Weekly Policy Watch: Colorado Braces for April

“You do your worst —and we will do our best.”

That was Winston Churchill’s message from the people of London to Germany in the bleak early days of World War II. It rings true today for Coloradans and people around the world preparing for the worst of the COVID-19 pandemic.

April will be a decisive month in the course of the outbreak. President Trump is predicting a painful two weeks ahead and a national death toll between 100,000 and 240,000. But experts have criticized the White House forecast of an April peak as too optimistic.

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Colorado is locked down and preparing for the weeks and months ahead. The state’s policy response in the past week accelerated in several areas. Here’s a quick look at three topics: the governor’s team, telehealth, and the state’s political dispute with hospitals.

Mobilizing Government and Business

Gov. Jared Polis has assembled a team from his administration and the private sector to work on multiple aspects of the crisis. On March 22, Polis launched the Innovation Response Team, led by Matt Blumberg, a tech entrepreneur who founded Return Path, a Broomfield-based email company. (CHI is serving on the team.)

The team mobilized quickly around three workstreams: The New Normal, Mass Testing and Isolation, and Constrained Critical Supply, such as ventilators and personal protective equipment for medical workers. A private sector task force is working on telemedicine, manufacturing, isolation of people who might be infected, and software engineering.

Polis put Noel Ginsberg in charge of procuring medical supplies. Ginsburg is CEO of Intertech Plastics and a former Polis opponent in the governor’s race. Colorado companies are making hand sanitizer and face shields, and a shipment of hospital-grade masks, gloves, and gowns is on its way to Colorado from Asia. Procuring ventilators is the biggest challenge, Ginsburg said Friday morning at a Denver Metro Chamber of Commerce morning.

Polis also has created the Governor’s Economic Stabilization and Growth Council, led by Federico Peña, a former Denver mayor and U.S. secretary of transportation.

Other key players on Polis’ innovation team are:

• Sarah Tuneberg, a public health emergency response expert and CEO of Geospiza, which develops disaster response software.
• Dr. Jay Want, who has held several roles in Colorado health policy and now leads the Petersen Center on Healthcare in New York.

Telehealth’s Moment Arrives

Telehealth has been “the next big thing” for the better part of the past decade. But it has never become the current big thing — until now.

With much of the population staying in their homes, telehealth — the term for various technologies that allow patients and doctors to connect online — is often the only option for care. The state Division of Insurance (DOI) is moving to adopt emergency rules that waive roadblocks that have stood in the way of a wider adoption of telehealth, such as privacy rules that make it difficult to use common video chat programs. The DOI’s action follows federal guidance on March 17 that allows medical providers to talk to their patients on programs like Skype, Zoom for Healthcare, or GoToMeeting.

The long-term question will be whether telehealth will return to purgatory after the crisis passes, or whether it’s here to stay.

A Truce With Hospitals?

The DOI is backing off its push for affordability standards in health insurance. The division announced March 30 that it was terminating its rulemaking for House Bill 19-1233, which gave the agency the power to require health insurance to be affordable for consumers and to promote primary care.

The DOI had started making rules about insurance companies’ role in supporting primary care. It canceled that effort this week to allow providers and insurance carriers to focus on COVID-19.

A second phase of rulemaking for the same bill had not yet begun when the first phase was canceled. In the second phase, the DOI was planning to introduce rules that would have allowed the insurance commissioner to oversee negotiations between insurers and hospitals to make sure hospitals weren’t charging too much. In effect, this plan would have given the DOI a roundabout way to regulate hospital prices. Hospitals, obviously, had been strongly opposed. But the rulemaking had not formally begun, and it’s unlikely to launch anytime soon.

The cancellation calls into question another idea that hospitals have fought hard against — the state option for health coverage. House Bill 1349 calls for insurers to offer plans that pay a reduced price to hospitals and pass the savings on to consumers. The legislature is on pause during the COVID-19 outbreak, and the prospects for this bill will be dim when legislators return.

Legislators and the Polis administration have targeted hospitals for the high profits that many of them earn. But the pandemic might consume most of those profits. The Colorado Hospital Association is forecasting a $1.4 billion revenue loss for Colorado hospitals because elective procedures have been canceled during the COVID-19 crisis.

Sponsors have not made any announcements about legislation. But from the vantage point of early April, it appears that Colorado’s effort to control health care costs is on hold — like so much else in our lives.

What We’re Reading

How Can Medicaid Enhance State Capacity to Respond to COVID-19? Kaiser Family Foundation.

This issue brief is chock full of ideas on how states and the federal government can use existing structures in Medicaid to help people with urgent health needs during a time of economic distress.

As virus takes hold, resistance to stay-at-home orders remains widespread — exposing political and social rifts. Washington Post.

The pandemic response has taken on partisan dimensions. That’s dangerous, because no city or state can isolate itself. Ultimately, our COVID-19 response will be as strong as our weakest link.

Mental health care in Colorado has gone virtual thanks to coronavirus. For some patients, it’s long overdue. The Colorado Sun.

The Sun explores the challenges and benefits of providing mental health care online and looks at changes that may stick long after the pandemic is over.

What’s Giving Us Hope

The Colorado Symphony can’t meet in a concert hall, so they performed “Ode to Joy" in their living rooms. It’s a three-minute gift to our collective mental health.