During my five minute lunch break today, I’m eating some pizza left over from last night’s nine-hour committee meeting. We heard three bills:
One that would make it harder for seniors and low-income Coloradans to vote (defeated 3-6)
One that would allow Colorado businesses to freely discriminate against the LGBTQ community (defeated 3-6)
One that would join Colorado into the national popular vote interstate compact (passed 6-3)
Colorado law allows every legislator to get a fair hearing on five bills each year, and as you can see from the first two listed above, not all of them are good ideas. With the third, though, I’m very excited that Colorado will soon be joining an interstate compact in which we award our nine electoral votes to the winner of the national popular vote. The law will go into effect once enough states have joined the compact to make up 270 electoral votes. To be clear, the electoral college will still exist as required by the US Constitution, but Colorado will be exercising our right to award our electoral votes as we see fit. This idea’s time has come and I’m excited we’ll finally be treating every American vote as equal!
In other news, we’ve been incredibly busy working on everything from health care affordability to clean energy to education funding. Here are just a few highlights:
My hospital cost transparency bill passed the House with bipartisan support and will soon be heard in the Senate. Check out this recent story.
A bill I sponsored with Rep Kerry Tipper to make it easier for local governments to license tobacco retailers passed the House. With Colorado’s teen vaping rate the highest in the country, we must do a better job preventing retailers from selling to minors. Check out our press release.
One of the bills from last summer’s opioid study committee will be heard this Friday in the House Public Health and Human Services Committee. This bill, which I’m carrying with Rep Jonathan Singer, will establish tough standards for sober living facilities and increase housing support for people in recovery.
I’ve been working with Rep Julie McCluskie on a bill to reduce health insurance premiums on the individual market through a reinsurance program. It was introduced last week and will be heard in committee soon. Check out our press release.
That’s only a snapshot of what I’ve been up to, and we’ll have much more to talk about soon. Bring your questions and join us this Saturday at 10:00am for our monthly Lakewood Town Hall meeting.
DENVER — Local governments would be able to assess their own taxes on tobacco products without losing what revenues they already receive from the state under a bill working its way through the Colorado Legislature.
Under current law, local governments that assess their own fees, licenses or taxes on the sale of any tobacco product forgo their portion of cigarette tax revenues collected by the state, 27 percent of which are distributed to municipalities and counties based on sales in their jurisdictions.
House Bill 1033, which cleared the Colorado House and now awaits debate in the Senate, would change that.
But the two sponsors of the bill didn’t introduce it so local government can find a new revenue source. They introduced it to allow counties and statutory cities to ban the sale of e-cigarettes to minors, as home-rule municipalities are already allowed to do.
Local governments that want to keep minors from the so-called practice of vaping would jeopardize their tobacco tax revenues, so it’s become a disincentive to ban the practice, said Lakewood Democratic Reps. Kerry Tipper and Chris Kennedy, who jointly introduced the bill.
“We’re trying to give parity amongst all local governments,” Tipper said. “For example, we had a young lady, I think she was 16 or 17 years old, who testified from Eagle County that her friends and many of the kids she knows in school as young as 11 get access to these e-cigarettes. It’s unbelievable.”
That measure isn’t the only one related to nicotine that the Legislature is considering. House Bill 1076, which has not yet been heard in committee, would add electronic smoking devices that contain nicotine to the Colorado Clean Indoor Act, which banned smoking in most public places.
A bill to require hospitals to open up their financials for state and public inspection passed through the Colorado House of Representative on Thursday after the trade group for state hospitals agreed to support it — the second major instance this week of a business group dropping years-long opposition to a proposal that seems almost definite to pass through the newly Democratic-controlled Legislature.
The Colorado Hospital Association gave its support to House Bill 1001 after sponsoring Rep. Chris Kennedy, D-Lakewood, added five amendments during debate on the House floor this week to allow institutions to shield proprietary information on acquisition prices for facilities and physician practices and to limit their mandate to turn over per-hospital financial audits when the audit is done on a parent company as a whole. While the changes got CHA on board with the bill, it did little to convince skeptical Republicans who believe the measure’s increased regulations will lead to increased costs and a continuing lack of consumer transparency; Rep. Matt Soper of Delta was the only GOP representative who joined Democrats in voting to move the bill on to the Senate on Thursday.
