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Colorado Health Care at a Crossroads: Building a Path to Health Care for All
Adam Thompson on October 18, 2007 - 8:11am
Colorado State Rep. Morgan Carroll opened a health care public forum on Tuesday night in Denver with
I am unapologetically biased towards the consumer perspective. We are not and should not be here to do what insurance companies or pharmaceutical companies want. They have had their way. Now our day is here.
The forum - Colorado Health Care at a Crossroads: Building a Path to Health Care for All - was attended by over 150 Coloradans, legislators and health care experts to highlight progressive priorities and values for health care reform in Colorado.
It was sponsored by the Progressive States Network and also by the Colorado Progressive Coalition, ProgressNow, The Bell Policy Center, UHCAN, AFSCME, SEIU, the Center for Policy Alternatives and the Herndon Alliance. In addition to State Rep. Morgan Carroll, panelists included: Robin Baker, Senior Policy Analyst at The Bell Policy Center; Ella Hushagen, Health Policy Analyst with FamiliesUSA; John Arensmeyer, Founder and CEO of Small Business Majority; and Adam Thompson, Senior Health Policy Specialist with the Progressive States Network.
Health Care Debate in Colorado
Colorado is in the throes of a focused, thorough and, at times, emotional debate about how best to guarantee all residents the care they need when they need it. In 2006, State Representative Anne McGihon sponsored SB 208, a bill creating the Blue Ribbon Commission on Healthcare Reform, now known as the 208 Commission. Since May, the Commission has been studying four different reform plans submitted by health care stakeholders. The proposals range from a comprehensive single-payer type plan to less expansive and, frankly, detrimental individual mandates and limited-benefit-health plans.
Recently, the 208 Commission itself developed and presented for study a fifth proposal. The fifth proposal includes many features of the other four, including individual mandates, signaling the approach to reform it is likely to endorse in its final report to the legislature due in January.
Several other states have commissions or task forces studying how best to achieve health care security for all residents, including Iowa, New Mexico, New York, and Kansas. As we have discussed previously, commissions can be effective ways to bring stakeholders to the table to study reform options and iron out differences of opinion in order to move comprehensive health care reform.
Progressive Values for Reform
The forum on Tuesday highlighted progressive priorities for reform by discussing elements of the five plans before the Commission and discussed some of the unique challenges facing reform in Colorado. Issues and perspectives addressed by the panelists included:
Individual Mandates - Panelists referenced the inability of Massachusetts to ensure affordable options for all residents, causing the state to exempt tens of thousands of residents from the mandate. Individual mandates are patently unfair absent meaningful and shared responsibility from all health care stakeholders - employers, insurance companies and providers.
Limited-Benefit Plans with Low Annual Caps - Panelists stressed that these plans do not protect Coloradans with chronic diseases or who suffer a major medical event or diagnosis, like a heart attack or cancer.
Affordability of Coverage- Panelists discussed the need for a mechanism to ensure affordability such as capping family expenditures to a percentage of income, perhaps on a sliding scale, and which reflects other real-world family costs like housing, transportation, food and the ability to accrue savings.
Health Insurance Connectors - Panelists strongly asserted the need for robust oversight and regulation of insurance companies if reform pursues a public/private partnership offering health plans to residents. Connector-like programs, which are designed to negotiate with insurance companies to bring more affordable options to market, need robust health insurance rate review and regulation to be successful.
Budgetary Constraints - Major institutional barriers to reform in Colorado are its budgetary rules, which limit the public sector's ability to marshal financial and health care resources to achieve health care security for all residents. First, Colorado cannot expand general fund appropriations more than 6 percent in any year. Second, the 1992 voter-approved TABOR law sets draconian limits on how much the state can raise and spend each year. However, in 2006, voters created a window-of-opportunity by enacting Referendum C, which waives for five years the spending limits imposed on state government by TABOR. Increased funds allowed by Referendum C are to be used for education, health care and transportation.
Audience Feedback and a Call to Action
Questions and comments from the audience showed tremendous interest in a guaranteed or single-payer type health care reform, a sentiment also prevalent at one of the 208 Commission's public hearings. Incidentally, the Lewin Group, which has studied the 4 original proposals and is currently examining the 5th, showed that the Colorado Health Services Single Payer program is so far the only proposal that would achieve coverage security for all Coloradans and would dramatically reduce health care spending more than any other proposal, by $1.4 billion.
Audience members also asked what they can do to influence the outcome of the health care debate in Colorado, to which Rep. Carroll offered a call-to-action:
We have the opportunity to do something right for all of us. I can not emphasize enough how critical your voice is in this process. You and your participation are the best check and balance we have to the wealthy special interests under the dome.