State Lawmakers Consider Bills To Address Rising Prescription Drug Prices

State Lawmakers Consider Bills To Address Rising Prescription Drug Prices

Denver CBS4 (March 9, 2018)

As a group at the Colorado Capitol tries to put the brakes on the runaway cost of health care, some lawmakers are demanding more transparency from insurers, hospitals and pharmaceutical companies.

A bill being heard this week would require pharmaceutical companies to give notice of big price increases and justify them. Insurers would also need to report which drugs had the highest price increases each year.

That prescription drug bill is one of three that were being considered in a committee Thursday that address the escalating cost of health care.

Read Full Story at Denver CBS4

Transparency in Health Care

Transparency in Health Care

We all know that the high cost of health care is a problem, but the solutions are far from obvious. That’s why we must start by increasing the transparency of our health care system, and more specifically, hospitals.

There are many sources of information about hospital spending including the Medicare Cost Reports, the Colorado Healthcare Affordability and Sustainability Enterprise Annual Report, the Financial Health of Colorado Hospitals Report, and the All-Payer Claims Database, but none of them are able to answer a key question:

After all the money we’ve invested in our hospitals to improve Medicaid reimbursements and reduce uncompensated care, why is the cost shift to privately insured patients increasing?Text BoxHouse Bill 18-1207 requires hospitals to share more of their financial information with the Colorado Department of Health Care Policy and Financing, including audited financial statements, utilization and staffing information, and access to the existing secure data system containing utilization and financial data at the individual hospital level. With this data, HCPF will be better equipped to engage with Colorado hospitals to design the Delivery System Reform Incentive Payments (DSRIP) program, also known as the Hospital Transformation Project, which seeks to accelerate hospitals’ transitions to value-based payment systems and improved care coordination.

 

The Expulsion of A Serial Sexual Harasser

The Expulsion of A Serial Sexual Harasser

On Friday, I voted yes to expel Representative Steve Lebsock from the Colorado House of Representatives. A thorough, independent investigation reviewed 11 allegations from 5 women and found them all to be credible. One incident that stood out to me was when he solicited sex from a female lobbyist who had stopped by his office to talk to him about a piece of legislation.

This was probably the most serious vote I’ve been asked to take since being elected, and I did not arrive at my decision lightly. I read the redacted report and all related materials that were made available for those of us voting on the expulsion resolution. I was sufficiently convinced that Rep. Lebsock’s behavior has been both severe and pervasive, and there is no place for such behavior in any workplace, let alone the State Capitol.

You can hear my remarks during Friday’s debate here:

I am so proud of the conversation we had on Friday. Members of both parties took their responsibilities very seriously and worked through a difficult decision about expelling a member for the first time in 103 years. At the end of the day, 16 Republicans joined 36 Democrats in casting their vote to expel.

We were called upon to make a decision that was not about the fate of one man – it was about whether or not we would continue tolerating sexual harassment in the workplace. Now that we’ve taken this step, we must move forward with a commitment to changing this culture and setting a new standard at our own workplace and workplaces across our state and country.

Caucus is This Tuesday!

I’m excited to be running for reelection this year, and the first step is coming up on Tuesday, March 6th at 7:00pm. Both the Democratic and Republican parties will be holding their precinct caucuses all across Colorado, and I’ll be attending the Democratic precinct caucus in my area and seeking to earn the support of attendees, many of whom will be elected delegates to the Jefferson County Assembly on March 17th. At that assembly, I hope to be nominated to get my name on the ballot for the June 26th primary election.

If you’ve never been before, it can be a bit of a process. Fortunately, there’s some great info available on the Jeffco Dems webpage and the Colorado Dems webpage.

If you’re a Democrat living in House District 23, join us at Creighton Middle School (50 S. Kipling St, Lakewood) at 7:00pm. It shouldn’t be nearly as much of a circus as 2016 and I expect there to be ample parking in the school lot. That said, you should still plan to arrive between 6:00 and 6:30 so we can get started right on time.

