Western Slope Lawmakers Unite to Address Insurance Prices

We knew when western Colorado health insurance prices skyrocketed this year that the region’s legislators would have something to say about it. This week, they spoke loud and clear.

Prices on the individual market in those western counties are up an average of 25 percent. That’s by far the highest increase of the nine insurance pricing regions in Colorado. (If you missed CHI’s analysis of the regional premium increases, you find it here.)

Several Western Slope lawmakers have been talking about ending the right of insurance companies to charge higher premiums based on where people live. Their bill finally was introduced this week. House Bill 1336 is a bipartisan effort, with sponsorship by Reps. Millie Hamner (D) and Bob Rankin (R) and Sen. Kerry Donovan (D). Rep. Diane Mitsch Bush (D) and Sen. Ellen Roberts (R) are co-sponsors.

That’s a “who’s who” list of Western Slope legislators.

The bill is softer than the version that had been discussed earlier this year. It merely directs the Division of Insurance to study the idea of getting rid of geographical ratings. Still, we expect it to be controversial. The Affordable Care Act limited insurance companies’ ability to discriminate in pricing to three factors: an enrollee’s age, smoking status or geographic area. HB 1336 would take away one of those options.

But it’s the only bill on the table that addresses the issue of high health care prices on the Western Slope — an issue that is reaching crisis level for the area’s residents and businesses.

In Denver, Attorney General Cynthia Coffman made waves this week when her office issued a formal opinion stating that converting the Hospital Provider Fee to an enterprise fund — which would make its revenue exempt from the Taxpayer’s Bill of Rights and prevent taxpayer refunds in the coming years — would be constitutional. It remains to be seen if the opinion from Coffman, a Republican, changes the minds of any Republican leaders, who have been firmly opposed to considering a move. A bill proposing the change is expected from House Democrats this session.

And the debate over Amendment 69, the ColoradoCare initiative, continues to heat up. More than 200 people, mostly medical students, jammed a lecture hall at CU’s Anschutz Medical Campus this week to listen to supporters and opponents discuss the proposal to create the first state-based system of universal health coverage.

A poll at the beginning of the debate found that 59 percent of the audience planned to vote in favor of the initiative. When the same question was asked at the end, favorable votes had risen to about 75 percent. The number of those opposed also increased by the end of the debate, but only by four percentage points. Audiences in other parts of the state, and in older age brackets, have responded less favorably. (Check out this two-minute animated Hospital Provider Fee explainer from CHI’s Joe Hanel.)

We watched a handful of votes in House committees this week:

• The State, Veterans and Military Affairs Committee voted down HB 1146 by a 5-4 margin. The bill sought to define any fetus or infant as “born alive” for abortions as well as natural births. All Republicans were in favor but the Democratic majority was opposed.

• The Finance Committee advanced HB 1079, which proposes to create an official state label for marijuana grown without pesticides, on a 6-5 party-line vote, with Democrats prevailing. It goes next to House Appropriations. The committee was scheduled to consider HB 1142, which would create a new tax credit for preceptors who train students to become primary care providers in rural areas, but the bill was removed from the agenda. It is not clear when it will be heard.

• The Health, Insurance and Environment Committee heard HB 1101, which proposes to allow doctors to make decisions for patients without criminal liability if no family or friends can be found. The bill squeaked through on a 7-6 vote, with Democrats in favor and Republicans opposed.

House Appropriations has a dozen bills on its agenda for today. Among them: HB 1103, which aims to clarify rules about licensing for mental health professionals including social workers, and Senate Bill 90, which would give the state the choice to collect marijuana data at the regional level rather than the county level, as is currently required.

Many bills are up in the House next week as well:

• The first House floor vote for HB 1164, which would move the authority to review student immunization exemption from schools to the Department of Public Health and Environment, is set for Monday (March 7). The bill is likely to die in the Senate if it makes it out of the House.

• The Health, Insurance and Environment Committee is scheduled to conduct the chamber’s first hearing for SB 27, which would allow Medicaid enrollees to receive their prescription drugs by mail. The committee will also consider HB 1203, the “Women’s Health Protection Act” that would require all abortion clinics to be inspected by the attorney general and relicensed each year. HB 1102 is up for a vote several weeks after its initial hearing. It would direct drug manufacturers to submit a report to the Colorado Commission on Affordable Health Care for any drug that costs at least $50,000 per year, and direct the commission in turn to submit recommendations on cost containment to the legislature.

• Public Health Care and Human Services is scheduled to hear four bills of note. SB 94 aims to give rural counties greater flexibility in how they allocate funding and decision-making for their district public health agencies. HB 1210 would ban psychiatrists and other mental health providers from engaging in conversion therapy — which attempts to change sexual orientation — with patients under the age of 18. A similar bill failed in 2015. HB 1112 would create a program to pair qualified military veterans (all with referrals from mental health professionals) with dogs to train as service animals. And HB 1277 would increase how much notice the Department of Health Care Policy and Financing (HCPF) must give Medicaid enrollees about changes to their benefits, as well as extend the time window for enrollees to appeal a decision.

• The Finance Committee is set to consider HB 1266, which would grant the state authority to seize and destroy marijuana that contains unauthorized pesticides.

There was little of note in Senate committees this week and we’re not seeing anything next week, either. The chamber passed two bills. SB 127, which would repeal a 2010 law that established the Medical Clean Claims Task Force, was approved 30-5 and is going next to the House Health, Insurance and Environment Committee. HB 1148, which proposes to give the Legislative Exchange Oversight Committee greater authority over the state insurance marketplace, Connect for Health Colorado, passed the Senate unanimously and is on to Governor John Hickenlooper’s desk for a signature.

The Senate Finance Committee considered SB 135, which would allow insurance plans to cover services provided by pharmacists as long as they meet certain requirements. The committee approved the bill, which had already passed Senate Health and Human Services, and recommended that it be added to the Senate’s consent calendar.

Several dozen new bills were introduced in the House this week. In addition to HB 1336, detailed above, we’ll be monitoring four of them:

• HB 1320 is a reaction to some recent criminal accusations against massage therapists in Colorado. The bill would extend the power of the Department of Regulatory Agencies to take disciplinary action, including filing criminal charges, against professionals who exhibit unlawful behavior from fraudulent practice to indecent exposure. It also grants more power to cities and counties to create and enforce local rules for massage therapists.

• HB 1321 would direct HCPF to get the go-ahead from the federal government to implement a Medicaid “buy-in” program for Coloradans who are eligible for home- and community-based services. Such programs allow qualified adults to pay into the state Medicaid program and receive benefits, even though their income is above the range for Medicaid eligibility. HCPF already has a Medicaid buy-in program for children and adults with disabilities.

• HB 1322 is another bill dealing with contraceptives from insurance plans. (HB 1294, which would require plans to provide a broad range of contraceptives, is scheduled for its first hearing on March 17.) The new bill requires plans to reimburse providers who prescribe multi-month supplies of contraceptive pills. It specifies that providers must be reimbursed for a patient’s initial three-month supply and for a 12-month supply after that. Rep. Don Coram (R), who notably sponsored the failed HB 15-1194 to provide free long-acting reversible contraception last year, joins two Democrats as a sponsor of this legislation.

• HB 1326 is the third try for a bill that was first vetoed by Hickenlooper in 2014. The bill seeks to improve access to physical rehabilitation services. It is much narrower than last year’s version, focusing on preventing insurance companies from imposing inconsistent standards or unreasonable delays on patients who require physical rehab treatment.

Senior Communications Expert Joe Hanel contributed to this report.