Mile High Health Reform Hopes in Colorado
I'm in Denver for a FamiliesUSA board of directors meeting, and while here, had the chance to connect with CO public officials and activists on their health reform dreams, intentions, plans and progress. Back in 2006, a Republican Governor and Republican controlled Legislature agreed to establish a special commission to come up with plans to create universal health care and to report back no later than then end of January 2008. The group is called the Blue Ribbon Commission for Healthcare Reform, though insiders refer to is as the "208 Commission" -- guess they're as imaginative as we are when it comes to naming things (i.e.: Chapter 58).
The Commission invited anyone to submit a plan for how Colorado could get to universal coverage, and then selected four of them for rigorous review and cost analysis by the Lewin Group. The Commission also decided to put a fifth, its own, plan on the table for consideration along with the others. The ideological range travels from Health Care For All Colorado's single payer proposal to the Colorado State Association of Health Underwriters' market-based plan. The Committee for Colorado Health Solutions and SEIU also have proposals in the mix.
The Commission's fifth offering includes the following elements:
1. All Coloradans required to have insurance or pay assessment through income tax filing if they do not
2. Employers not required to offer insurance
-- Required to offer payroll deduction/pre-tax plans to help employees to purchase insurance themselves
3. "Connector" for employers/employees to purchase insurance
4. Reform individual insurance market
-- "Healthy" people can't be turned down
-- Premiums can vary by age, geography
-- Expand Cover Colorado to cover more people with chronic conditions
5. Subsidies up to 400% FPL
-- Catastrophic care fund for those eligible for subsidy
6. Combine and expand Medicaid/CHP+
-- Cover children up to 250% FPL
-- Cover parents and childless adults up to 200% FPL
-- Buy-in program for disabled
-- "Medically Needy" and 'Medically Correctable" programs
7. Optional "Continuous Coverage Portable Plan" similar to Medicare
8. 24-hour coverage option for employers
The political landscape has changed dramatically since the 208 Commission was created. For the first time in 40 years, the Governor's office, House and Senate are controlled by Democrats, and there's a significant public demand for addressing the needs of about 750,000 uninsured. The new Gov, Bill Ritter, is enjoying huge voter popularity at the moment. But Colorado's constitution has a Taxpayer Bill of Rights (TABOR) embedded in it that would require almost any plan raising significant new revenues to go before the voters before it could take effect. Now there's a roadblock. Polling shows the public wants a significant health expansion and does not want to raise taxes to pay for it.