More questions? Email me at chris@kennedy4co.com. See you Tuesday!

Jeffco supports bill for online-only publication of fiscal information

By Corinne Westeman (February 27, 2018)

Jeffco Commissioner Tina Francone told the Colorado State Senate on Feb. 14 that she and her fellow commissioners support a bill that would no longer require counties to publish full financial reports in newspapers.

Instead, counties would only have to publish a link in the newspaper that would take readers to the corresponding information on the counties’ websites.

Those who oppose the bill have argued that the current system allows for more transparency, but Francone said she believes that — if the bill is passed — counties would still be transparent via their own websites while saving taxpayer dollars.

SB-156 is sponsored by Sen. John Cooke, R-Greeley, and Rep. Chris Kennedy, D-Lakewood. It was assigned to the Senate Committee on State, Veterans & Military Affairs on Jan. 29, and the committee moved it to the floor in a 5-0 vote on Feb. 14.

Currently, the law requires counties to publish reports regarding its expenses and contracts, the salaries of public employees and officials, and the financial statements for each fund kept by the county treasurer. The expense report is published monthly and the salary report is published twice a year.

But SB-156 would change these two reports to annual reports effective Jan. 1, 2020, and counties only would be required to publish links to the expense report, the salary report and the financial statement on their websites. They would still have the option to publish full reports in newspapers.

Read the full story at ColumbineCourier.com

Coverage of Rental Applications Bill

Session delivers bills on transportation, pension reform

By Ellis Arnold (May 18th, 2018)

n a work season buoyed up by unforeseen revenue, Colorado lawmakers passed a deal to put more money toward the state’s deep transportation needs, gave the green light to a last-minute compromise on its public-retirement system and made progress on curtailing the opioid epidemic.

As conservative lawmakers note, the Legislature passed heavy spending lifts without a tax hike — enabled by favorable forecasts to the tune of a $1.3 billion increase in state revenue from last fiscal year. Strong economic growth and changes in federal tax policy set the state up to take in more revenue.

But Democrats and Republicans still battled on how to split that pie, and compromises left both sides without their ideal path forward.

Meanwhile, developments were less noteworthy on affordable housing, as prices continue a years-long spike.

The regular session — the 120-day term when bills can be passed — ended May 9. Here’s a look at some of what was accomplished.

Wheels turn on transportation

Colorado landed itself in a $9 billion hole as of 2016, according to state projections of transportation-spending needs through 2025, and lawmakers aimed to chip further away at that price tag.

“Transportation was a — if not the — priority for Republicans this session,” said state House Minority Leader Patrick Neville, R-Castle Rock. Roads and bridges had been “neglected by the Democrats for 13 years,” he added.

For the Democrats’ part, state House Speaker Crisanta Duran supported an unsuccessful bill last year to ask voters to raise sales and use taxes by 0.62 percentage points to raise about $375 million per year for the Colorado Department of Transportation, with other revenue going to counties and municipalities.

Senate President Kevin Grantham, R-Cañon City, supported that bill along with Duran, D-Denver.

This time around, lawmakers passed a $645 million boost over the next two years in a bill that would also ask voters in 2019 to approve about $2.3 billion in bond funding for transportation. That option would put Colorado on the hook for up to $3.25 billion in borrowing costs over 20 years.

But before that, outside groups may ask voters in 2018 to approve either another spending requirement without taxes, or allow a sales-tax increase.

“The Legislature will have no choice, I think, but to spend more on transportation and spend less on other things” if the first option passed, said Chris Holbert, state Senate majority leader. Holbert, R-Parker, was skeptical of the tax increase passing, “given the voter reaction to prior tax increases.”

Senate Bill 18-001, the deal lawmakers passed, headed to the governor’s desk May 17.

Small steps on housing

Housing affordability, on the other hand, didn’t see a grand bargain that would move the needle much.

“There was more lip service than anything else,” said Eric Sondermann, a Colorado independent political analyst.

Democrats unsuccessfully tried to pass a tax on shopping bags to fund affordable-housing assistance, while Republicans focus on what they say are regulations that make construction unaffordable.

