As Polis takes office, major changes to health-care companies are looming

As Polis takes office, major changes to health-care companies are looming

By Ed Sealover (January 8th, 2019)

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.

Ranked by Number of licensed beds as of Jan. 1, 2018

Rank

Business Name

Number Of Licensed Beds As Of Jan. 1, 2018

1

Presbyterian-St. Luke’s Medical Center

680

2

UCHealth University of Colorado Hospital

673

3

Denver Health

555

View This List

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.”

Read Full Story at Denver Business Journal

First Ten Bills & Speaker KC Becker’s Remarks

The 2019 Legislative Session opened on Friday, January 4th.

Incoming Speaker of the House KC Becker (D-Boulder) delivered her opening day remarks, and we introduced our first ten pieces of legislation. These bill represent some of our top priorities for the session, and I’m honored to have my hospital cost transparency bill introduced as House Bill 19-1001!

Jefferson County politicians named to legislative committees

By Christy Steadman (December 14th, 2018)

The 2019 legislative session begins on Jan. 4, and committee assignments for both the House and Senate for the Democratic and Republican parties have been announced.

Colorado House of Representatives

Along with appointing the chairs, vice chairs and Democratic members of all 11 House committees, Speaker-designate KC Becker, D-Boulder, reorganized various committees. However, the House will have to adopt a House resolution and a House-and-Senate Joint Resolution that authorizes the reorganization of committees at the beginning of the 2019 session.

The re-organized committees are:

The Agriculture, Livestock and Natural Resources Committee will be renamed the Rural Affairs Committee. It will oversee issues important to rural Colorado, such as agriculture, water, rural broadband and rural economic development. Rep.-elect Brianna Titone, D-Arvada, will be a member of this committee.

The Health Insurance and Environment Committee will be renamed the Public Health and Insurance Committee. Titone, as well as Rep.-elect Colin Larson, R-Jefferson County, will also be a member of this committee.

As for committee chairs from Jefferson County, Assistant Majority Leader Rep. Chris Kennedy, D-Lakewood, will preside over the State, Veterans and Military Affairs Committee. Rep.-elect Monica Duran, D-Lakewood, will be a member of this committee.

Kennedy will also serve on the Appropriations Committee.

Read Full Story at goldentranscript.net

Becker Elected to Serve as Speaker of the House

Becker Elected to Serve as Speaker of the House

By Conor Cahill (November 8th, 2018)

(Nov. 8) – Earning the support of her colleagues, KC Becker was designated this afternoon by the House Democratic caucus to become the next Speaker of the House. Speaker-designate Becker served as Majority Leader in the 71st General Assembly, helping shepherd the House through two of the state’s most productive legislative sessions. Beginning her fourth and final two-year term in the House, Becker is set to serve as one of the top four individuals in the Colorado state government.

Becker’s elevation to speaker will become official when the full House votes on Jan. 4, the opening day of the 2019 session.

“In this historic election, Coloradans chose Democratic leadership and inclusiveness over those who would seek to divide us,” said Speaker-designate Becker, D-Boulder. “My colleagues and I are dedicated to expanding opportunity for all, governing responsibly and protecting the Colorado way of life.”

Becker represents House District 13, which includes parts of Boulder County and all of Clear Creek, Gilpin, Grand and Jackson counties. It’s the only House district that spans the Continental Divide and stretches to the Wyoming border.

Prior to her legislative service, Becker served on the Boulder City Council. Becker also served as an attorney/advisor at Department of the Interior, working on environmental and natural resources law.

“We built this majority by meeting voters face to face and listening to their hopes and concerns,” said Speaker-designate Becker. “I’m honored to serve as the next Speaker of the House. We must work together – regardless of party – to problem solve and to turn the hopes of our fellow Coloradans into action.”

The House Democratic caucus, which grew to least 39 Democrats – and with three races too close to call with ballots still being counted the number could expand up to 42 –  elected Rep. Alec Garnett, D-Denver, as Majority Leader. Rep. Garnett was previously the Assistant Majority Leader, and served on the Education, Finance and Business Affairs & Labor Committees.

“We have a lot of work to do on behalf of Coloradans,” said Rep. Alec Garnett. “They sent us here with the clear message that they support the values we ran on, from investing in education, to finding solutions to health care issues, and helping people in every community earn a good life,” said Rep. Alec Garnett.

