Lawmakers in the House on Monday voted on party lines on final passage of the so-called public option bill, moving the session’s landmark legislation on health care on to the Senate.

House Bill 21-1232 from Reps. Dylan Roberts, D-Eagle, and Iman Jodeh, D-Aurora, is an effort intended to offer affordable health care to 18,000 more Coloradans in the individual and small group markets, about 15% of the total insured. Under the bill, health insurers are required to lower premiums by 18% over three years, which Republicans indicate is a made-up number with no actuarial data behind it.

The final version of the bill is significantly different from the introduced version, reflecting negotiations to bring stakeholders in the health care field away from positions of outright opposition.

A strike-below amendment, which essentially amounted to a rewrite of the bill, was approved by the House Health & Insurance Committee on April 27. The strike-below moved the health insurers into an amend position; the Colorado Hospital Association is now monitoring, a type of neutral position.

The version that is now on its way to the Senate dropped the “public” from public option, changing the bill from a quasi-state run and developed standardized plan to be known as the Colorado Option, a state-developed standardized plan. Under the amended bill, doctors and hospitals would be required to offer the Colorado Option or risk warnings and fines.

Much of the hour-and-a-half debate on HB 1232 ahead of final passage mirrored the chamber’s nine hours of debate on the bill last week: Republicans vigorously opposed the bill, citing concerns about cost-shifting and forcing doctors and health care providers out of the state.

Minority Leader Hugh McKean spoke to those concerns with a personal story, telling the chamber about how he and his wife uprooted their lives and moved to Ann Arbor to seek specialized medical care after learning their daughter had a heart condition while in utero. The Loveland Republican said his daughter died after five days, leaving the total bills after a stay in the neonatal ICU and a “very complicated” open-heart surgery that cost around $500,000.

“I really had these moments as I’m poring through bills, after bills, after bills, after bills that come in for weeks on end… it was an imperfect world, but every penny that we spent, which was tough, was worth it,” he said.

McKean said that experience made him intimately familiar with health care insurance, and he believed the overall cost of health care is a problem “too complicated for government to fix.”

“Do I wish that we could have paid less? I’m going to be blunt – we went a lot of weeks without food that we would have preferred to eat. But no,” he said. “Do I wish that we had had a different outcome? Of course. But do I wish that the system was different and somehow had mandated things so that it was cheaper for me, but I wouldn’t have been sure that I would have gotten the best care? No.”

Roberts countered that the concerns raised by his GOP colleagues that the bill would drive out providers and decrease access to care, particularly in rural areas, were “laughable.”

“Why would anybody ever want to do that? I would take my name off this bill and pull it off the calendar if that were actually the case,” he said. “We all know that’s not the case.”

Roberts also chided some of his colleagues, implying some of the problems they raised with the bill were born out of ignorance of the legislative text.

“I don’t expect every citizen of Colorado and every physician to read the bill, but I do expect my colleagues to,” he said. “If you have, you’ll know that those concerns have been addressed. Rural hospitals will get paid more under this plan so that those hospitals and clinics operating on the margin will get the cost and the financial support that they need.”

Meanwhile, Jodeh cited statistics on the number of Coloradans with medical debt in calling on her colleagues to support the bill.

“Fifteen percent of Coloradans have medical debt in collections and that number skyrockets to one in four Coloradans that are black, people of color, indigenous, marginalized communities,” she said. “When these numbers come to the surface, there is simply no denying that there is a direct correlation to the lack of access to affordable quality healthcare and systemic racism.”

That comment drew direct responses from three Republicans: Assistant Minority Leader Tim Geitner of Falcon and Reps. Andres Pico of Colorado Springs and Ron Hanks of Penrose. Each of the trio took exception to Jodeh’s characterization, with Pico and Hanks being gaveled by Speaker Alec Garnett.

After Hanks said “the false cries of systemic racism are the pounding drums of the long march to national socialism,” Garnett put the chamber in a temporary recess. When he called the House back into order, the chamber spent another half-hour debating the bill before passing it on a 40-23 party line vote.

The bill now heads to the Senate.