The 2018 Colorado Legislative session ended on May 9th.  There were some significant achievements including bills that partially addressed transportation, education, and the public employee retirement system (PERA).  One area that the Legislature did not come to agreement on is Health Care, specifically Health Insurance.

Health Insurance costs for everyone are quite high, whether you get health insurance from your employer or if you get health insurance from the individual marketplace. A health insurance policy for a household can cost over $20,000 a year.  Regardless if your employer pays for the policy, or you pay for it yourself, that cost is a burden that prevents businesses from more productive investments and prevents individuals from saving for their children’s college or saving for their own retirement.  

Many community leaders have come together for this fight, and we have many people to thank for helping us.  Jen Fanning, the executive director of the Grand County Rural Health Network and her entire team took the lead early on to educate us on how the individual marketplace works.  Elected Leaders like Eileen Waldow of Fraser and Dan Gibbs of Summit County have been instrumental in rallying leaders to this mission. And my fellow Commissioners, the County Manager, and the staff of Grand County and many other local leaders have all helped to develop workable solutions at the state level.  If we are successful in achieving lower health insurance costs for the individual marketplace, there will be increased participation making the pool healthier. This will reduce risk for insurers and reduce hospital loss to uninsured which translate into lower costs for small and large group plans too, meaning lower health insurance costs for everyone.     

Health Insurance costs are largely influenced by national law.  But national law is not the only factor, Colorado State policies also have huge implications.  We decided to focus on what can be changed at the State Level to improve the system. I testified at the State Legislature in the spring of 2017 in support of bills that would have lowered health insurance costs.  Those bills failed, but our testimony raised visibility. We spent the summer and fall of 2017 working with other County Commissioners across the state as well as Legislators to better understand the situation and garner support.  We got support from Representative Bob Rankin (R), HD-57; Representative Chris Kennedy (D), HD-23; Senator Don Coram (R), SD-6; and Senator Kerry Donovan (D), SD-5. We got the majority of Colorado Counties Incorporated (CCI), and Counties and Commissioners Acting Together (CCAT), both associations of County Commissioners, to vote in favor of several bills in 2018 that would reduce health insurance costs.  Club 20, an association consisting of 22 Western Slope Counties, is working to find viable solutions. We gained serious momentum!

We approached the 2018 Legislative Session with 2 basic approaches to reduce Health Insurance costs in Colorado:  

1) Move from 9 geographic rating areas to 1

2) Re-insurance

The best solution for Colorado would be Solution 1) Go from 9 areas to 1 geographic rating area.  Geographic rating areas artificially impose zones where health care costs are estimated. In this scheme Grand County is in zone 9, the West Zone, which is the most expensive in the state.  Our health insurance policies can be TWICE as expensive as the cheapest zones which include Denver. A household of two, both 55 years old, would pay $2,255 per month for insurance in Grand County.  In Denver the same household would pay $1,178. This needs to change. Six States and the District of Colombia have a single Geographic Rating Area statewide, the largest of which is New Jersey. Unfortunately this bill did not have the votes.  The sponsors of the One Geographic Rating Area, HB18-1311, decided to postpone indefinitely, which killed their own bill. They did this to focus their efforts on the Reinsurance Bill.

Solution 2) The Reinsurance Bill, was HB18-1392.  It came the closest to passing, making it through the House with bi-partisan support.  However, it was killed in committee in the Senate on May 4th.  Reinsurance basically has the State cover a segment of high cost patients, which allows the insurance companies to reduce their risk, and then they lower premium cost.  This strategy has been endorsed by both Republican and Democratic governors and elected insurance commissioners in Alaska, Minnesota, and Oregon, all of which have re-insurance programs.  Wisconsin and Maryland just passed bills for re-insurance and Louisiana is expected to pass legislation this year.  This re-insurance bill would have reduced Grand County health insurance by about 25%, and Denver’s health insurance by about 15%.  Everyone in Colorado would have lower health insurance, yet the Senate killed this bill.

Finding healthcare options and solutions that make sense to families throughout Colorado is my passion and we will continue to work on this.  The Road Ahead for health insurance is to shape the debate for 2019. We will spend time again in meetings and conferences through this summer and fall to develop workable solutions for our healthcare systems.  We will make presentations to associations like CCI, CCAT, and CML (Colorado Municipal League) and others. We will meet with the insurance industry and hospitals and doctors. We will shape the perspective of the 2019 Legislature to get a bill passed that finally improves the affordability of health insurance in Colorado.  Then people can have a little extra money to save for retirement, or pay for college or trade school, or buy a better vehicle or healthier food.