Rounding out the caucus leadership are:
·        Chris Kennedy, D-Lakewood as Assistant Majority Leader
·        Edie Hooton, D-Boulder as Majority Caucus Chair
·        Dafna Michaelson Jenet, D-Commerce City as Majority Deputy Caucus Chair
·        James Coleman, D-Denver and Jeff Bridges, D-Greenwood Village as Majority Co-Whips

Read full story at cohousedems.com

 

KC Becker Named Next Colorado House Speaker

By Associated Press (November 8th, 2018)

Colorado’s House majority leader, KC Becker, has been elected speaker by fellow Democrats for the 2019 legislative session.

Becker was chosen Thursday during party caucus in which Democrats marked their increased House majority.

The party also flipped Colorado’s Senate in Tuesday’s elections.

Rep. Alec Garnett of Denver will replace Becker as majority leader. Jefferson County Rep. Chris Kennedy was selected assistant majority leader, and Rep. Edie Hooten of Boulder County was named caucus chair.

House Speaker Crisanta Duran was limited after serving four House terms and could not seek re-election.

Read full story at Denver.CBSlocal.com

Colorado House District 23 candidate Q&A

By the Denver Post (October 10th, 2018)

Why are you running for office?
I believe that everyone who works hard and does their fair share should have a fair shot to get ahead and enjoy the Colorado way of life. Though our economy is booming, the rapid growth and high cost of living are making it hard for too many Colorado families to get by. I believe we must do more to make sure our economic growth benefits everybody – not just the folks at the top.

What three policy issues set you apart from your opponent(s)?
I can’t speak to my opponent’s policy positions, but I believe my commitment to LGBTQ rights, reproductive freedom, and fighting climate change are likely contrasting positions. I also believe we need to do more to fund education, transportation, affordable housing, mental health, and other priorities in Colorado. That means we must demonstrate to Colorado voters that we are making responsible decisions with their tax dollars and ask them to consider raising their own taxes to fund these key priorities. We can’t cut our way to prosperity.

What are the biggest areas of agreement between you and your opponent(s)?
The one time I’ve heard my opponent speak, she praised some of Jeffco’s nonprofits for the important work they’re doing in our community. I couldn’t agree more. The partnerships between government and the nonprofit world are critical to providing the services that so many Coloradans depend on.

Where would you like to see Colorado’s transportation system in two decades, and what’s the best way to get there? What’s your position on the competing state transportation initiatives?
While we need to do more to repair and expand our roads and bridges, we must also recognize that increasing transit options and bike paths are important parts of the whole. I strongly support Proposition 110, which increased our sales tax by 0.62% to fund infrastructure investments. I strongly oppose Proposition 109, which essentially forces the legislature to make deep cuts in education and health care in order to fund transportation.

What role, if any, should the state legislature play in managing the impact of growth along the Front Range and ensuring that rural areas share in the benefits?
Growth is the number one concern I hear about when I’m knocking on doors. While we may not be able to control growth, we can certainly stop incentivizing it by trying to attract big companies to relocate here. We must figure out how to make growth pay its own way so that it doesn’t put so much strain on our roads, neighborhoods, and available housing.

Colorado’s health insurance exchange and Medicaid expansion have given hundreds of thousands more residents coverage, but health care remains a top concern in state polls. Affordability and access are particularly challenging in remote areas. Where should the state go on this issue, and what will you do to get us there?
The Affordable Care Act did a lot to expand access so that more people could get health insurance, but by building on top of a broken system, little was done to control costs. We must push further on ideas like cost transparency for hospitals and pharmaceuticals while taking steps away from the fee-for-service system and moving closer to a value-based payment system. We must also work on insurance reforms that will allow everyone in the state to access insurance with reasonable premiums and deductibles. To do that, we need to explore either a reinsurance program, and public option, or both.


Joan Poston has not returned the questionnaire.

Read the full story at DenverPost.com

Opioid education day focuses on solutions to crisis

Opioid education day focuses on solutions to crisis

By Natalie Ianniciello (October 9th, 2018)

The Physical Therapy Program in the University of Colorado School of Medicine recently held an educational day titled, “Pain & Healthcare in Society: Changing Attitudes, Behaviors and Health Systems to Address the Opioid Crisis.” The event drew 250 students, alumni and community members from various disciplines.

