Health care exchange bill on to governor

But future of bill on interstate compacts remains in doubt
The Colorado Statesman

Despite growing opposition from Republicans, supporters of the health insurance exchange bill can claim victory this week as the bill cleared the House and is on its way to the desk of Gov. John Hickenlooper for signing. But another bill, on interstate compacts for health insurance that has one of the same sponsors as the health exchange bill, is one step away from the trash.

It took help from 20 Democrats in the state House this week to pass Senate Bill 11-200 out of the House, and the bill’s passage on May 4 got support from 31 out of 32 Democrats. The vote that kept it from being unanimous came from Rep. John Soper, D-Thornton.

On the Republican side, only 13 out of the chamber’s 33 GOPers voted to support the bill, and the debate on the previous day, as well as the opposition in a May 2 committee hearing, showed the bill was not going to pass without substantial Democratic help. Among the “no” votes: Rep. BJ Nikkel, R-Loveland, who co-sponsors the interstate compact bill, House Bill 11-1273, with House Majority Leader Amy Stephens, R-Monument.

The Senate on Thursday concurred on minor House amendments to SB 200 and it is now on its way to the governor.

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.

On Monday, intending to show the bill’s strong support, Stephens held a press conference where she trotted out small business owners, consumer representatives and members of the 2007 healthcare commission that had recommended health insurance exchanges. Sometimes it takes time for the word to get out, Stephens said, but this bill has “come alive to the business community, business chambers and those who are having a tough time purchasing insurance…It’s a pro-market opportunity to have an offering of insurance where I can choose,” she said.

Stephens on Monday also addressed an editorial issued the previous week by Tony Gagliardi, Colorado state director of the National Federation of Independent Business, where he chided the mounting conservative opposition to the bill. Noting that the Utah Legislature had just concluded its session, “it would be nice to have the power to import some good, old-fashioned Republicans from the Utah Legislature over to Denver to help steel the nerves of their counterparts in the Colorado House and Senate,” Gagliardi wrote.

“Many of our Colorado legislators fear the wrath of Tea Party activists who have made support of Senate Bill 200, which would establish a healthcare exchange similar to Utah’s, a needless ideological litmus test on which to oppose Republican lawmakers in primary elections.”

Stephens said she did not believe Gagliardi’s editorial was directed at her, and Gagliardi confirmed that Monday with The Colorado Statesman. Stephens has been strongly criticized by Tea Party activists over SB 200, and she asked Senate Republicans to run an amendment to the bill that would have required the state to opt-out of the federal Patient Protection and Affordable Care Act (ACA). The amendment was seen as a nod to the Tea Party opposition. That amendment failed, both in committee and on the Senate floor, and Stephens said Monday she would not try it when the bill was up for second reading in the House. “What is detrimental to the debate is to deny Colorado the opportunity to control its own destiny, and sitting on our hands waiting for the court to decide,” Stephens said Monday, referring to the ongoing lawsuits across the country against the ACA. She also acknowledged some of the angry rhetoric from conservatives and Tea Party members. “Governing is not for the faint of heart…I’ve carried tough bills before but this is landmark and worth it.”

Gagliardi’s concerns appeared to materialize on Monday, when Tea Party activists also held a press conference in which they threatened to either recall or lodge a primary against any House Republican who voted for SB 200. (The bill got no Republican votes in the Senate.) Nancy Rumfelt of Loveland, director of Liberty Watch, claimed Republicans were no longer taking the Tea Party seriously. “The political elite think they can ignore us and tell us [to] go home until they need us to do our bidding,” she said, adding that SB 200 does nothing to lower healthcare costs or insurance premiums or to increase competition.

The hearing in the House Health and Environment Committee that followed drew many of the same opponents that had testified the week before against HB 1273, and with many of the same arguments. Some referred to the bill as socialism and claimed it would double the cost of health insurance. Most witnesses testifying against the bill said they represented only themselves.

That was in contrast to the representatives of business and consumer groups, who claimed to represent hundreds of thousands of Coloradans and their businesses, a point brought up by Rep. Jim Riesberg, D-Greeley. Rep. Sue Schafer, D-Wheat Ridge, said she was hopeful that bill would help address the health insurance crisis for 700,000 uninsured Coloradans and for small businesses who can look to the exchanges for affordable insurance.

The bill got little love from the committee’s Republicans, including Rep. J. Paul Brown of Ignacio, who said he did not believe the exchange is the answer to the health insurance problem. Four of the committee’s seven Republicans voted against SB 200, which meant it needed Democratic votes to get out of committee, and it got all six.

On the House floor during the second reading debate, SB 200 got muted public opposition and only from freshmen Republicans. Rep. Don Beezley of Broomfield encouraged support for interstate compacts rather than the exchange. Rep. Chris Holbert, R-Castle Rock, said a “small measure of government is not the proper response to a large measure of government,” and called SB 200 the wrong solution. Virtually all the Republicans, both pro- and con-SB 200, referred to the ACA as “Obamacare,” which Democrats had complained was derogatory; in committee hearings witnesses were asked not to use it.

While Democrats helped SB 200 across the finish line in the House, they were almost unanimous in their opposition to Stephens’ other bill, HB 1273. It got only one Democratic vote on Wednesday, from Rep. Wes McKinley, D-Walsh, and strong opposition from Democrats during the second reading debate on May 3 that took place almost immediately following SB 200.

HB 1273 would allow Colorado to enter into interstate compacts with other states, to create their own rules and regulations on healthcare and to opt out of at least some parts of the ACA. But Democrats noted that getting Colorado out of the ACA would require not only approval of Congress but the President, which they called unlikely. Democrats also pointed out that voters have already rejected a ballot measure that sought to get Colorado out of the ACA.

Despite the fact that it passed the House on Wednesday, as of press time Friday HB 1273 has not yet been assigned to a Senate committee but sources told The Statesman that it was likely to go to the Senate State, Veterans and Military Affairs Committee.