Still, the agreement between the CHA and Kennedy to get hospitals behind a bill that requires them to open for public viewing everything from their surgical revenues to their overall costs of building new facilities to the amount of unreimbursed care they provided — all so that consumers, employers and state regulators can examine ways to pressure the industry to bring down costs — was a major step in the debate over health costs.
“This bill demonstrates hospitals’ commitment to finding solutions to Colorado’s health-care affordability crisis, and it’s an important first step — but certainly not the last one — to expand transparency into how the health-care market works,” CHA senior vice president Katherine Mulready said in a statement after the amendments were added to the bill on Tuesday.
Newly inaugurated Gov. Jared Polis has made health-care affordability his top priority during his first month in office, so much so that he issued an executive order last week creating an Office of Saving People Money on Health Care, listing passage of the hospital transparency act as one of its primary aims.
While health-care costs are rising across the board, many business leaders in particular have begun to focus on hospitals as a particular sore spot. A Colorado Business Group on Health study that Denver Business Journal detailed last year showed that privately insured patients are paying 66 percent more on average than Medicaid and Medicare patients at facilities throughout the state and that some common procedures cost as much as seven times the rate of Medicare reimbursement as they are billed to private payers.
House Minority Leader Patrick Neville, R-Castle Rock, criticized HB 1001 because it allows state regulators to see aspects of hospitals’ finances to which they’ve never had access before, but it does very little to increase transparency to consumers of why the costs on their bills can be so high.
Kennedy said that because only a limited number of consumers price-shop when getting health care — and then, it’s largely on elective procedures — he believes that allowing state-government leaders to understand hospitals’ pricing and spending can help them to craft policies that can bring down costs for all residents.
The CHA’s backing of HB 1001 came the same week that major business groups such as the Colorado Chamber of Commerce and National Federation of Independent Business dropped what had been three years of opposition to a proposal to prohibit employers from asking on application forms whether job seekers have criminal records. The groups went neutral on the “ban the box” bill after getting several concessions from its authors, including a provision that disputes involving criminal-record inquiries must go to a state administrative board rather than be adjudicated in court.
Colorado’s House has passed legislation to require hospitals to provide annual reports on their spending and their uncompensated patient care costs.
Democratic Rep. Chris Kennedy’s bill is designed to allow state officials to study why privately insured individuals are paying more for care while the state and federal governments are spending hundreds of millions of dollars to support hospitals, especially in rural areas.
Kennedy says hospital care comprises about 40 percent of total health care costs in Colorado. His bill directs the Department of Health Care Policy and Financing to compile the annual transparency report.
John Batholomew, the department’s chief financial officer, testified at a bill hearing that in 2017, Colorado’s hospital prices were 23 percent above the national average.
A bill requiring hospitals to disclose certain financial information is headed to the state House floor.
Titled “Hospital Transparency Measures To Analyze Efficacy,” and sponsored by Rep. Chris Kennedy, D-Lakewood, the bill would mandate the disclosure of expense reports, patient revenue, available beds, emergency department admissions and more. Some of that information would be posted in an annual report on the Department of Health Care Policy and Financing’s website.
“This bill will ensure our continued support for rural hospitals and to prepare hospitals for the future in which they are reimbursed for value, not volume,” Kennedy said in a statement.
Lawmakers will consider the legislation Jan. 25, along with several other bills, including a bipartisan effort to include funds for career and technical education in a state grant program.
Colorado’s new legislative session is underway, with Democrats in charge of both chambers and the governor’s office. Blue control might be a game changer for health care legislation. Before, it was a stalemate. Democrats controlled the House and blocked Republican bills. The GOP controlled the Senate and blocked Democratic bills.
Nonpartisan nonprofit Colorado Health Institute tracked about 80 Democratic-proposed health bills that died in a Senate committee in recent sessions. But now, CHI spokesman Joe Hanel said, “you have one party that controls the levers of power, so they’ll be able to do a lot more than they had in the past four years.”