“House Republicans are optimistic that the construction-litigation reform law passed in 2017 will spur more affordable home construction, but we need to give the market time to adjust before enacting more legislation,” said Cole Wist, state House assistant minority leader, R-Centennial.

Lawmakers passed a bill that extends the state’s ability to allocate affordable-housing tax credits through the year 2024. It would have expired at the end of 2019, according to the Legislature’s website.

It was a welcome move, but Coloradans need more support, state Rep. Faith Winter said.

“I’m excited that we were able to (extend) affordable-housing tax credits so that more affordable-housing projects can get off the ground,” said Winter, D-Westminster. “However, the response from the Legislature was woefully inadequate in addressing the affordable-housing crisis in Colorado.”

The Legislature passed what state Rep. Chris Kennedy called a “renters’ rights bill” that would require landlords to provide a copy of a lease to each tenant, as well as receipts for cash rent payments, he said.

Read Full Story at ArvadaPress.com

State Bill Aims To Relieve Rental Applicants From Burden Of Multiple Fees

By Tyler Young (March 05, 2018)

GRAND JUNCTION, Colo. – Rental application fees, they can run as high as $50 to $60 dollars and do not have a cap on what a property management can charge.

“We do have a rental application fee of $35. That fee just covers our background checks which in covers credit criteria background check and felony criminal background check”, says Cindy Hoppe a property manager for Bray Property Management.

Every property management company charges an application fee to cover background check costs, with background checks pricing around $32 combined both credit and criminal background check.

“It’s making them fully disclose what their fees are and we’re already doing that”, says Hoppe, “Now, different companies have different fees and they’re probably using different processing companies and the fees will fluctuate based on who you use and how many credit applications you put through a month, that kind of thing.”

Read full story at WesternSlopeNow.com

Colorado landlords would have to limit rental application fees and explain why tenants were rejected under measure

By Jesse Paul (February 26, 2018)

Landlords would be required to tell prospective rental-property tenants more about their application costs and requirements in a measure that passed the Democratic-controlled House on Monday.

House Bill 1127 also seeks to limit rental application charges to the costs of background and credit checks and mandate that landlords spell out to applicants the requirements for approval — such as rental and credit histories and income.

The legislation would also require landlords to provide a written notice to rejected tenants, as well, explaining on what grounds they were turned away. Landlords, under the measure, would also be barred from charging different rental application fees to different applicants and from changing those fees between different properties they might be offering for rent.

Read full story at DenverPost.com

Dems try to ease cost of apartment screenings

By Charles Ashby (February 18, 2018)

DENVER — Landlords who charge for rental screening applications would be restricted on just how much they can charge under a bill the Colorado House is to debate this week.

The measure, HB1127, which has no support from House Republicans so far, is aimed at making it less expensive for low-income people to get affordable housing, said its main sponsor, Rep. Dominique Jackson, D-Denver.

“The fact of the matter is, this is pretty common-sense stuff,” Jackson said. “Everybody knows that we’ve got a massive affordable housing problem. If you can’t even get into a piece of property because you’re paying so much for application screening fees, the bill limits the amount that a landlord can charge to screen a prospective tenant to their actual cost of those screenings.”

Jackson said many people can’t afford to spend money on multiple screenings at different apartments they are considering renting, and then come up with first- and last-month’s rent along with a security deposit.

Rep. Chris Kennedy, D-Denver, who also is sponsoring the bill with Jackson, said he’s hopeful changes to this year’s bill will win the approval from the Colorado Apartment Association with some changes, which haven’t been worked out yet.

Read full story at TheGJSentinel.com

State Lawmakers Push For ‘Renter’s Rights’ Bill

By Shaun Boyd (February 12, 2018)

DENVER (CBS4) – Finding an affordable apartment in Colorado is tough enough, but some people are spending hundreds of dollars just to apply for places.

Two state lawmakers say it’s time renters had some rights.

Rep. Dominique Jackson and Rep. Chris Kennedy are carrying a bill that would limit application fees to the actual cost of screening a prospective tenant.

