The Colorado Public Option

Last session, HCAC supported legislation that required the Department of Health Care Policy and Financing (HCPF) and the Division of Insurance (DOI) to develop and submit a proposal to the General Assembly concerning the implementation of a state option for health care coverage, HB19-1004.  

The final report, based on meetings with stakeholders from across the state and including extensive written public comments, was submitted in November 2019 with a preliminary actuarial analysis.  The final actuarial analysis will be completed in February 2020. 

Colorado is the second state to pursue a “public option” which is called a “state option” by the authors of the report.  Their recommended design is a public-private partnership, where the state sets the standards for the plans and the insurance companies administer them and bear the financial risk.  These plans are currently projected to have premium savings of 9-18%, achieved by addressing the underlying costs of care including hospital reimbursement rates, pharmaceutical company incentives, and current insurance medical loss ratio.  The authors gave a presentation on their recommendations to the General Assembly on January 10, 2020. 

The legislature now needs to act, including passing enabling legislation.  Opposition from industry is fierce.  HCAC’s “Reflections on the Public Option,” found on our website, identifies the problems from our perspective when compared to our goal of universal health care. Also, you can find a copy of the Public Option presentation given at the January Denver Chapter meeting.

The Final Report for Colorado’s Public Option can found at

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