The event was focused on improving pain management through a better knowledge of systems-level barriers to achieving effective collaboration, a deeper understanding of pain management across health care disciplines and examples of innovative approaches to pain management and collaboration.

“The scope of the opioid crisis and the challenges of caring for people with pain are sometimes overwhelming,” noted Andrew Kittleson, PT, DPT, PhD, core faculty, Physical Therapy Program. “This event showcased so many brilliant and compassionate people — both nationally and right here in our community — who are working to make a difference.”

CU welcomed speakers from other areas of the University, including Venu Akuthota, MD, chair of the Department of Physical Medicine & RehabilitationParticipants from other institutions included Colorado Rep. Chris Kennedy (D-Denver) and national thought leaders Anthony Delitto, PT, PhD, FAPTA, dean of rehabilitation science, the University of Pittsburgh; Alice Bell, PT, DPT, of the American Physical Therapy Association; and Robert Saper, MD, MPH, from Boston University.; Rob Valuck, PhD, of  the Skaggs School of Pharmacy and Pharmaceutical Sciences; and Daniel Goldberg, JD, PhD, of the Center for Bioethics and Humanities. Participants from other institutions included Colorado Rep. Chris Kennedy (D-Denver) and national thought leaders Anthony Delitto, PT, PhD, FAPTA, dean of rehabilitation science, the University of Pittsburgh; Alice Bell, PT, DPT, of the American Physical Therapy Association; and Robert Saper, MD, MPH, from Boston University.

Areas of discussion were focused on the history and scope of the opioid crisis, barriers and opportunities for inter-professional collaboration and examples of innovative solutions and ideas for managing pain holistically, equitably and effectively.

Not just a day of presentations, a core group of professionals met following the event to brainstorm action items for the Physical Therapy Program, UCHealth and the CU Anschutz campus community.

Event sponsors were RehabVisions, Aegis Therapies and New Health.

Read Full Story at cuanschutztoday.org

Gubernatorial candidate Jared Polis unveils plan to lower health care costs

Gubernatorial candidate Jared Polis unveils plan to lower health care costs

By Eli Pace (September 17th, 2018)Saying it could save Coloradans up to 40 percent or more on their health care costs, gubernatorial candidate Jared Polis rolled out a 100-day, multi-point roadmap Monday in Frisco to reform the state’s health care system.

Winning the democratic primary in June, the congressman from Boulder is set to face Republican Walker Stapleton in the November election. While many in the GOP believe surging state and national economies will rank high on voters’ minds at the ballot box, Colorado Democrats are appealing to people with promises of lowering the cost health care and framing it as an economic issue.

“You know, health care is an important issue because it’s a big part of our economy and it’s a big cost factor that affects Colorado families,” Polis said before his running mate, Dianne Primavera, added that the Medicaid expansion brought roughly 20,000 new jobs to Colorado alone.

Polis decided to roll out his plan at the Ebert Family Clinic in Frisco, he said, because of Summit County’s unique position as a superbly healthy community that pays too much for health care.

By almost every measure, Summit is one of the healthiest places in the U.S. The county has earned a No. 1 nationwide ranking for life expectancy, has one of the lowest cancer mortality rates and stands as one of the leanest counties in the country’s fittest state.

Despite all that, Summit still has some of the highest health care costs in the U.S. with locals often paying three to five times what they would for the same care on the Front Range. Those costs are frequently passed onto consumers in the form of higher health insurance premiums here, too.

Read Full Story at SummitDaily.com

Hickenlooper signs health care bills at Lutheran

Hickenlooper signs health care bills at Lutheran

By Clarke Reader (May 23rd, 2018)

Gov. John Hickenlooper stopped by Wheat Ridge’s Lutheran Medical Center on May 21 to sign into law three bills that aim to fight the opioid crises facing the state and those in need of mental health services.

“The opioid crises isn’t an urban or suburban issue — it’s grown into an epidemic all over the state,” Hickenlooper told the crowd of supporters, hospital staff and bill sponsors in attendance. “This has been an amazing legislative session, and this package off bills is as important as anything that was accomplished.”

SB 270 – Behavioral Health Transition Referral Program

Sponsored by Sens. Cheri Jahn (I-Lakewood) and Tim Neville (R-Jefferson County), and Reps. Brittany Pettersen (D-Lakewood) and Cole Wist (R-Arapahoe County).