“We talked about whether we wanted to set a specific dollar amount. We decided we did not, that it was okay for the landlords to figure out what those costs were,” said Kennedy.

Read full story at CBS Denver

Lawmakers seek to give renters more rights when applying for an apartment

By John Herrick (February 12, 2018)

Renters looking for a more affordable place to live are spending hundreds of dollars applying for apartments, prompting Democratic lawmakers to set limits on how much landlords can charge for these applications.

bill to cap apartment application fees cleared the House Finance committee on Monday by a 7-6 vote along party lines. The bill would cap the fee at the actual cost to screen the applicant.

There is no legal limit on how much landlords can charge for applications. Rep. Chris Kennedy, D-Lakewood, a lead sponsor on the bill, said he wants to make sure landlords are not profiting off these fees. He also said renters should have more rights.

“It’s tackling just another facet of the affordability problem,” Kennedy told The Colorado Independent.

Read the full story at ColoradoIndependent.com

Capitol zeros in on opioid problem

By Charles Ashby (February 25, 2018)

The Colorado Legislature is slowly making progress on some of the measures that have been introduced this year to deal with the opioid crisis.

Last week, the Colorado Senate approved a bill designed to restrict the number of pills a health care provider can prescribe, to a seven-day supply.

While there are some exceptions to that restriction ­— such as patients that have chronic pain that lasts longer than three months — SB22 is designed to help prevent overprescribing, and prevent people from accumulating too many unused pills that others might find and abuse.

“The latent supply of prescription opioids in people’s cabinets, waiting to be acquired by those who may abuse and misuse, is a looming danger,” said Sen. Jack Tate, R-Parker, who introduced the bipartisan measure with Sen. Irene Aguilar, D-Denver, and Lakewood Democratic Reps. Brittany Petterson and Chris Kennedy. “Reducing these latent supplies that result from clinical opioid overprescribing is a critical first step.”

Seven Republican senators opposed the bill, including Sen. Randy Baumgardner, whose district includes Garfield County, saying they did so because partly it was unfair to rural patients who might have to travel miles to their local pharmacies to get medications.

The bill is one of six related measures recommended by the Opioid and Other Substance Abuse Disorders Interim Study Committee, which met last summer to discuss the issue.

That panel, of which Tate was a member, recommended this bill and several others:

■ HB1007 requiring all individual and group health benefit plans to similarly restrict certain opioid prescriptions.

■ HB1136 adding residential and inpatient substance abuse disorder services to be eligible for the state’s Medicaid program.

■ SB24 making several changes to the Colorado Health Service Corps Program, including adding grant money to substance abuse providers in underserved areas.

■ SB40 offering liability protection to health care providers who provide clean syringes.

■ HB1003 creating a permanent legislative committee to monitor the issue and recommend changes as needed.

The House measures aren’t scheduled to be discussed in the House Public Health Care and Human Services Committee until late March.

SB22 now heads to the House, while SB24 awaits approval in the Senate Appropriations Committee because of its $2.5 million price tag.

Read full story at TheGJSentinel.com

Presentations from Public Lands Town Hall

Presentations from Public Lands Town Hall

We had a fantastic town hall this morning with great speakers talking about all the ways we protect the lands that make our country and our state so special. If you missed it, check out the presentations below.

 

Public Lands 101

Josh Kuhn from Conservation Colorado gives an overview of federal and state lands.

Contact Josh at josh@conservationco.org.

 

 

Private Land Protection

Jordan Vana from Colorado Open Lands talks about how private landowners can opt to protect their land from development in perpetuity through our conservation easement system. Jordan didn’t give a powerpoint, but we have a map of Colorado’s conservation easements and you can learn more at the Colorado Open Lands website.

Contact Jordan at jvana@coloradoopenlands.org.

 

 

A History of Jeffco Open Space

John Litz from PLAN Jeffco talks about the 1/2 sales tax adopted by Jeffco voters in 1972 and all the projects funded with that revenue over the last 47 years.

