The Colorado legislature recently introduced House Bill 20-1349, a bill which will create a public insurance option for the state. As the legislature deliberates on this bill, CAFP supports its tenets, as it enhances primary care and expands healthcare access for Colorado families.
Too many Coloradans are struggling to afford the healthcare they need. Families across the state cannot afford the rising cost of insurance or pay thousands of dollars a year for insurance they can’t use because of high deductibles and co-pays.
During the early discussion of this bill, CAFP sought provisions that would bolster family medicine and expand access to care for patients. Specifically, we wanted to see this bill:
- Emphasize more investment in primary care;
- Offer lower premiums and patient cost-sharing;
- Cover pre-deductible primary care; and
- Preserve family physician reimbursements.
The bill does all of these things.
Why Support the Option?
CAFP supports this bill because it safeguards patient health. Family Physicians are advocates for their patients, and HB20-1349 keeps Family Physicians centered as the lynchpin of patient and community health.
Moreover, affordable health insurance is a top concern of patients – high costs often prevent patients from getting the care they need. HB20-1349 is expected to expand insurance to 18,100 Coloradans. 22 counties in Colorado only have one option for insurance, which places them at a disadvantage when rates rise. This bill will provide new options for gaining insurance.
As a public-private partnership, this bill will expand access and lower costs. Furthermore, it will lower premiums for the affected patients, cover primary care pre-deductible, and keep family physician reimbursements at negotiated rates through the commercial market.
In addition, HB20-1349 will save on costs. The bill is estimated to reduce individual market insurance premiums by an average of 12%, ranging between 7.1% and 19.8%, depending on geography. The bill will also include the Essential Health Benefits and would cover pre-deductible primary care and behavioral health care.
Physician reimbursements would not be set by the state and would be subject to negotiation as they are today in the commercial market.
HB20-1349 also requires insurers to offer the public option. 22 counties in Colorado have only one insurer, so the Commissioner of Insurance is going to be empowered to require additional insurers to offer the option in those counties after considerations such as structure (e.g. whether it is an HMO like Kaiser, where the insurer is contracted with a single medical group), and whether the insurer already offers other insurance products in that county such as through the small or large group market.
Lastly, the Commissioner of Insurance would have authority to implement the option, with an Advisory Board comprised of 9 voting members and 8 non-voting members. A vote of 7 Board members could override a decision of the Commissioner. The members are appointed by the Governor, as well as by the majority and minority parties in the legislature.
Objections to the bill
The biggest objection to the public option bill has come from hospital associations. CAFP believes that hospitals are an important asset to our communities across the state and need to be included as a part of any sort of state public option discussion. We do think cost saving needs to be an ongoing and continuous discussion for all parties involved. However, in this case, the bill provides exemptions and appeals processes for hospitals that can demonstrate that taking the option would jeopardize their operations.
Our primary concern is for community and patient health in Colorado, and the vital role Family Physicians play in safeguarding that health.
While we recognize this bill is not perfect, it is a step in the right direction. As the bold champion for Colorado’s Family Physicians, patients, and communities, CAFP strongly supports HB20-1349 and hopes to see it enacted into law.