If the majority party just dusted off those earlier bills and ran them again, that’s a big agenda already, Hanel said. Unlike before, Democrats can now propose and pass their own health care agenda. They’ll offer an ambitious slate of proposals on a variety of things, from costs to insurance to opioids to e-cigarettes to mental health.
“This is a progressive group of Democrats, led by a very progressive governor with Jared Polis,” he said. “You saw a lot of voters come out and vote for them, and I think Democrats do feel like they have a mandate to do big, transformational things.”
“Now, we don’t want to give this office a bureaucratic or fancy name to make it sound important,” Polis said. “We want to give it a simple name because it is important.”
The new office aims to reduce patient costs for hospital stays and expenses, improve price transparency, and make health insurance more affordable.
Democrats want to reduce high prescription drug costs, possibly by importing medication from Canada. Another problem, sky high insurance costs in mountain communities, might be solved by the creation of a reinsurance market, basically insurance for insurance companies to bring costs down and help pay for the most expensive patients.
“We have hospitals that in some cases operate monopoly power,” he said. “So they’ve been able to basically charge whatever they want and then they’ve been reinvesting those dollars into capital construction projects rather than passing those savings on to consumers.”
Hospitals disagree, and say there are a lot of reasons health costs are so high, many beyond their control. Those include Colorado’s high cost of living and high insurance costs. Republicans see it as government overreach and stopped similar bills in prior years.
There’s no question that rent is a growing concern for Coloradans.
An analysis by Apartment List, a rental listing site, found that half of tenants in Denver spend more than 30 percent of their paycheck on housing. Rates are similar in Grand Junction and Pueblo. It’s even worse north of the metro. Numbers rise to 60 percent in Boulder and 61 percent in Fort Collins.
One potential way to tackle the high costs has been off the table for more than 30 years in Colorado: rent control.
State law bans cities from regulating the rental market. The restriction has forced Colorado communities to find creative ways to add affordable rental units, all while staying on the right side of the law.
Now, State Sen. Julie Gonzales, part of a new class of Democratic lawmakers at the Capitol, hopes to scrap the ban entirely. While the exact language is still in the works, the plan is to introduce a bill to let cities regulate their rental markets.
“I think that municipalities should have a full set of policy options to decide what makes the most sense for them,” she said.
Most states have similar rent control bans. Gonzales’ bill would bring a national debate over those policies to Colorado. A California ballot measure to end limitations failed last November. In Illinois, parts of Chicago have voted to lift the state ban on rent control, as part of a nonbinding effort to pressure state lawmakers.
Depending on who you ask, doing away with Colorado’s prohibition is either the first step to reining in out-of-control housing costs or economic insanity that could actually make housing even less accessible. The proposal will also likely become the left goalpost in a broader debate about Colorado’s cost of living during the 2019 legislative session.
A Far-Reaching Ban
For Denver City Council Member Paul Lopez, the bill is welcome news. The outgoing councilman, now a candidate for city clerk and recorder, joined the council just before the Great Recession. He watched the city go from a housing bust to a building boom, but now worries about who the recovery is really for.
“I see all these cranes in Denver’s skyline,” he said. “And I’d feel a lot better about those cranes if 20, 25 maybe 30 percent of those units were [priced] at an affordable, attainable level.”
That idea is often called inclusionary housing. It’s a catch-all term for policies meant to encourage developers to build more affordable places to live as a part of new construction. Early in his career, Lopez proposed the simplest form of the idea: requiring Denver developers set aside a portion of new rental units as affordable.
“I don’t know how many lawyers told me you can’t do that,” he laughed. “I don’t know how many policy people told me you can’t do that.”
He was told “you can’t do that” due to the interpretation of Colorado’s rent control ban. In 2000, Colorado’s Supreme Court heard a case about a similar policy in the mountain resort town of Telluride. The court decided the rule against price-setting applied to current apartments and new construction. Cities simply could not force the developers to build below-market rental units.
