of the insurance commissioner and around cost reduction targets.
Eighteen amendments to the measure were presented Tuesday during the bill’s second hearing in the Senate – only five of which were passed, but which helped allay the concerns of doctors and their representatives.
An amendment proposed by the main sponsor, Senator Kerry Donovan, D-Vail, removed the penalties for doctors who do not want to accept patients on the standardized plan offered by private insurers.
Another adopted amendment proposed by Donovan removed the ability of the Insurance Commissioner to revoke a hospital’s license if he refuses to participate in the scheme. The current version would still allow the commissioner to suspend a license or impose other penalties.
Previously, the measure would have allowed fines of $ 5,000 per year for physicians. The bill still allows hospitals that have refused to participate to be fined up to $ 10,000 per day for the first 30 days they refuse to participate in the program and up to $ 40,000 per day per day. the following.
And promoters will now demand that the standardized plan be at least 15% cheaper by 2025 than the premium rates offered this year – down from an 18% reduction.
In the latest version of the bill, private insurers are expected to come up with the standardized plan developed by the Insurance Commissioner that achieves these 15% rate reductions from 2021 premiums in individual and small group markets. The employer’s insurance would not be affected.
If private insurers do not achieve this 15% reduction over three years, the state can set certain rates.
Changes to more private-public partnership have caused some healthcare groups to take a neutral stance on the bill. They had previously opposed it because of the state-run option that would have competed with private insurers in the state market.
Some Republicans have expressed concerns about the power of the Insurance Commissioner to create the standardized plan and then monitor the program, and believe him, or the doctors themselves, could face legal challenges if he was signed by the government. Jared Polis, who lobbied for a state-backed or managed plan.
“This could potentially open up a legal exposure or a lawsuit of some kind against this vendor who says, ‘Hey, I understand there’s no fine, but you’re breaking the law,'” said Senator Jim Smallwood, R-Parker, after the measure was passed. “… I am extremely concerned that patients are going to be the ones to sue their health care providers in retaliation if they do not agree to the standardized plan.
Smallwood said he was not convinced the bill will result in lower premium rates. This has been a common concern to many, as a similar program in Washington state led only 1% of residents to join and resulted in higher costs for average public option premiums, the Washington Post reported.
“I just thought it was unrealistic to promise our citizens any kind of rate reduction knowing that this number keeps decreasing and that there is always a provision that takes into account an increase in inflation,” he said. he declared.
The Colorado Health Plans Association said it was opposed to the bill after the amendments. They said they believe that higher reimbursement rates will not lead to lower premiums, that premiums have gone down over the past two years and that insurers may stop offering certain plans in the market due to the standardized option.
“The CAHP and its members continued to offer industry perspective and technical advice to improve the chances of success of the bill,” the group said. “As this directive was not accepted by the legislature, we view HB21-1232 as unrealistic and potentially dangerous for Colorado’s well-regulated healthcare market.”
Donovan said the iteration of the measure about to make it to Polis’s office was the product of a compromise with medics to remove the fines. She said she believed removing some of the potential penalties would lead insurers, providers, doctors and the state to compromise on rate cuts in the years to come.
“If, at the end of the day, we can’t develop an adequate network that cuts costs, then we have to have something but make sure we can enforce those goals,” Donovan said.
She said lawmakers had “accomplished what once seemed impossible” by trying to get everyone affected by the measure to provide comments that changed the bill several times during the session.
“Will this bill solve all of the systemic health equity issues we have in the system?” No. But today is the start of a commitment that we don’t just expect the status quo, ”Donovan said.
The bill is now returning to the House for adoption of Senate amendments. It passed its third reading there in a 40-23 vote, and House sponsors have said they are likely to accept the Senate amendments and send the bill to Polis.