Representative Roberts, bill co-sponsor, presented HB21-1232.  The bill directs the Commissioner of Insurance to develop a standardized health insurance plan that may be offered by health insurance carriers.  Carriers are encouraged to offer the standardized plan, and required to set goals for reducing premiums.  The Colorado Option Authority is created as a nonprofit public entity to offer health insurance if carriers do not meet premium reduction goals.

Standardized health insurance plan.  By January 1, 2022, the commissioner must establish, by rule, a standardized health insurance plan that can be offered by private health insurance carriers in the individual and small group markets.  The plan must offer coverage at the bronze, silver, and gold coverage levels, and include all essential health benefits.  The plan may be updated annually.

Beginning January 1, 2023, insurance carriers are encouraged to offer the standardized plan in any zip code where they currently offer coverage in the individual and small group markets.  Each carrier that offers a standardized plan is required to set a goal of offering the plan at a premium rate that is below the 2021 rate for health insurance plans offered by the carrier in that respective market by at least 10 percent in 2023 and 20 percent in 2024.  Cost-shifting from the standardized plan to another plan that requires state approval is prohibited.

Colorado Option health insurance.  The Colorado Option Authority is created as a nonprofit unincorporated public entity to operate as a health insurance carrier.  The Authority must offer individual and small group market health insurance (referred to as the Colorado Option) if all carriers fail to meet the premium rate reduction goals described above.  Implementation and operation of the Authority is contingent upon federal approval and receipt of federal funds.

The Authority is defined as an instrumentality of the state; except that debts and liabilities of the Authority do not constitute debts and liabilities of the state.  The Authority is not a state agency.  It is governed by a 9-member board appointed by the Governor and confirmed by the Senate.  The board must appoint an advisory committee to make recommendations concerning the Colorado Option.

Provider participation and reimbursement.  Health care providers are required to accept patients who are enrolled in any Colorado Option plan offered by the Authority.  Failure to do so is deemed grounds for professional discipline.  Providers will be reimbursed according to a schedule established in rule by the commissioner.  The reimbursement schedule must be designed to achieve at least 20 percent premium reductions for 2025 plans relative to plans offered by carriers in 2021.  The schedule may account for circumstances of hospitals and providers that serve uninsured individuals or those covered by other public health insurance plans; these providers may be reimbursed at modified rates or exempted from the reimbursement schedule.  The schedule must be available to other health plans, as determined by the commissioner.  

Federal waiver.  The commissioner must seek a State Innovation Waiver from the federal Department of Health and Human Services to implement the bill and to identify savings to the federal government attributable to the bill.  Upon approval of the federal government, a portion of the savings generated may be passed through to the state.  This pass-through funding may be used for the establishment of the Authority and for the Colorado Health Insurance Affordability Enterprise to increase the value, affordability, quality, and equity of health care coverage in Colorado.

Repeal.  The Authority is repealed if a national public option program is established that meets or exceeds premium reduction goals defined in the bill.  

The sponsors discussed a powerpoint with the committee which can be found in Attachment A.

Additional handouts distributed to the committee can be found in Attachment B.

Representative Jodeh, bill co-sponsor, continued with opening remarks on the bill.

Representative Roberts continued with opening remarks on the bill.

Representative Jodeh continued with opening remarks on the bill.

The bill sponsors responded to questions from the committee.

The bill sponsors continued to respond to questions from the committee.

Dr. Mark Conklin, representing Panorama Orthopedic and Spine Center, testified in opposition to the bill. The witness responded to questions from the committee.

Adam Fox, representing Colorado Consumer Health Initiative, testified in support of the bill. Karla GonzalesGarcia, representing Colorado Organization for Latina Opportunity and Reproductive Rights, testified in support of the bill. The witnesses responded to questions from the committee.