The bill establishes a community transition specialist program in the office of behavioral health in the department of human services. The program coordinates referrals of high-risk individuals to transition specialists by behavioral health programs and organizations.

“This bill will impact my life and the life of many others,” said Evan Silverman, who has struggled with mental health issues for years. “This will put many, many people on a path to a better life trajectory.”

SB 077 – Clinical Practice for Opioid Prescribing

Sponsored by Sens. Jack Tate (R-Centennial) and Irene Aguilar (D-Denver), and Reps. Brittany Pettersen (D-Lakewood) and Chris Kennedy (D-Lakewood).

The bill restricts the number of opioid pills that a health care practitioner, including physicians, physician assistants, advanced practice nurses, dentists, optometrists, podiatrists, and veterinarians, may prescribe for an initial prescription to a seven-day supply and allows each health care practitioner to exercise discretion to include a second fill for a seven-day supply.

“My mother’s story of opioid addiction recovery began in this hospital, where I saw how broken the system to help those suffering from addiction is,” Pettersen said. Her mother has been dealing with addiction issues for years. “I know this is some of the most important work I’ll do in my life.”

HB 1003 – Opioid Misuse Prevention

Sponsored by Cheri Jahn (I-Lakewood) and Kevin Priola (R-Adams County) and Rep. Brittany Pettersen (D-Lakewood).

In 2017, the state legislature created the Opioid and Other Substance Use Disorders Interim Study Committee. The committee met throughout the summer and fall of 2017 and recommended a package of substance use disorder-related bills that were introduced during the 2018 legislative session. This bill would extend the committee’s charge through 2020.

“Anyone who has had firsthand experience with opioid addiction knows that it can happen out of nowhere. It is impossible to predict,” Hickenlooper said. “I’m not saying we’re done, but this is a great first step.”

Read Full Story at LakewoodSentinel.com

Opioids Package Signed by Guv

(May 22nd, 2018)

DENVER, Colorado, May 21 The Colorado House Democrats issued the following news on behalf of Colorado State Rep. Brittany Pettersen, (D-Lakewood):

Gov. John Hickenlooper went to Lutheran Medical Center in Wheat Ridge today to sign five bills to tackle opioid abuse, which has become the leading cause of death for Americans under the age of 50.

“The war on opioids will not be won overnight, but today we gain some ground,” said Rep. Brittany Pettersen, D-Lakewood, who has spearheaded legislative efforts to combat an epidemic that has killed more Americans than the entire Vietnam War.

The bills signed into law today are:

* SB18-022, sponsored in the House by Reps. Pettersen and Chris Kennedy, D-Lakewood, limiting many opioid prescriptions to a seven-day supply and mandating that medical professionals check the Prescription Drug Monitoring Program database before writing refills.

* SB18-024, sponsored in the House by Reps. Jonathan Singer, D-Longmont, and Pettersen, expanding the Colorado Health Service Corps program, which includes loan repayment and scholarship programs for medical professionals who commit to working in underserved areas where substance abuse is more likely to go untreated.

* SB18-270, sponsored in the House by Reps. Pettersen and Cole Wist, R-Centennial, coordinating referrals of high-risk individuals with significant mental health or substance use disorders to transition specialists who can provide housing services, program placement and access to other behavioral health treatment or benefits.

* HB18-1007, by Reps. Kennedy and Singer, requiring insurance companies and Medicaid to provide faster approval of medication-assisted treatment so patients with substance use disorders don’t go back to opioids while waiting for approval to begin their treatment.

* HB18-1003, by Rep. Pettersen, commissioning further study of the substance use disorder problem in Colorado.

Read Full Story at PharmacyChoice.com

Coverage of Reinsurance

Marching On

By Julie McCluskie (May 28th, 2018)

This year in Colorado, activism surged.  Thousands of men, women and children marched for a variety of causes: women’s rights, climate action, public education and school safety.  This level of  engagement has  inspired many of us.  However, with every march comes the question, “Now what?”

How do we capture this passionate energy and transform it into meaningful action at the local, state and national levels?

Here’s how: we elect candidates to Colorado’s state legislature, like myself, who are responsive to the people in their communities and ready to work collaboratively across party lines to solve the problems we face.