Contact John at jklitz@comcast.net.

February Under the Golden Dome

February Under the Golden Dome

We’re now in the 4th full week of the 2018 legislative session. Things still feel a little quiet, but there’s a ton of work going on in the background as we all engage with stakeholders on our bills and finalize drafting. Six of my bills have now introduced, and I’m signed onto three in the Senate. Check them out here!

My first bill, HB18-1032, passed the House yesterday 44-20. I worked closely with Rep. Dan Thurlow (R-Grand Junction) on this bill to facilitate the sharing of certain health data to improve the quality of care. With the advent of electronic health records, more medical professionals are able to access patient data to better coordinate care, reduce duplicative tests, and save cost.

This is one of many bipartisan bills I’m working on this session. In fact, I’m partnering with Republican colleagues on nearly all of my bills. There will always be areas of disagreement, but the truth is there is a great deal of common ground. You just have to invest the time and energy to seek it out and build trust across the aisle.

Meanwhile, committee meetings are in full swing and we’re regularly working through bills. Just last week, my committees heard bills about oil and gas permitting, four-year nursing degrees, marijuana taxes, newborn hearing screenings, child care tax credits, teacher’s license renewals, and aquatic nuisance species.

Believe me when I say that it takes a bit of practice to jump from topic to topic every day like that. But it’s so interesting to learn about so many different issues and to see the legislators and advocates who engage to solve these kinds of problems.

This week, many of us are participating in #FightingForFamilies week. It’s the 25th anniversary of the federal Family and Medical Leave Act (FMLA), and we’re spending a lot of time talking about steps we can take in Colorado to build upon FMLA. One of our top priorities of the session is the similarly acronym’d FAMLI Act, which will establish an insurance program to provide wage-replacement benefits for workers who are sick or who need time off to care for a child or other family member.

For my part, I’m pretty focused on the ways that the high cost of living makes it difficult for working families to get by. While it’s true that our economy is doing well, the costs of housing, health care, and child care are growing faster than income for many hard-working Coloradans.

Along with Rep. Dominique Jackson (D-Aurora), I’m sponsoring a bill to limit rental application fees and require landlords to be more transparent when processing applications for vacant units. You can read the bill here, and you can check out a little video I recorded with Rep. Jackson here:

Happy February!

Funding A Sticking Point As Colorado Debates Reinsurance Program

By Amy Lotven (January 29, 2018)

Stakeholders in Colorado continue to debate the development of a reinsurance program for the 2019 plan year that would cost about $346 million in order to significantly reduce premiums. Sources note that gathering the funding is a key sticking point in the debate because issuers are hitting back on using a premium assessment and other funding is elusive.

Colorado’s legislature approved a bill last year requiring the state’s Department of Insurance to look into options for setting up a reinsurance program through a 1332 waiver. The department commissioned a report to study how much a reinsurance program would cost, and its impact on claims, premiums and the morbidity of the risk pool.

While some states have opted to explore or implement condition-based programs, or so-called “invisible high-risk pools” that reimburse carriers claims for patients with certain high-cost diseases, Colorado has opted to do a claims-based approach under which plans typically are partially reimbursed for claims after a certain “attachment point” and up to a set threshold.

Milliman did an analysis and found that in order to achieve a 25 percent claims reduction, the program would cost $346 million in 2019. The firm says about half of the program costs would be covered by the federal pass-through money under the 1332 waiver, while Colorado would need to provide $178 million. The program would reduce premiums an average 21 percent statewide, boost enrollment by 17,000 and lower morbidity by 2.0 percent compared to the baseline, Milliman says in its final report. Importantly, Milliman notes, premiums would fall by 35 percent in the high-cost Western region and rural areas of the state; the average decrease in non-rural areas would be 17 percent (hence the 21 percent average).

The state legislature is now working to craft a bill that would create the reinsurance program, but the big question is funding, according to Mara Baer, president of AgoHealth, the lead author of the DOI’s report to the legislature.