Sarita Parikh, representing herself, testified in support of the bill. Dr. Chester Cedars, representing himself, testified in support of the bill. Jeff Rogoff, representing himself, testified in support of the bill. Mr. Ross Brooks, representing Mountain Family Health Centers, testified in support of the bill. The panel of witnesses responded to questions from the committee.

Shawn Satterfield, representing Good Business Colorado, testified in support of the bill. Katharine Knarreborg, representing Merlin Instrument Company, Good Business Colorado, testified in support of the bill. Ms. Erin Miller, representing Colorado Children's Campaign, testified in support of the bill. Sandra Payne, representing herself, testified in support of the bill. The panel of witnesses responded to questions from the committee.

Dr. Carolyn Dresler, representing herself, testified in support of the bill. Ms. Jennifer Roberts, representing Colorado Cross Disability Coalition, testified in support of the bill. Ms. Bethany Pray, representing Colorado Center on Law and Policy, testified in support of the bill. The previous witnesses responded to questions from the committee.

Gary Arnold, representing Pipefitters Local 208, testified in opposition to the bill. Mr. Chris Brown, representing Common Sense Institute, testified in a neutral position on the bill. The witnesses responded to questions from the committee.

Lauren Masias, representing Colorado Competitive Council, testified in opposition to the bill. Janie Wade, representing SCL Health, testified in opposition to the bill. The witnesses responded to questions from the committee.

Anneliese Steel, representing Colorado Concern, testified in opposition to the bill. Debbie Brown, representing Colorado Business Roundtable, testified in opposition to the bill.

Dr. Richard Zane, representing himself, testified in opposition to the bill. Dr. Margaret Reidy, representing UCHealth, testified in opposition to the bill. Brenda Higgins, representing herself, testified in opposition to the bill. The witnesses responded to questions from the committee.

Dr. Mark Johnson, representing Colorado Medical Society, testified in opposition to the bill. Dr. Patrick Pevoto, representing Colorado Medical Society, testified in opposition to the bill. Dr. Lonnie Loutzenhiser, representing himself, testified in opposition to the bill. Dr. Amit Agarwala, representing himself, testified in opposition to the bill. The witnesses responded to questions from the committee.

Dr. Ron Pelton, representing Colorado Society of Eye Physicians and Surgeons, testified in opposition to the bill. Dr. Gary Ghiselli, representing Colorado Orthopaedic Society, testified in opposition to the bill. Dr. Armodios Hatzidakis, representing Western Orthopaedics PC, testified in opposition to the bill. The panel responded to questions from the committee.

Dr. Chris Linares, representing Colorado Medical Society, testified in opposition to the bill. Dr. Alison Sandberg, representing Colorado Radiological Society, testified in opposition to the bill. Dr. John Froelich, representing himself, testified in opposition to the bill.

Mr. Kevin Stansbury, representing Lincoln Health, testified in opposition to the bill. Mr. Chris Thomas, representing Community Hospital, testified in opposition to the bill. Mr. Dave Ressler, representing Aspen Valley Hospital/Valley Health Alliance, testified in opposition to the bill. Mr. Bryan Johnson, representing St. Mary's Medical Center - SCL Health, testified in opposition to the bill. The witnesses responded to questions from the committee.

Mrs. Christine Bogott, representing Colorado State Association of Health Underwriters, testified in opposition to the bill. Richard Orf, representing Associated Governments of Northwest Colorado, testified in opposition to the bill.

The committee took a recess.

Mrs. Maureen Hinkle, representing herself, testified in support of the bill. Stephanie Salazar-Rodriguez, representing herself, testified in support of the bill.

Bianey Bermudez, representing herself, testified in support of the bill. Beth Dombroski, representing herself, testified in support of the bill. The witnesses responded to questions from the committee.

Angelique Espinoza, representing Good Business Colorado, testified in support of the bill. Rachel Stewart, representing herself, testified in support of the bill.

Hillary Jorgenson, representing Healthier Colorado, testified in support of the bill.

Written testimony submitted by the public can be found in Attachment C.