Problems like our shortfall in funding public education. Thanks in large part to the leadership of our own Rep. Millie Hamner, school districts across the state will receive more funding for educating students than ever before. I testified for two bills that passed both chambers and now await the Governor’s signature. Both will address our teacher shortages by helping rural communities attract and retain teachers by investing in high-quality teacher preparation and residency programs. While we have not resolved the deeper challenges that keep us from long term equitable and adequate funding for public education, our legislature took steps in the right direction.

Unfortunately, there were also examples where hard-working legislators ran headfirst into unnecessarily divisive partisan politics.  Rep. Chris Kennedy (D-Lakewood) and Rep. Bob Rankin (R-Carbondale) carried a reinsurance bill that would have reduced insurance rates for many in our rural communities by as much as 30 percent. Healthcare costs in our part of Colorado are some of the highest in the nation and create a weighty burden for our local working families. Reinsurance, essentially insurance for insurance companies, has been successful in several other states and is a promising solution to Colorado’s high-cost insurance marketplace.

There was also the tragic failure of Rep. Alec Garnett’s (D-Denver) and Rep. Cole Wist (R-Centennial) bipartisan Red Flag Law. This law was a sensible gun safety measure that would have protected our communities from people experiencing major mental health issues. An impressive number of law enforcement representatives and community leaders stood in support of this bill. I believe this measure was a responsible and prudent step toward protecting our communities from future gun violence.  

I believe these bills laid out real, workable solutions on challenges facing our state. I’m disappointed that both were defeated in committee before Coloradans had their chance to give their full input on the bills.

I was a member of the Women’s March in Denver in 2017 and joined this year’s Women’s Marches in Gunnison and Crested Butte. While marching and talking with members of these communities, I heard many folks applaud the work of Rep. Millie Hamner. However, it is clear there is more work to be done. Please help me pick up the torch and continue the march to the State Capitol for good, honest and responsive representation. I’m working hard at getting to know the people and the issues across the five counties of this District, and I hope to earn your vote this November.

Read Full Story at AspenDailyNews.com

Proposed fee to stabilize Colorado’s individual health-insurance market dies in the Senate

By Ed Sealover (May 06th 2018)

The idea of launching a reinsurance program to save Colorado’s flailing individual health-insurance market was big and it was bold. But in the end, it wasn’t bipartisan enough.

Republicans on the Senate State, Veterans and Military Affairs Committee on Friday killed House Bill 1392 3-2 on a party-line vote. That decision came after its Republican Senate co-sponsor, Don Coram of Montrose, looked at his colleagues on the committee and acknowledged that he didn’t know exactly what the answer was to bring down skyrocketing premiums in his part of the state but that he had to try something like this.

Under a reinsurance program like those that have been implemented in Alaska and Minnesota, the state would place a 2 percent fee on all large-group, small-group and individual plans offered by private insurers and use that to generate a money to insure the insurers who face the highest costs in the individual market. Those insurers could submit to the state claims between $25,000 and $1 million and ask for them to be covered by this new pool of revenue — a cushion that would allow individual-market insurers to bring down premiums statewide by an average of 16 percent but bring them down even more in extremely high-cost areas of the state like the mountain towns and the Western Slope, said co-sponsoring Rep. Chris Kennedy, D-Lakewood.

Kennedy and co-sponsoring Rep. Bob Rankin, R-Carbondale, also set the program up to end after five years, so the state could determine whether it had achieved its purpose.

“It’s a 2 percent tax on a broad spectrum of insurance providers with a 35 percent decrease for people in this spiked-up pool in western Colorado,” Rankin told the House during debate on the measure on April 27th. “This is a necessary step if rural Colorado is to survive and not have people leaving there.”

Read Full Story at DenverBusinessJournal.com

Reinsurance program can stabilize health insurance costs

By Tom Jankovsky (April 29th 2018)

Garfield County residents and Coloradoans across the state are struggling with ever-increasing health insurance costs, which have reached exorbitant levels on the individual market, and are getting worse every year.

According to the Colorado Division of Insurance, the issue is being felt regardless of zip code, with three years of annualized premium increases in excess of 20 percent (and even higher in rural and mountain communities). This means the average cumulative premium increase in the individual market was approximately 72 percent over the past three years. This has a staggering effect on our residents.

The failure to find a solution is hurting many Colorado citizens, and particularly small business owners, mom-and-pop operations, nonprofits, and individuals working in the trades, who don’t qualify for group plans. Critical and immediate action is needed to secure stabilization in the individual market.