The funding is tricky, says Colorado Democratic Rep. Chris Kennedy, who shepherded the legislation to get the study and is now working on the bill to create the program. A large problem, Kennedy says, is that unlike most other states, the Colorado legislature cannot legally raise taxes due to a 1992 state constitutional amendment. The state now requires voter approval for any tax hikes. In addition to its tax-raising restrictions, the legislature also faces budget caps, Kennedy notes, “so funding anything is challenging.”

Other funding possibilities have been discussed but each has their own drawbacks. Increasing the “provider fee” on hospitals would be difficult because the tax is already high and needed to support rural hospitals, Kennedy says. There are talks about getting private grants, but while that could help with start-up funds, the key is to find something that is sustainable over the years.

One funding source that Kennedy says should be on the table is related to the state’s income tax base. Kennedy explains the state’s taxable income base is anchored to the federal base, which was broadened under the tax law passed in December. According to the Denver Post, the base expanded due to the elimination of deductions and will bring in from $196 million to $346 million in state revenue.

However, Kennedy notes, GOP lawmakers want that money to go toward transportation.

This leaves the state with essentially one option, a per-member, per-month assessment on insurance plans, to collect a large portion of the funding. And because the state cannot tax self-insured employer-sponsored coverage, the fee would likely fall on fully insured group plans, individual plans, and stop-loss coverage.

According to Milliman, for the 25 percent claims impact, that fee would have to be set at $7.98 per-member, per month. And, Kennedy acknowledges, because Milliman conducted the report prior to enactment of the legislation repealing the individual mandate, that number could go up.

While insurers are supportive of the reinsurance proposal, they are less pleased with the price-tag. Issuers have argued that slapping a fee on plans basically re-circulates the dollars and does nothing for underlying costs, Baer says. State officials have acknowledged the concerns, but note that getting the program up and running is a good opportunity to help force a direct conversation on cost control.

Kennedy, who has been meeting with a wide range of stakeholders, says he often hears that industry agrees there is a crucial need to save the market, especially in the Western region. But issuers also complain that reinsurance funded by assessments is a cost-shift that fails to tackle the underlying issue.

For that reason, Kennedy says he is exploring some cost-control measures that could be added to the reinsurance bill. Details of those potential policies are being hashed out now, according to Kennedy, who declined to publicly discuss the options.

Other key details for the reinsurance program, including the attachment point and co-pay rate, are also unclear at this point. Kennedy says that once the funding level is clear, lawmakers can work backward to figure out the best design.

Meanwhile, at the federal level, lawmakers continue to work on legislation that would provide funding for reinsurance programs. In exchange for her support of the tax bill, Sen. Susan Collins (R-ME) secured an agreement with Majority Leader Mitch McConnell (R-KY) to back $10.5 billion in reinsurance funding, of which she wants $500 million available for seed money in 2018.

Collins and Senate health committee Chair Lamar Alexander (R-TN) and Patty Murray (D-WA) have said they are continuing to work on marketplace stabilization legislation and want to see it attached to the omnibus bill expected in March. Senate Minority Leader Charles Schumer (NY) said in floor remarks last week that he would like to see market stabilization legislation move along with an expected Feb. 8 continuing resolution.

Collins recently said that House Speaker Paul Ryan (R-WI) and his colleagues are warming to the idea of reinsurance legislation. Others have noted that the concept should carry support from House Republicans considering they all voted for it as part of their repeal-and-replace legislation: In April, the House attached to its repeal bill an amendment from Freedom Caucus members Rep. Gary Palmer (R-AL) and Rep. David Schweikert (R-AZ) that would have allocated $15 billion from that bill’s Patient and State Stability Fund from 2018 to 2026 to create a federal “invisible risk sharing program.”

Kennedy says he would appreciate federal reinsurance funding but is not wildly optimistic that it will come through. He notes he has had some initial conversations with Sen. Michael Bennet’s (D-CO) staff, and hopes to speak with other members of the Colorado delegation who could help push for funding.

Story also posted (behind paywall) at InsideHealthPolicy.com