State panel calls for mandatory insurance

DENVER - The Blue Ribbon Commission for Health Care Reform recommended Monday spending more than $1 billion to provide Coloradans with more access to insurance, but it stopped short of supporting a Canadian-style, singlepayer system.

It also stopped short of saying how to pay for its recommendations.

Members called for the state to require residents to purchase some sort of coverage and to offer subsidies so low-income families and workers can afford it. Doing so could cut the number of uninsured Coloradans — about 792,000 — by roughly 85 percent, they said.

Formed under Republican former Gov. Bill Owens and expanded under Democratic Gov. Bill Ritter, the panel has worked for more than a year toward a goal of increasing access to health care while reducing the amount many people pay for it. The plan, opposed by just three of the 27 commission members, will be fine-tuned and then presented to the General Assembly in January.

Though the panel was not charged with coming up with something that is politically feasible, commission Chairman Bill Lindsay said afterward he thinks the proposal’s many facets should be accepted by the public.

“The thing I would pick out of all of this is that there is an understanding that there must be some shared responsibility,” Lindsay said, noting that insurers, employers, individuals and health care providers will all be asked to take on new roles under the plan. “It isn’t just one segment of the system where there’s a problem or issue.”

The plan mandates that individuals purchase health care under threat of tax penalty but doesn’t assume there will be 100 percent compliance with the law. To aid those who now are uninsured, it requires insurance carriers to offer minimum-benefit plans and offers financial help to families and individuals.

It proposes, for example, expanding government-funded health care programs to include families earning less than 205 percent of the federal poverty level — about $41,000 for a family of four. It also would offer subsidies to uninsured workers who earn less than 400 percent of the federal poverty level — about $39,000 for an individual.

Though the recommendations have no specific price tag, they are expected to cost $1.1 billion a year.

Funding suggestions for a health care program have included increasing the income tax, imposing a payroll tax and creating a sales tax on health-affecting items such as alcohol, tobacco, candy and fatty foods.

The members who voted against the plan did not state why at the meeting, but two have expressed consistent concerns throughout the process. Linda Gorman, the health care policy center director for the free-market Independence Institute, has said that government is stepping on the job of private business. Disabled activist Mark Simon has argued in meetings that funding increases required for this plan could end up taking services from the state’s most vulnerable populations.

It is up to the Legislature now to determine if it wants to push forward with this or any other health care reforms. Ritter has said he will support just one tax increase question on the 2008 ballot, and transportation and education advocates are expected to push for their causes as well.

Some legislators had expressed interest in gutting the private insurance system and having the state government oversee health care as is done in Canada. Commission members considered that as one of the four final submitted plans, but they included in their final recommendation just a request for an independent study on the feasibility of letting Coloradans enroll in a public health plan that would stay with them when they change jobs.

“I think as a general rule what we’ve said is that the single-payer proposal is intriguing, but we’re questioning whether it can be done on a single-state basis,” Lindsay said.

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

OTHER PRESCRIPTIONS FOR COLORADO

Health Care Reform approved specific recommendations on expanding access to health insurance Monday and will forward the plan to the General Assembly. But it also will pass along four other plans proposed by various organizations.

Here is a look at them:

Solutions for a Healthy Colorado

The plan: It requires residents to purchase health insurance but expands Medicaid eligibility for children, pregnant women and parents of minors, and it offers sliding-scale tax credits for adults at less than 250 percent of the federal poverty level.

Total program cost: $1.37 billion

New revenues needed: $853 million

Percent of uninsured who become insured: 82.5 percent

Better Health Care for Colorado

The plan: There are no mandates, but this increases public healthplan eligibility for children and pregnant women, offers subsidies to adults and creates a group health care buy-in for small businesses that don’t offer insurance now.

Total program cost: $980 million

New revenues needed: $389 million

Percent of uninsured who become insured: 40 percent

A Plan for Covering Coloradans

The plan: It requires employers to offer health care, expands Medicaid eligibility for all groups of people and offers a sliding-scale premium subsidy program to everyone but the aged.

Total program cost: $3.15 billion

New revenues needed: $2.01 billion

Percent of uninsured who become insured: 86.3 percent

Colorado Health Services Program

The plan: Replaces private insurance and existing government programs with a state-administered single-payer system funded largely by a payroll tax and increases in the income, alcohol and tobacco taxes.

Total program cost: $26.58 billion

New revenues needed: $15.03 billion

Percent of uninsured who become insured: 100 percent