Places like Denver and Boulder still have inclusionary housing ordinances, but because of the Telluride decision, they have to offer developers alternatives to adding affordable units to a specific building. Both cities allow builders to pay for an exemption, which goes into an affordable housing fund.
There are also plenty of rental properties with restricted rents in Colorado. That’s because cities can work with developers to limit rents when they take taxpayer dollars for a project. When public money isn’t involved, landlords are free to price apartments as they see fit.
Andrea Chiriboga-Flor, an organizer with 9to5 Colorado, is part of a coalition of housing and economic justice groups pushing the bill to end the rent control ban. She knows the prospect of rent regulation will set off alarm bells, but said the fear that “people would have to roll back rent costs is just a misconception.”
Chiriboga-Flor listed more common approaches: a cap on year-over-year rent increases or a temporary stabilization of rent. Whatever the policy, she said a city could tailor its approach to its specific housing market. Denver could craft laws to slow gentrification and Telluride could work to preserve worker housing.
Opponents say it’s not that simple.
Teo Nicolais, a landlord and vice president for the Apartment Association of Metro Denver, said he understands that people want to do something about housing costs, but rent control shouldn’t be part of the conversation. He said it’s a policy “which feels good, it sounds good, it’s easy to understand, but rent control has disastrous consequences.”
There’s a reason even liberal economists have no patience for rent control, he said. By setting price controls in the market, a city could discourage developers from building new rental units. For him, it’s basic economics. Prices go up when demand outstrips supply.
Nicolais also cited a Stanford analysis of rent control policies in San Francisco. It found gentrification in the city may have accelerated since new construction is exempt from the limits. That encouraged many developers to replace rent-controlled apartments with high-end units or owner-occupied condos, according to the research.
He doesn’t want to see a similar story play out in Colorado.
“As a Denver Native, as a citizen of this city, and someone who’s kind of a nerd on housing policy, I don’t like to see bad policy,” he said. “And rent control is bad policy.”
Key lawmakers appear to agree with Nicolais. Democratic state Sen. Angela Williams has her own plans on housing, such as a bill to extend the amount of time renters would have to cure a violation for overdue rent.
But letting cities regulate rent increases? Not so much.
“I don’t think cities and counties should be in the business of telling businesses how to run their businesses,” said the northeast Denver senator and chair of the Senate business committee.
Democrats in the Colorado House are also cautious about the idea. Assistant Majority Leader Chris Kennedy said his caucus has a separate package of renter protection bills. It includes policies like reigning in rental application fees and making it illegal for landlords to deny tenants based on their source of income.
“I don’t think there’s any doubt that we are trying to do more to help renters find affordable housing and fund more housing supply,” he said. “I think the question of whether rent control is an appropriate policy is something that bears a lot of conversation before we jump forward.”
That likely means the rent control proposal will be a tough sell, even with Democrats in full control of state government.
Colorado Democrat seeking to unravel the mystery of hospital costs
By Anna Staver (January 14th, 2019)
Colorado sends about $2.9 billion annually in state and federal dollars to hospitals across the state, but the agency that regulates the hospitals doesn’t really know how it’s being spent.
Lawmakers from both parties have wanted to change that for years, but they could never agree on the details. Now, Democrats see their control of the statehouse as an opportunity to unravel some of health care’s mysteries as well as some of its costs.
“It’s like trying to put together a puzzle when you don’t have all the pieces,” Rep. Chris Kennedy, D-Lakewood, said.
The missing pieces make it hard for state regulators such as the Department of Health Care Policy and Financing to see whether payments for Medicaid, uncompensated care and hospital provider fees improve patient outcomes. The data the state has collected — for instance, that Colorado hospitals spend 33 percent more on construction and administrative costs per patient than the national average — tells Kennedy that perhaps those dollars are being spent in ways that contradict the goals of those state and federal programs.
Overall reimbursement from the state when compared to the cost per patient has increased 153 percent since 2009, according to a December 2018 report from the Colorado Healthcare Affordability and Sustainability Enterprise (formerly known as the hospital provider fee). During that same time the amount people with private insurance paid above the cost of their services increased by 63 percent.
