The Governor’s Commission on Health Care Reform performed its final task yesterday — presenting the findings it gathered during 2007 to the General Assembly.
Health care analysts say the legislature will consider a range of bills, but Gov. Bill Ritter has said that no comprehensive reform — which would likely require approval from voters — will occur during 2008. So, the state will move slowly on health care reform based on the proposals outlined by the commission.
The recommendations include elements from 31 proposals received by the commission, incorporate suggestions from task forces and “reflect on common themes” that emerged during community meetings.
The goal is to require legal residents of Colorado to have at least a minimum benefit plan, with an average monthly premium of $200 for an individual. The program would be enforced through a tax penalty that automatically enrolls people who are eligible into fully subsidized public coverage programs.
The panel recommended that Colorado employers establish premium-only plans that allow employees to purchase health insurance with pre-tax dollars and provide subsidies for the uninsured up to 300 percent of the federal poverty level. Workers without employer insurance would receive subsidies if their income is 400 percent of federal poverty levels.
The recommendations include ways to reduce administrative costs, including standard claims attachment requirements and combining the administrative functions of public health insurance programs. The commission recommended implementing standard electronic ID cards, standard prior authorization procedures and uniform insurance applications.
The commission favors health savings accounts and a choice of minimum benefit plans for all consumers purchasing individual insurance.
The group recommended allowing health insurance premiums to be reduced for enrollees who engage in healthy behavior, eliminate co-payments for preventive care and reduce co-payments for chronic care management.
Other recommendations include:
Improving end-of-life care
Supporting the adoption of health information technology
Supporting the provision of evidence-based medicine
Paying providers based on quality
Ensuring information about insurer and provider prices is available
Under the plan, every legal resident would be required to have at least a minimum benefit plan, which would be designed and reviewed by committee to improve health care. The plan would include incentives to encourage employees to participate in employer-sponsored coverage that includes enforcing waiting periods for eligibility for the premium subsidy program.
That step would discourage employers from dropping coverage to enroll their employees in public programs.
The goal is to offer three or four standard benefit plans, using the same rating rules as the individual and small group market.
The commission also hopes to guarantee access to affordable coverage for people with chronic conditions by requiring insurance providers to issue coverage to anyone who applies who isn’t eligible for public programs. Premiums would be based on age and geographic location — not on past or current health conditions.
While the commission dissolved after the report yesterday, not everyone is pleased with the recommendations.
“Rather than true systemic remedy for deteriorating health care access, the Colorado Blue Ribbon Commission … proposes an expansion of fragmented, costly, administratively wasteful multi-payer health insurance, in addition to expanded categories of Medicaid and subsidies to commercial insurances,” said Richard Gingery of Health Care for All Colorado, one of the co-authors of a single-payer proposal that made the cut but was not part of the recommendations made by the commission.
“Instead of addressing the ‘800 pound gorilla in the room’ — the multi-payer commercial insurances that siphon more than 20 percent of our health care dollars to profits, exorbitant CEO salaries and administrative waste — the commission is proposing a Massachusetts-style mandate for individual/family purchase of minimum benefit plans with high out-of-pocket costs.”
The group said that double-digit increases in insurance premiums are derailing the Massachusetts plan.
“In turn, taxpayers ultimately subsidize growing numbers in both private insurances and public programs,” Gingery said. ““Essentially, the 208 Commission recommendations trade one problem — the uninsured — for another, increasing numbers of underinsured.”
Amy Gillentine covers health care for the Colorado Springs Business Journal.