Will Health Care Policy Tilt To The Left Under Colorado’s Democratic Trifecta?

January 17, 2019
Photo: State Capitol Dome 1 HV 20190102

Colorado’s new legislative session is underway, with Democrats in charge of both chambers and the governor’s office. Blue control might be a game changer for health care legislation. Before, it was a stalemate. Democrats controlled the House and blocked Republican bills. The GOP controlled the Senate and blocked Democratic bills.

Nonpartisan nonprofit Colorado Health Institute tracked about 80 Democratic-proposed health bills that died in a Senate committee in recent sessions. But now, CHI spokesman Joe Hanel said, “you have one party that controls the levers of power, so they’ll be able to do a lot more than they had in the past four years.”

If the majority party just dusted off those earlier bills and ran them again, that’s a big agenda already, Hanel said. Unlike before, Democrats can now propose and pass their own health care agenda. They’ll offer an ambitious slate of proposals on a variety of things, from costs to insurance to opioids to e-cigarettes to mental health.

“This is a progressive group of Democrats, led by a very progressive governor with Jared Polis,” he said. “You saw a lot of voters come out and vote for them, and I think Democrats do feel like they have a mandate to do big, transformational things.”

A New Office With A Unique, Lengthy Name

In Gov. Polis’ first State of the State address, he said high health costs were “ripping off” Colorado families. In response, he announced the Office of Saving People Money on Health Care, a name that earned some applause in the House chamber.

“Now, we don’t want to give this office a bureaucratic or fancy name to make it sound important,” Polis said. “We want to give it a simple name because it is important.”

The new office aims to reduce patient costs for hospital stays and expenses, improve price transparency, and make health insurance more affordable.

Democrats want to reduce high prescription drug costs, possibly by importing medication from Canada. Another problem, sky high insurance costs in mountain communities, might be solved by the creation of a reinsurance market, basically insurance for insurance companies to bring costs down and help pay for the most expensive patients.

Highlighting Hospital Costs

Democrat Rep. Chris Kennedy is sponsoring a bill to require hospitals to turn over more financial data to the state.

“We have hospitals that in some cases operate monopoly power,” he said. “So they’ve been able to basically charge whatever they want and then they’ve been reinvesting those dollars into capital construction projects rather than passing those savings on to consumers.”

Hospitals disagree, and say there are a lot of reasons health costs are so high, many beyond their control. Those include Colorado’s high cost of living and high insurance costs. Republicans see it as government overreach and stopped similar bills in prior years.

Exploring A Public Option

A headliner issue is the public option, a term often heard in early debates over national health reform. This idea would allow residents to buy into the state’s Medicaid plan, at first as part of a pilot program in the mostly rural and mountain communities where residents may have just one insurer.

New House speaker KC Becker said the concept promises to add competition, drive down costs and make health care more accessible. Things aren’t working now “and we have to have changes,” Becker said. “And I support my members introducing ideas that are robust and new and challenging the status quo.”

Colorado would need the federal government to sign off to create a public option statewide if it passed. However, it could set up a pilot program on its own.

Tackling Tobacco, Teen Vaping And Opioids

Among 37 states surveyed by the Centers for Disease Control and Prevention, Colorado leads the nation in e-cigarette use among teens. Lawmakers have heard from concerned parents, educators and doctors about it. Democrats have proposed one bill to update the indoor air law to ban the use of e-cigarettes in public spaces and workplaces. Another would allow local communities to regulate the retail sale of all tobacco and nicotine products, including e-cigarettes.

Democrats also want to fight the opioid crisis on a variety of fronts. The new Senate president, Sen. Leroy Garcia, is looking to beef up a program to provide medical treatment to southern Coloradans fighting opioid addiction. It would send $10 million over two years to a program administered by the University of Colorado College of Nursing, to expand access to medication-assisted treatment to patients in Pueblo and Routt counties.

Where Does The Money Come From?

The biggest constraint on some of these Democratic ideas is money. Big proposals often need big money, and that could be the tallest hurdle. Gov. Polis’ full-day kindergarten priority has an estimated price tag of $227 million a year. His proposed budget is $33.7 billion and Republican lawmakers still want to see investments in schools and the state’s roads and bridges.

Colorado’s economy is still rolling and generating jobs and tax money, so the state’s budget looks to be in decent shape. But it’s an open question whether there will be enough money to achieve top Democratic priorities, including those on the health front.