“We have been pumping more and more money into the system, but the costs for patients have been going in the wrong direction,” Kennedy said.
He wants to figure out why that’s happening and hopefully lower the amount people with private insurance pay for hospital services by changing the financial reporting rules. HB19-1001, the first House bill of the 2019 legislative session, would direct hospitals across the state to share things such as staffing information, annual financial statements and uncompensated care costs. It’s scheduled for its first hearing Wednesday.
“If we give regulators the tools to do their jobs, the hope is they can be more effective,” Kennedy said.
Kennedy tried to pass a similar bill during the 2018 session, but it died in the Senate, where Republicans held a majority. Sen. Jim Smallwood, R-Parker, sponsored the 2018 bill, but he found himself backing away from it over differences with Democrats about how much financial data they really needed from the hospitals to get a clear picture.
Colorado lawmaker seeks deep dive into how hospitals spend tax dollars
By Kelly Gooch (January 14th, 2019)
A Colorado lawmaker wants to make changes that would shed more light into how hospitals are spending state and federal dollars, The Denver Post reported.
Rep. Chris Kennedy, D-Lakewood, is sponsoring HB19-1001, which calls for the state’s department of healthcare policy and financing, in consultation with the state’s healthcare affordability and sustainability enterprise board, to develop and prepare an annual report showing uncompensated hospital costs and the different categories of hospital spending.
The bill would require Colorado hospitals to provide the department with hospital cost reports submitted to CMS; annual audited financial statements; the amount of unreimbursed care; and the gross patient service revenue.
“If we give regulators the tools to do their jobs, the hope is they can be more effective,” Mr. Kennedy told the Post.
The bill comes after a Post investigation last year revealed that the average capital and administrative costs of a hospital visit in Colorado increased at nearly double the rate of the national average from 2009 to 2016. The publication also cited a December 2018 report from the Colorado Healthcare Affordability and Sustainability Enterprise, which found that reimbursement from Colorado when compared to the cost per patient has climbed 153 percent since 2009. At the same time, the amount privately insured individuals paid above the cost of their services rose 63 percent.
Mr. Kennedy aims to decrease the amount privately insured individuals must pay for hospital services through financial reporting changes.
It was a busy week at the State Capitol as lawmakers started debating an initial round of bills at committee hearings and Gov. Jared Polis issued his first executive order to promote electric vehicles.
Here are some highlights, and some things to look for when lawmakers come back on Tuesday.
Some potentially impactful legislation has already passed through committees at the Capitol.
One bill getting early support is a measure that aims to add more transparency to hospital costs. The bill from Democratic Rep. Chris Kennedy would require hospitals to provide the state with a more detailed spending report each year. Proponents say it will allow the state to see and flag any excessive or wasteful spending. The bill passed an initial vote in the House Health and Insurance Committee.
In a Senate committee, a bill that would give the state more resources to combat the problem of drones interrupting firefighting operations passed unanimously.
DENVER (CBS4) – Transparency in health care pricing is coming under scrutiny at the State Capitol like never before. Lawmakers have already introduced a half dozen bills dealing with health care costs.
They’re going after hospitals, drug companies and insurers to shed light on an industry that touches every Coloradans life.
Jeanine Draut among those watching closely. She buys her health insurance on the individual market where she pays $600 a month for insurance she says she can’t afford to use.
“I try not to use healthcare because those high deductible plans have $5,000 deductibles,” she said.
“I would like to see more transparency around prices and networks so I can make good decisions.”
This session, she may get her wish. Rep. Chris Kennedy is taking the lead on health care reform starting with hospital transparency. He says hospitals are charging privately insured patients 66 percent more than their care actually costs even though he says the state is reimbursing hospitals an average of $200 million a year more for Medicaid.
“I think there’s some question particularly when we see 40 percent profit margin at some for profit hospitals in Denver. Are we actually distributing dollars right?” Kennedy asked.
Lawmakers also demanding more transparency by pharmaceutical companies.
“We’re looking to do everything we can to give consumers advance notice of price changes,” said Kennedy. “As well how much money pharmaceutical companies are spending onthings like marketing as opposed to research and development.”
