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First hearing for hybrid public option in Colorado attracts strong opinions

By Saja Hindi

The Denver Post

The proposal to create a hybrid public insurance option in Colorado garnered vehement opposition from hospital, insurance and business representatives Wednesday evening, with more than 90 people signing up to testify about the bill.

Although sponsors of the bill said they have been working with all stakeholders to make it more palatable, it was clear at the bill’s first public hearing at the House Health and Insurance Committee, with more than 130 in attendance, they hadn’t won over hospital and other industry executives.

A majority of those who spoke by 8 p.m., whether in person or remotely, opposed the bill, although several people who shared stories of high medical costs urged lawmakers to vote in favor it.

The bill would create another option for Coloradans who purchase health insurance on the individual market through private insurance and is estimated to be available to about 8% of Coloradans. Lawmakers say the bill is intended to create competition, particularly in rural counties that may have only one option for health insurance on the individual market, and to lower costs of health care. It sets Medicare reimbursement rates to hospitals for people on the plan, one of the largest points of contention for hospitals. But it also requires participation from insurers and penalizes hospitals that refuse to participate in the plan.

Chris Gessner, president and CEO of UC Health, testified against the bill, saying the bill focuses on cutting costs but not on the quality of health care. He called it punitive and said the hospital reimbursement rates set were disturbing.

“I think the bill is fundamentally flawed,” Gessner told The Denver Post.

Amanda Massey, executive director of the Colorado Association of Health Plans, told committee members that although the industry is committed to making health care more affordable, the “Colorado Affordable Health Care Option” is not the right solution.

“The state government option would raise costs for carriers and our members, reduce vital consumer services and risk destabilizing the market. And carriers (would) make difficult decisions about how they can engage in the Colorado market,” Massey said. “This is not a partnership, and we do not believe it will be effective in achieving goals in the affordability conversation.”

While the majority of hospital representatives similarly spoke against the bill, Denver Health said it was opposed to it in its current form but could see a change in position if the bill were revised to address some of the concerns, including transparency of setting rates and a focus on affordability that isn’t just directed at hospitals.

But proponents of the bill pointed to increasing health care costs and the inability of many Coloradans to afford basic care.

Dr. John Cawley of the Colorado Academy of Family Physicians, asked for support of the bill as a primary care doctor who said the state option “would be just huge for Coloradans.”

Cawley shared the story of a 43-year-old patient, Mary, who is living with diabetes. She had restricted funding for health care costs, so she rationed her visits and treatment. Because she was unable to go to a doctor immediately when she began to notice problems on her foot, she ultimately had to have both her legs amputated.

“(With) early primary care … we can decrease the cost of health care altogether,” he said.

Adela Flores-Brennan, director of the Colorado Consumer Health Initiative, told committee members that when the nonprofit commissioned a study on barriers to health care, they found that 39% of Coloradans polled delayed procedures and about a third avoided going to a doctor or skipped a treatment because of cost.

She said the group supports the bill because it “reduces premium costs for consumers; it creates higher value insurance as an option to consider and standardized benefits that include essential health benefits and pre-deductible services,” among other reasons.

The committee was still taking testimony five hours after the hearing began. A vote is expected Wednesday evening.

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