Controversial health care exchange bill introduced

The Colorado Statesman

Colorado isn’t waiting for the outcome of several lawsuits over federal health care reform to carve its own way on health care.

Last week, Gov. John Hickenlooper and two legislative leaders announced a bill that would create health care exchanges in Colorado. Senate Bill 11-200 passed the Senate Health & Human Services Committee Thursday afternoon.

SB 200 would establish a non-profit health benefit exchange, governed by a nine-member board of directors appointed by the governor and legislative leadership.

The board would then be responsible for appointing an executive director, creating financial plans, applying for grants, developing the exchange’s structure, determining the size of the small employer market, and providing written reports to the General Assembly and governor.

SB 200 also would set up a new legislative oversight committee that would review grants and the financial and operational plans developed by the board, and make recommendations on legislation.

SB 200 is sponsored by Sen. Betty Boyd, D-Lakewood, and House Majority Leader Amy Stephens, R-Monument.

House Majority Leader Amy Stephens, R-Monument, is the House sponsor of SB 200, but is under fire from her conservative constituents for supporting it.

In announcing the bill last week, Hickenlooper said the exchange would create a voluntary insurance marketplace for individuals and small businesses. It will be easy to compare prices and options, he said, give Coloradans more control and protections when buying insurance, and “will bring competition and transparency. We want to make sure all businesses and individuals have access to health care, regardless of pre-existing conditions.” SB 200 will establish Colorado as a true leader in health care reform, according to Hickenlooper.

“This is good bipartisan work,” the result of many hours of hard work among legislators and the governor, Stephens said during the March 21 press conference. “We started that discussion years ago, how exchanges would provide a free market competitive environment, and regardless of what happens nationally, Colorado has to stand on its own,” she said.

Boyd noted that the idea of health care exchanges predates the 2010 federal legislation. In 2007, the General Assembly created the Blue Ribbon Commission for Health Care Reform, more commonly referred to as the “208 commission.” Boyd said that a health insurance exchange had been one of the recommendations from that group.

Boyd also addressed questions about the makeup of the board, and whether it would be loaded with insurance industry representatives. “We’re hoping they will be creative, thoughtful people, who will be working at creating the exchange.” The bill does allow for insurance industry representatives to be appointed to the board, she said, but the bill will include strong conflict of interest provisions to make sure that anyone who comes from an industry doesn’t benefit any more than anyone else in the industry. “The whole process will be very transparent.”

The exchange will be set up to allow businesses and individuals to band together to get better prices, Hickenlooper said, adding that these are businesses and individuals that have largely been shut out of getting insurance.

If SB 200 is signed into law, the board is to be appointed by July 1 and the legislative oversight committee appointed by August 1.

Boyd told The Colorado Statesman this week that the response she’s gotten from constituents and in town halls has been very positive.

Not so much for Stephens, who has been getting the opposite — criticism and flack for her sponsorship of SB 200 from members of her own party and in her own district. According to the Colorado Springs Gazette, Stephens was called to an “emergency town hall meeting” last week in Colorado Springs to defend her position. The bill is being referred to as “Amycare” by some conservatives.

Nancy Rumfelt of Liberty Watch said last week that the exchange is “a key component of ObamaCare in Colorado so we believe it is bad medicine for our state.” Rumfelt called a press conference to outline her concerns but canceled it on Monday at the last minute without notice. Rumfelt cited a September 2010 Rasmussen poll that said more than 50 percent of likely Colorado voters opposed federal health care reform. However, less than two months later, 53 percent of Coloradans rejected an Independence Institute-sponsored ballot measure that would have prohibited the state from participating in the federal health care reforms.

Stephens held a press conference Monday to defend her conservative credentials, to show off support for SB 200 from business groups, and to point out that she had been working on the health care exchange idea with then-Rep. Joe Rice, D-Littleton, for more than two years.

There are two issues at play, Stephens said: what to do about small business health insurance and lowering the costs for premiums, and how to form interstate compacts for health insurance, which is contained in a second bill she is carrying this session (House Bill 11-1273). “We have to have solutions,” she said, noting that in the past Republican ideas on reform were characterized as “don’t get sick. That had some truth,” Stephens said. “We didn’t have a lot of ideas on reform on the table.”

Stephens indicated she had to be practical in the solutions that Republicans came up with, given a Democratic-controlled Senate and a Democratic governor. The business groups came to Stephens in January, stating they had been left out of the conversation on the exchanges, she said. “I listened to everyone.” Then Boyd and the governor came in on the discussion, and they looked at how to make it work. “We all merged,” and the draft Stephens came up with became part of the final legislation and then negotiated the finer points.

Stephens took aim at Tea Party complaints about “exchanges,” pointing out that the word existed long before the federal law and dated back to at least the 208 commission. She attributed much of the complaints to people who didn’t read the bill, saw the word “exchange” and assumed “Obamacare.”

“We created a board and a legislative oversight committee — this issue is way too big to not have accountability,” she said. “That’s all it does.”

She’s also amused by the term “Amycare,” but turned it on its ear, saying “Amy cares about the free market, Amy cares about small business, Amy cares about affordable health care for Colorado’s working families. I laugh about it in the hallways.” People are jumping to conclusions without reading the bill, and many don’t understand the legislative process, Stephens explained. “Most people don’t see the hours that go into crafting decent legislation and all the players involved,” and she said she was “saddened” by the misinformation being circulated about the bill. “I did not do this lightly,” she said.

Tony Gagliardi, Colorado state director for the National Federation of Independent Business, stood up for SB 200 and for Stephens on Monday. Small business pays 80 percent of the health care premiums and has been opposed to the federal health care reform legislation. NFIB has supported health care exchanges for years, he said, and complimented Stephens and Boyd for bringing all the stakeholders to the table. Health insurance reform and the exchanges are a nonpartisan issue, Gagliardi said, and his members support a plan just for Colorado rather than the one-size-fits-all approach of the federal law.

The Colorado chapter of the National Association of Health Underwriters also spoke in favor of state exchanges and SB 200 Monday. “Health care rates have continued to rise during the last 40 years,” said Jim Sugden. “The free market alone hasn’t solved the problem. The exchange is one of the creative solutions” that will bring down costs.