Insurance reform is also on the agenda with bills to stabilize prices on the exchange and create a Medicaid buy-in plan for some Coloradans in high cost regions.
While Democrats are in control of both chambers, Kennedy says there is bi-partisan support for many of the bills. Draut is hopeful some reform will pass this year.
“It’s a big system that’s intertwined, but what I’ve always appreciated about Colorado is its willingness to step into these waters and try things here. I hope they continue do that.”
The nonprofit Colorado Consumer Health Initiative says health insurance premiums are now more than $13,000 a year for a family of four.
When Gov.-elect Jared Polis offers his inaugural address this morning, executives in sectors ranging from oil and gas to technology to small business will be listening for clues on what kinds of changes Colorado’s top elected official wants to bring after a sometimes opaque set of goals offered during his successful 2018 campaign.
But maybe no one will be watching with as much interests as leaders in the health-care industry. The former Democratic congressman’s most strident promise was to make a series of changes in his first 100 days in office that would begin to reduce hospital and pharmaceutical costs, would offer more access to behavioral-health services and would offer special attention to the mountain and Western Slope areas of the state that pay some of the highest costs in the nation for health insurance. His lieutenant governor, former state Rep. Dianne Primavera, marked her eight years in the Legislature with numerous attempts to mandate greater insurance coverage of costly conditions.
And even before Polis takes his oath of office, his agenda appears to be underway. On the first day of the 2019 legislative session Friday, Democrats introduced bills to require much greater transparency around hospitals’ costs and expenses, to allow individuals in the highest-cost counties to participate in same insurance plan offered to state government workers and to explore a publicly administered insurance plan for individuals who don’t qualify for Medicaid.
What this means for employers who purchase health insurance or for health-care businesses in Colorado — from hospitals to doctors to drug manufacturers — remains unclear. But despite the stated belief of Colorado Hospital Association officials that they don’t feel they “are on the menu” for the Legislature, the general consensus is that the entire sector may have to prepare for new regulations that both limit how they operate and, in some senses, create more competition from the government for the business they now offer.
“Everybody’s going to have to take their pound of flesh — hospitals, pharmaceuticals, insurance companies,” predicted Loren Furman, senior vice president of state and federal relations for the Colorado Chamber of Commerce. “They’re looking to cut costs … and I think Jared Polis is going to take a very strong role.”
During his time representing the Boulder-based 2nd Congressional District from 2009-19, Polis was an outspoken supporter first of the Affordable Care Act, better known as Obamacare, and then of creating a single-payer national health-care plansimilar to those offered in most European countries. The entrepreneur said during the campaign that universal, government-run health insurance remains his goal but added that he wants to see that come from Congress rather than pushing Colorado to go it alone.
Instead, his road map, laid out during the campaign, involves a combination of changing state laws and giving more enforcement capability to existing departments in order to affect cost, access and care.
On the enforcement side, Polis said he plans to give the Colorado Division of Insurance more power to reject proposed rate hikes and to investigate contracts between insurers and hospitals that he believes have led to costs of services remaining abnormally high in acute-care facilities, particularly in areas with little hospital competition. He also wants to take on insurers whom he doesn’t believe are offering parity in physical and behavioral health benefits, and he wants to penalize drug companies for over-inflated prices.
On the legislative side, Polis has talked often about establishing a reinsurance program that assesses fees on existing health-insurance policies throughout the state in order to create a pool that can cover the highest-cost patients and help to slow the rise of costly individual policies. He’s also talked about requiring more transparency in the costs incurred by hospitals and drug companies in determining their prices and in resurrecting a plan rejected by the administration of term-limited Gov. John Hickenlooper that would put all the state under the same insurance rating area — a plan that would bring down costs in the mountains but raise them in Denver and along most of the Front Range.
So far, there is no sign of that single-rating-area plan, and the newly elected legislator who covers most of the most price-affected counties, Democratic Rep. Julie McCluskie of Dillon, said that is not on her agenda. But McCluskie will sponsor the reinsurance bill that is guaranteed to set off sparks with the business community.