State lawmakers have a solution before them this session in HB 18-1392, the Individual Health Insurance Market Stabilization Act, which is co-sponsored by Colorado state Reps. Bob Rankin, R-Carbondale, and Rep. Chris Kennedy, D-Lakewood. This bipartisan bill creates a high-cost reinsurance program that buffers insurance companies against risk for unusually expensive claims, such as transplants and cancer care. It spreads the risks to avoid destabilization of the market, and incentivizes insurers to offer coverage in currently underserved areas.

Read Full Story at GJSentinel.com

Is reinsurance the antidote for high insurance premiums in Aspen, other mountain communities?

By Rick Carroll (April 28th 2018)

Pitkin County can lay claim to a bevy of bragging rights when it comes to quality of life, but not when it comes to the cost of health insurance premiums.

Along with other rural mountain communities, including Eagle, Garfield and Summit counties, customers on the individual market have seen their annualized premiums skyrocket by some 72 percent over the past three years, according to the state’s insurance division.

There might be help on the way, however, and it will boil down to what state lawmakers decide during the current legislative session.

House Bill 1392, the Individual Health Insurance Market Stabilization Act, aims to stabilize health plans on the individual market — those buyers who don’t get insurance through their employer or relatives, and don’t have Medicare or Medicaid. Many of those individuals who have been hurt in the wallet are those who weren’t eligible for federal tax credits under the Affordable Care Act.

In 2015 in Pitkin County, 3,020 residents, or 16.9 percent, were uninsured; 7,583 individuals, or 42.5 percent, had employer-sponsored insurance; and 3,361, or 18.9 percent, had individually purchased insurance, according to the Colorado Health Institute.

Another 1,629 residents, or 9.1 percent, were Medicaid enrollees and 139 individuals, or 0.8 percent, were enrolled in Child Health Plan Plus.

The reinsurance bill is hardly perfect, said Pitkin County Commissioner Rachel Richards. Still, she strongly supports it.

“It really would make a difference to people when the rates for 2019 go out in the fall,” said Richards, who testified about the bill April 19 before the state’s health education committee.

The bill’s goal is to lower premium increases on the individual market by 20 percent in 2019.

Read Full Story at AspenTimes.com

Colorado takes steps to shore up markets and protect consumers

By Bethany Pray (April 26th 2018)

Since the passage of the Affordable Care Act (ACA) eight years ago, Colorado has jumped on opportunities to improve health care access for its residents, expanding Medicaid coverage and creating a state-based health insurance exchange where Coloradans can take advantage of federal subsidies that help pay for the cost of coverage.

With the feds now in the process of undercutting the ACA, Colorado has an opportunity – through House Bill 1392, the Individual Health Insurance Market Stabilization Act – to use reinsurance to stabilize a market that the feds have knocked off-balance, and simultaneously to make premium prices more equitable for rural Coloradans. While Coloradans who qualify for subsidies can purchase more affordable coverage, those with incomes over 400 percent of the federal poverty level pay full price. Fortunately, HB 1392 and the reinsurance system could provide some relief from rising premiums.

Reinsurance works like this: a fund is created that helps cover costs for the most expensive enrollees in individual and small-group plans. Because insurance carriers know they’ll have help covering the highest cost enrollees and will bear less risk, they can set premium prices lower for everyone. Those lower premiums make coverage more attractive to the healthy individuals who might otherwise skip having coverage – a problem worsened since the federal government gutted the “individual mandate” that required us to get covered.  Bringing more healthy individuals into the risk pool helps further reduce the costs of insurance. Reinsurance programs are underway in three states, and the first to implement the plan – Alaska – has had significant success. In Alaska in 2017, projected premium rate increases of 42 percent were instead held to just 7.3 percent.

The special twist in HB 1392 is that reinsurance funds will be dispersed in such a way that premiums can be lowered most dramatically in high-cost areas, especially the Eastern Plains, Western Slope and the mountain corridor. We heard testimony in the House Health, Insurance and Environment committee recently about costs that exceeded 20 percent of one middle-class family’s income, or a whopping $25,000 for an individual’s policy, combining premium payments and deductibles. Families and businesses in rural Colorado can’t thrive unless residents above the income cut-off for subsidies have access to health care — whether that’s to provide prenatal care, treat a broken wrist or get access to necessary medications.

