The Colorado Public Option (HB21-1232)
Next Saturday, April 10th, bill sponsors of Colorado HB21-1232 Standardized Health Benefit Plan Colorado Option (the Colorado “Public Option”) will join us on Zoom to discuss the bill and answer your questions about it.
Please join us at 10am on Saturday, April 10 as we welcome Representative Dylan Roberts and Representative Iman Jodeh.
This bill offers an opportunity for State-based solutions to address the rising costs of health care insurance and health services. HB21-1232 attempts to stage progressive steps to reign in costs by addressing lack of competition specific to the health insurance market statewide.
HCAC invites you to join our Zoom conference to hear the sponsors discuss their bill. There will be time for questions & answers so come prepared with your questions.
- How will the Colorado Option work to make the insurance market more competitive?
- How will the Colorado option bill be enforced to ensure insurance companies offer healthcare benefits at a lower premium?
- How will insurance companies meet the targets to lower costs and put patients’ needs first?
About our guest speakers:
Dylan Roberts represents House District 26 in the Colorado House of Representatives, which encompasses Eagle and Routt Counties. Serving in this position since 2017, his work at the legislature has focused on lowering the cost of health care and prescription drugs, protecting our environment and water, finding ways to lower the cost of living, and promoting rural economic development. At the Capitol, he serves as the Chair of the Rural Affairs & Agriculture Committee and as a member of the Judiciary Committee. Dylan grew up in Routt County and now lives in Eagle County with his fiancé Sarah and their rescue-dog, Hattie.
Iman Jodeh is the Representative for House District 41 in Aurora, Colorado. As a first generation American, born to Palestinian immigrants and refugees, she has called Colorado, specifically HD41, home her entire life. As the first Muslim and Arab woman elected to the Colorado State Legislature, she is passionate about social justice work and advocates for criminal justice reform, fighting the rising cost of and increasing access to healthcare, increasing access to jobs and education, ensuring equal rights for all, and combating our climate crisis. Iman is fluent in Arabic and maintains a second home in Ramallah, Palestine. In her free time, she enjoys cooking, spending time with her large family, and fly fishing in the beautiful rivers of Colorado.
About HB21-1232 (from the Bill Summary):
The bill requires the commissioner of insurance (commissioner) in the department of regulatory agencies to establish a standardized health benefit plan (standardized plan) by rule to be offered by health insurance carriers (carriers) in the individual and small group markets. The standardized plan must:
- Offer health-care coverage at the bronze, silver, and gold levels;
- Be offered through the Colorado health benefit exchange;
- Be a standardized benefit design created through a stakeholder engagement process;
- Provide first-dollar, predictable coverage for certain high value services; and
- Comply with state and federal law.
Beginning January 1, 2023, and each year thereafter, the bill encourages carriers that offer:
- An individual health benefit plan in Colorado to offer the standardized plan in the individual market; and
- A small group health benefit plan in Colorado to offer the standardized plan in the small group market.
For 2023, each carrier shall set a goal of offering a standardized plan premium that is at least 10% less than the premium rate for health benefit plans offered by that carrier in the 2021 calendar year in the individual and small group market. For 2024, each carrier shall set a goal of offering a standardized plan premium that is at least 20% less than the premium rate for health benefit plans offered by that carrier in the 2021 calendar year in the individual and small group market. For 2025 and each year thereafter, carriers are encouraged to limit annual premium rate increases for the standardized plan to no more than the consumer price index plus one percent, relative to the previous year.
The Colorado option authority (authority) is created for the purpose of operating as a carrier to offer the standardized plan as the Colorado option if the carriers do not meet the established premium rate goals. The authority shall operate as a nonprofit, unincorporated public entity. The authority is required to implement a provider fee schedule as established by the commissioner in consultation with the executive director of the department of health care policy and financing. Health-care providers and health facilities are required to accept consumers who are enrolled in any health benefit plan offered by the authority.
The bill creates an advisory committee to make recommendations to the authority concerning the development, implementation, and operation of the authority.
The commissioner is required to apply to the secretary of the United States department of health and human services for a waiver and include a request for a pass-through of federal funding to capture savings as a result of the implementation of the standardized plan. The commissioner is required to disapprove of a rate filing submitted by a carrier if the rate filing reflects a cost shift between the standardized plan and the health benefit plan for which rate approval is being sought.
The bill makes the failure to accept consumers who are covered through the Colorado option or the balance billing of a patient in violation of this bill grounds for discipline under specified practice acts.
The bill repeals the authority and its functions if the United States congress establishes a national public option program that meets or exceeds the premium rate goals set forth in and health-care coverage pursuant to this bill.