A reinsurance program, as it’s been done in other states, would tack assessments onto employer-sponsored and individual plans in order to create a pool of money that would fund the highest individual claims in the state after costs exceed a certain level. The idea, put forth in a failed 2018 bill, is that insurers could limit the escalation of individual-plan costs, which rose by more than 40 percent in 2017 and 2018 combined in Colorado, if they knew they had a backstop they could reach into for the most catastrophic instances of care.
Business leaders, however, don’t like the idea that they would be called upon to subsidize the costs of plans for individuals who don’t work for them. Both Furman and Denver Metro Chamber of Commerce President/CEO Kelly Brough said their members are resistant to any plan that does not incorporate some other source of funding, either from the state or federal governments.
McCluskie, who has not introduced the bill yet because she continues to work on its details, said she is looking into possible federal funds but knows that it will be hard to find significant state money in the federal budget this year. Her goal is not to over-tax businesses but to bring some relief to individuals and small-business owners who can not afford individual policies now — at least for three to five years until some sort of bigger-picture federal health-care reform may come.
“This is about ‘How do we stabilize the market and bring down insurance rates by 20 percent, if not more, for folks on the Western Slope?” she said. “I think reinsurance is part of a much broader approach.”
Sen. Kerry Donovan, D-Vail, has introduced a bill that would allow residents in the highest-cost counties for health insurance to enroll in a pilot program that lets them buy into the same plan through which state-government workers can purchase policies. However, Senate Bill 4, in its initial version, does not allow small businesses to buy into that plan — a goal that groups like Good Business Colorado have said they would like to see in any kind of program expanding the state’s insurance plan to non-government workers.
Meanwhile, Rep. Chris Kennedy, D-Lakewood, authored House Bill 1001, expected to get its first committee hearing in the coming weeks, which would require hospitals to turn over to the state a slew of information about their expenses and revenues. That information would include statistics such as gross patient-service revenue, all operating expenses, the total number of inpatient surgeries, the number of admissions from the emergency department the percentage of different categories of expenses that contribute to the overall expenses of hospitals.
Kennedy, who’s been talking with Polis and his staffers as he’s put together the newest version of his twice-killed bill, said the goal of collecting the information is find ways to stop the constant rise of hospital prices — either through determining ways the state could use its Medicaid reimbursements to incentivize lower prices or by opening it to the public to have them demand changes. While Kennedy said that he normally would pause before seeking and opening up such expenses of private companies, he said the state is paying too much to these hospitals and too many consumers are being hurt by prices to not have the government step in to explore what it can do.
“One of the issues we’ve seen with our health-care system is there isn’t really a functional supply and demand that puts downward pressure on hospital costs. And we’ve seen hospitals able to charge whatever they want,” the assistant House majority leader said. “By requiring hospitals to turn over their audited financial statements, it will allow us to dig deeper into hospital spending to understand: Are they really putting their money back into care? Are they putting it into capital-construction projects? Are they acquiring physician groups?”
Despite this, Katherine Mulready, vice president of legislative policy for the Colorado Hospital Association, said her group plans to be proactive rather than just defensive in the face of a new focus on health care by Polis and the legislative Democrats who control both the House and the Senate for the first time since 2014. Hospital leaders hope to push a bill that could establish rules around more consumer transparency — making prices of procedures clearer to patients, rather than making the expenses of internal operations clearer to legislators — and they want to work on an administrative efficiency effort that will allow patients to get just one bill for services rather than the slew they now receive.
Mulready said, in fact, that she believes the new governor’s focus could be positive in that it could move the ball forward on issues that have stagnated in the past, such as efforts to cut down on surprise out-of-network billing that have led to an outcry against hospitals even as those institutions say they want to work on the problem as long as doctors, insurers and others must come to the table as well. But she is under no illusion that health care is going to be a focus of Gov.-elect Polis in a way that could leave to significant changes.
“I think there is huge opportunity here. The whole conversation gives an opportunity to move the ball forward and drive solutions around these tricky issues,” Mulready said. “There’s not a lot of things this year that scare us too much … I just think solutions that are truly impactful and don’t have a lot of unintended consequences are elusive.”