It would be difficult to find someone in Colorado who believes health care is inexpensive. We know that Coloradans, from sole proprietors to those who work in large companies, struggle with health care costs. Yet, the legislature’s latest attempt to address this issue, House Bill 1232, doesn’t truly cut costs at all. It simply moves costs from some Coloradans to others, which isn’t a solution for Colorado.

This year’s proposal directs the Commissioner of Insurance to establish a single, standardized health benefit plan for the individual and small group markets. Private insurers in the individual and small group markets would then be forced to offer this government-designed plan and meet arbitrary premium reduction goals of 18% for the new product, without any real leverage to lower underlying health care costs. If plans fail to meet the premium reduction goals, the Commissioner of Insurance is empowered to establish reimbursement rates for health care services that hospitals and doctors are forced to accept.

In summary: a government-designed benefit plan. Government-set premium reduction targets. A government mandate to insurance companies to sell the plan. Government-set reimbursement rates for hospitals, doctors and other health care providers. But no real solutions to lower the underlying cost of providing health care.

It is illogical and short-sighted to believe that the state can demand insurers and health care providers arbitrarily reduce their costs by 18% without consequences elsewhere in the system. And so, this is where the real concern lies: this legislation won’t solve any of our health care cost challenges – it simply shifts the burden.


If current experience is our guide, then the most likely – almost inevitable – consequence of this policy is that losses incurred from this state standard plan will be made up for in increased costs to the rest of the market. This is called cost-shifting and it happens today. Underpayment in Medicare and Medicaid gets shifted to privately insured Coloradans, a contributing factor in our annual premium increases. And, here’s the kicker: just over 50% of Coloradans get their insurance through their employer, and that’s who will likely get stuck with increased health care costs to cover a modest benefit for a few.

Supporting a modest cost savings for a sliver of the population by increasing costs for everyone else is not only bad policy; it doesn’t even address the issue we are demanding be addressed – the cost of care for all of us.

We fear there could be other consequences as well, primarily, reduced competition in the marketplace and reduced access to care exacerbating both cost and quality no matter what health care plan we buy or where we buy it.

Coloradans need market-driven, sustainable solutions that will lower costs for all of us, not gimmicks that only reshuffle the costs.

While we’re far from a sustainable solution to our health care challenges, we have made real progress in addressing health care costs in Colorado in recent years. This progress has been achieved in large part through private market solutions and public-private collaborations. Reinsurance, growth in high-value limited-network insurance plans, value-based payment arrangements between health care providers and insurers, and the health care industry’s investments in telehealth and other innovative technology solutions have all begun to drive premiums down. And those premium reductions have come for consumers across the state: in mountain, Western Slope, eastern plains and Front Range communities alike. It is a good start. And, yes, there is more work to do.

Colorado has seen larger reductions on a percentage basis in the Affordable Care Act’s average benchmark health insurance premiums than Washington State, the first state to establish a public option two years ago. Since 2018, Colorado’s benchmark premiums have fallen by 25.3%, compared to a 15.5% increase in Washington State. While the approach in House Bill 1232 is not the same as Washington’s plan, it is still an instructive comparison as we look to contrast the results of a market-driven approach vs. a government-driven approach.

We know there is much more work needed to achieve real solutions to the health care woes that we face. But let’s be honest: we are all saddled by the burden of high costs in health care. And we should focus on solutions that benefit us all.

Laura Giocomo Rizzo is senior vice president of external affairs at the Denver Metro Chamber of Commerce.