Health care reform: A bold yet realistic approach'

DENVER - Lawmakers heard long-awaited recommendations on health care reform Thursday, then split on whether major changes or minor reforms would be better.

Several Democrats said they will push for debate on creating a Canadian-style, government-run health care system, which was not part of the recommendations, but was requested by advocates for the disabled.

Republicans said they’ll introduce legislation to help businesses insure workers, but will try to block placing a tax increase on the November ballot.

Just about every option is on the table to try to fix a health care system that has seen insurance premiums double during the past 12 years. Roughly 792,000 individuals do not have insurance, and families with health care end up paying about $934 more each year to subsidize the bills of those without it, according to various studies.

The recommendations from the Blue Ribbon Commission on Health Care Reform called for legislators to mandate that all Coloradans buy insurance, expand access to government-funded programs such as Medicaid and offer subsidies for low-income workers to buy private insurance.

The 27-member panel also suggested reforming the private insurance system to require providers to offer health coverage to all but the most chronically ill and advocated the creation of a central “connector” where individuals and small businesses could learn about insurance options.

Chairman Bill Lindsay called it “a bold yet realistic approach.” He said full implementation of the 30 recommendations could cost $1.23 billion, adding members did not go as far as suggesting the elimination of private insurance.

“What we believe these facts tell us is that the status quo isn’t working and that we really can’t afford to do nothing,” commission member Elisabeth Arenales said at a meeting of the Joint Health and Human Services Committee.

Reform advocates and legislators had different interpretations of what those words mean.

House Health and Human Services Committee Chairwoman Anne McGihon, a Denver Democrat whose committee is likely to be the first stop for many health care bills, said she’s looking to expand publicly funded programs to get coverage to most of Colorado’s 180,000 uninsured children. A ballot issue that involves a substantial tax increase isn’t likely this year, she said.

Rep. Spencer Swalm, a Centennial Republican and employee benefit broker, cautioned against anything that would help health care at the expense of other areas, such as transportation.

He’ll introduce a bill to help small employers offer limitedbenefit plans to workers — only 41 percent of Colorado small businesses now provide insurance.

The loudest voices, however, came from backers of a singlepayer, government-run system.

About 100 supporters held a rally on the Capitol steps, and commission member Mark Simon said in his minority dissent to the report that the recommended plan does nothing to move Colorado’s health insurance system away from the hands of for-profit insurance companies. Under the recommended plan, consumer spending would increase by $75 million, the Medicaid budget would double and $553 million more would go to insurance subsidies, he said. Democratic Reps. Jerry Frangas of Denver and John Kefalas of Fort Collins said they’ll support debate on a single-payer bill.

Conservative advocates said any plan that puts more people on government programs would do little to solve the health care crisis because the state already has a shortage of doctors who accept Medicaid patients.

Medicaid reimburses medical providers for only 65 percent of their costs, the commission noted.

“The government programs have created much of the problem,” Arvada resident Lin Zinser said. “Putting more people onto these programs that are underfunded makes no sense.”

McGihon said she expects her committee to begin taking up reform proposals next week.

CONTACT THE WRITER: (303) 837-0613 or ed.sealover@gazette.com

PANEL’S RECOMMENDATIONS

Here are the highlights of Thursday’s recommendations from the Blue Ribbon Commission on Health Care Reform:

- Mandates that all Colorado residents have a minimal level of insurance and enforces the law through fines on income-tax payments.

- Expands eligibility for publicly funded insurance programs and provides subsidies for low-income workers to buy private insurance.

- Requires private insurers to offer some sort of coverage to everyone regardless of health status, within certain limits.

- Requires employers to offer pretax premium-only plans to help employees buy health coverage.

- Creates a “connector” to assist individuals and small employers in understanding and choosing insurance options.

- Reduces administrative costs by $167 million a year by streamlining and combining functions.

- Encourages individual responsibility by allowing insurance discounts for quitting smoking, for example.

- Repays health care providers based on quality of service.

- Creates a Medicaid buy-in program to allow disabled people to continue receiving Medicaid benefits while employed.

- Reduces barriers to rural health care access by giving more responsibility to advanced nurse practitioners and increasing Medicaid reimbursements to doctors, among other things.

IN OTHER STATES

A look at what other states are doing in health care reform:

- 39 states have enacted legislation during the past two years to expand access to specified services, including those for children or pregnant women.

- 15 states have had commissions or campaigns examining broad-based health care reform.

- At least five states are looking at plans that would require employers to set up plans with which all workers can buy insurance.

- Massachusetts is the only state that has mandated all residents buy insurance. It’s also the only state that has set up a “connector” listing insurance options for individuals and small companies.

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