Rep. Chris Kennedy and Colorado’s Division of Insurance, under Acting Commissioner Michael Conway, have engaged closely with stakeholders over the past year. Much of that work involved developing a mechanism to create the reinsurance fund, which would combine new fees on individual, group and stop-loss policies, along with a re-purposed portion of the federal funds Coloradans receive through the premium tax credit program.

This is a solid plan that deserves strong support. At the same time, we need to continue efforts to identify providers, facilities and procedures that contribute to the outsize costs that inflate premiums, and to develop mechanisms to rein in outliers and ensure quality, affordable care. Costs matter. But we simply can’t afford to leave Coloradans in those areas out in the cold. Adopting a reinsurance plan now is the right choice.

Read Full Story at Colorado Center on Law & Policy

Bill aims to lower health care rates

By Charles Ashby (April 28th 2018)

DENVER — One way to lower health care costs in areas of the state that are seeing double-digit increases in premiums is to get insurance companies to pool people together under the same health care plans.

But to get insurance companies to do that hasn’t been an easy task because of the high cost of doing so, lawmakers say.

That’s why Rep. Bob Rankin, R-Carbondale, and Chris Kennedy, D-Lakewood, got preliminary approval in the Colorado House on Friday to provide insurance for insurance companies, a practice called reinsurance.

Such a program allows insurance companies that buy reinsurance coverage to make claims for high costs just like patients do.

“When it comes to payment reform ideas and trying to address what I see as an irrational subdivision of our insurance market into these little subgroups,” Kennedy said. “What we really need is the broadest pool possible to share the risk. That’s what insurance is all about. This is the single best thing that we can do to stabilize the health care markets.”

But it drew opposition partly because the measure, HB1392, calls on the Colorado Division of Insurance to assess a 2 percent fee on all premiums statewide to fund the reinsurance program, which would be about $360 million, half of which would be federal money.

“This is once again feeding a monster without any accountability,” said Rep. Susan Beckman, R-Littleton. “Until we get some transparency in the system, move it to more of a free market, we’re going to be taking a group of people to fund other groups.”

Others didn’t like the bill because it attempts to repair errors created by the federal Affordable Care Act, also known as Obamacare.

Rep. Dan Thurlow, R-Grand Junction, said he just can’t see how the measure would help.

“I would love to say … here’s a magical formula that we’re going to lower your rates,” Thurlow said. “I’m sorry, but I just don’t believe it. We can’t just magically say let’s take two percent from all the other (insurance) plans … and say now we’re going to put that two percent into the other market, and that it’s not going to create higher … rates. I think we’re kidding ourselves.”

The measure somewhat replaces an idea that Rankin and Rep. Millie Hamner, D-Frisco, have supported, and that’s to make the entire state its own geographic rating area when it comes to determining premiums, instead of the current nine.

But that effort died because it would lead to higher insurance rates in the more populated areas of the state, such as the Front Range.

The bill requires a final House vote before heading to the Senate, where Sen. Don Coram, R-Montrose, and Kerry Donovan, D-Vail, will try to get it to the governor’s desk.

Read Full Story at GJSentinel.com

Legislature considers raising fees on employer health plans to stabilize individual market

By Ed Sealover (April 20th, 2018)

Colorado’s individual health-insurance market is failing, with average premiums rising 20 percent in 2017 and another 27 percent this year.

As such, a bill moving through the Colorado Legislature asks this question: Is it fair to ask some 2 million people in this state to pay between 2 and 8 percent more for their insurance premiums next year in order to stabilize the individual market for roughly 140,000 people who face the prospect of even more skyrocketing costs without some kind of help?

The proposal, from Democratic Rep. Chris Kennedy of Lakewood and Republican Rep. Bob Rankin of Carbondale, would establish a reinsurance program that, in many ways, offers insurance to health insurers who have taken the sickest and most expensive patients into individual plans since the Affordable Care Act required all Americans to buy policies in 2014 and banned insurers from rejecting customers because of pre-existing conditions.

Reinsurance allows insurers to turn over to the state their highest claims once they exceed a certain cost, such as $25,000, and to have the state cover those bills until the claims reach $1 million. Doing so would reduce insurers’ risks and allow companies to bring down the overall costs of premiums between 10 and 25 percent as compared to what they otherwise would charge in 2019, Kennedy and interim Colorado Insurance Commissioner Michael Conway said.

Read Full Story at DenverBusinessJournal.com