State lawmakers continue to fight over Colorado’s participation in the federal health care law Congress passed last year.
But today Democrats and Republicans came to an uncomfortable compromise about how to move forward.
It has to do with an $18 million federal grant request to help the state implement an important part of the law, as CPR Health Reporter Eric Whitney explains.

CPR Health Reporter Eric Whitney: The federal health law says every state has to set up a so-called “health insurance exchange.” That’s a new kind of marketplace that’s supposed to make health coverage less expensive and easier to shop for.
Many Republicans in the Colorado legislature fought a bill to set up an exchange here. It eventually passed, meaning the state could apply for federal money to help pay for it.
But when it came time to apply for that federal money this fall, Bob Gardner, a Republican representing El Paso and Fremont counties blocked it. He has that power as co-chair of a special committee.

Colorado Rep. Bob Gardner: The first grant proposal took no cognizance of Colorado flexibility and implementation of free market reforms.

Reporter: But Gardner and his committee were under the gun on Thursday. Colorado’s last chance to apply for federal exchange money is the end of this month, and the state couldn’t apply if the panel didn’t give the OK.
Gardner, like a lot of Republicans, actually likes the idea of health insurance exchanges. But Republicans don’t like the way exchanges are included in the federal health law, the Affordable Care Act. Gardner wants the exchanges to be very free market, the Affordable Care Act sees them as places people can use government subsidies to buy government-approved health plans.
So Gardner lobbied to change Colorado’s application for federal help in setting up an exchange, to give the state more flexibility.
That didn’t sit well with Democratic State Sen. Irene Aguilar of Denver.

Colorado Sen. Irene Aguilar:  It looks to me like you took out all reference to federal health care reform.

Reporter: Aguilar sits on the same special committee as Gardner. That committee votes on what kind of exchange Colorado is going to establish, and must approve applications for federal money to do it.

Aguilar: Seems a little ridiculous to be submitting a grant for a federal program that is created under federal health care reform, and in the grant, take out all the components of federal health care reform.

Reporter: To Aguilar, Colorado’s exchange should work hand in glove with all the goals and components of the federal health law. Gardner thinks otherwise, and points out that it’s not yet clear whether those goals and components are even constitutional. The U S Supreme Court is set to hear arguments about that in March.

Gardner: That is an important issue to us, that this grant proposal not presuppose the outcome of that litigation, and any language in this grant proposal as it was drafted that presupposed or even implied a presupposition of that litigation was objectionable to five members of this committee.

Reporter: But just as Republican Representative Gardner doesn’t want to commit the state to setting up an exchange that aligns with White House goals, Democratic Senator Aguilar doesn’t want the state to be stuck with an exchange that gets in the way of White House goals.

Aguilar: Utah actually has an exchange that is consistent with the grant that you’ve written, and it’s utilized very little. And I guess I’m concerned that if we’re creating a Utah exchange, I feel concerned about asking the federal government to give us $19 million for that. 
 
Reporter: In the end, Senator Aguilar held her nose and voted to OK Colorado’s application for federal money to set up a health insurance exchange. Representative Gardner was clearly pleased that he won changes in the application.
But it’s still far from clear how aligned with White House goals Colorado’s exchange will be.  The state still has two years to set it up, and the biggest factor in what it does is how the U S Supreme Court rules. That decision is expected next summer.

[Photo: CPR/Eric Whitney]