Lawmakers unveil compromise bill for health insurance changes

After several weeks of negotiations with the health care industry, Colorado lawmakers announced Monday they are introducing an overhauled bill aimed at reducing high health insurance costs in the state — and ending the opposition of major industry groups.

“We think this bill gets to a better place for them, but still keeps us on track to having a new health insurance option that is both lower in price and higher in quality for all Coloradans, no matter where they live, who purchase on the individual and small group markets,” said Rep. Dylan Roberts, of Avon.

The compromise bill scraps the threat of a controversial public health insurance option and instead requires health insurance carriers and networks in the state to offer a new standardized benefit plan with premium reductions totaling 6% a year for three years — 18% in total.

The first version of House Bill 1232 — introduced in March by Roberts, Rep. Iman Jodeh, of Aurora, and Sen. Kerry Donovan, of Vail — called for the creation of a new standardized benefit plan to be offered in the state’s individual and small group markets, with a goal of achieving 20% reductions in premiums over two years.

But the legislation offered no assurance the industry would be able to achieve those reductions, Roberts said. Instead, if it failed to achieve reductions, the bill authorized the state to create a nonprofit, quasi-governmental authority to offer the standardized plan as a competing public option in the individual and small group markets.

Under the compromise bill, the standardized plan would be offered through existing health insurance carriers and networks in the individual and small group markets, requiring them to meet both benefit requirements and premium reduction targets.

“Under the new version, the 18% over three years is required,” Roberts said. And while that premium reduction is 2% less than the 20% goal of the first bill, it is still in line with legislators’ original targets and will still amount to “hundreds of dollars saved every month.”

The proposal sets payment floors for hospitals and health care providers who treat patients with the standardized plan, something not included in the earlier version of the bill. It also ends a controversial provision that required health care providers to participate in the plan or risk losing their licenses. Under proposed changes, providers could only be required to participate if network adequacy is not met, or if a provider is the reason why a carrier cannot achieve the needed premium reductions.

Monday’s announcement by the legislators comes after several weeks of negotiations with the health care industry, following a lengthy hearing on the previous bill in front of the House Health and Insurance Committee on April 9. Following that hearing, the legislation was tabled before a vote by committee members.

Negotiations have included the Colorado Hospital Association, Colorado Association of Health Plans, Service Employees International Union, Colorado Rural Health Alliance and Academy of Family Physicians. Each group previously opposed the bill, but will now be neutral, Roberts said.

“If the bill is amended as we have agreed to with the sponsors, the association is moving to neutral,” Chris Tholen, the president and CEO of the Colorado Hospital Association said in a statement Monday. “We will re-evaluate our position if there are significant material changes made to the bill that impact Colorado hospitals. We thank the sponsors, Reps. Dylan Roberts and Iman Jodeh and Sen. Kerry Donovan, and members of the administration for the collaborative approach working on this bill.”

Roberts said the proposed changes will improve the likelihood of the bill’s passage, while still achieving the goal of helping more people afford quality health insurance coverage. The bill is scheduled to be considered by the Health and Insurance Committee on Tuesday.

“We think this ensures that the bill will move forward and pass and go to the governor’s desk. And what that means is that our constituents back home in Eagle County and across the Western Slope will have a new option that is lower in price, higher in quality,” Roberts said. “That was always the goal. Even changing how we get there, we’re still getting there, and that’s what our constituents care about. Not how it’s done, but what it means for their pocket book and quality of care.”

Jodeh, Donovan and House Speaker Alec Garnett also spoke in support of the compromise bill during a Monday afternoon press conference.

“For decades the price of health care in Colorado has been on the rise. For the one-in-five of us who struggle to pay for health care, or make the devastating choice to go without care entirely, the current system isn’t working,” Donovan said. “We refused to accept that there was nothing that could be done to change the status quo, and set out to make that change by inviting a diverse coalition of stakeholders to the table. This bill is a result of that collaborative process and we’ll move forward together in ensuring that all Coloradans have access to high-quality, affordable health care.”