2021 Affordable Healthcare Bills
HB21-1232 colorado health insurance option bill
GBC Position: SUPPORT
Good Business Colorado supports the Colorado Health Care Option bill because it would address two important GBC healthcare goals: helping small businesses access lower cost more robust healthcare insurance plans, and addressing racial disparities in healthcare outcomes. It meaningfully reduces insurance premiums so families and small businesses can afford to purchase quality coverage, creates more no-cost services, lowers out-of-pocket costs like copays and deductibles, and specifically requires that plans address historic health inequities and racial health disparities. It holds the healthcare industry accountable to keeping health insurance affordable and accessible.
Here is how it works. The state will partner with diverse stakeholders to create a standardized benefit plan for individuals and small groups in every county in the state. Private insurance carriers will have to offer the plan, ensure an adequate network of providers that is diverse and equitable, have a plan to reduce racial health disparities, and figure out how to reduce premiums by 18% over three years. The state will create Colorado’s first-ever health insurance Consumer Ombudsperson role, and use federal dollars from an Affordable Care Act "waiver" to make premiums more affordable for Coloradans.
Insurance carriers who don’t meet the reduction targets or other requirements will go through a new public hearing process to ensure fairness and accountability. The state may also employ a rate setting formula to meet consumer savings targets. This formula protects and benefits rural, critical access, and independent hospitals and cannot be lower than 165% of Medicare for any specific hospital. Providers will be required to participate only if network adequacy is not met or the provider is the reason that a carrier cannot reach the premium reductions. Provider reimbursement rates cannot be lower than 135% of Medicare.
sb21-175 prescription drug affordability board
GBC Position: SUPPORT
This bill would establish a five member board of experts to investigate and review the costs of the most expensive prescription drugs in Colorado, and to set an upper limit on the cost of those drugs. It would ensure greater transparency and accountability in drug pricing as well as opportunities for stakeholder engagement through public comment and an advisory board, and an appeals process to ensure their decisions are just. Any prescription drug manufacturer intending to remove a Board price-capped drug from Colorado must notify the commissioner, the attorney general, and each entity in the state with which the manufacturer has contracted for the sale or distribution of the prescription drug at least 180 days before the withdrawal. A manufacturer who fails to comply may be required to pay a penalty of up to $500,000.
If the bill passes as currently envisioned, it would address two important GBC healthcare goals: lowering overall healthcare costs for our members and addressing health equity. BIPOC Coloradans are more likely to have chronic illnesses requiring prescription drug treatment, such as asthma, heart disease and diabetes, and are less likely to have health insurance to help cover these costs.