Colorado Politics

Reject reckless push for single-payer health insurance | OPINION

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Jim Smallwood



Like most of my colleagues, I view this year’s state legislative session as an important opportunity to advocate for common-sense policies to solve problems and make life better for Coloradans. But as we continue toward our constitutionally appointed May 8 adjournment, some legislators have instead chosen to pursue unaffordable, disruptive health care policies Coloradans have already rejected.

I am regrettably referring to HB24-1075, a bill to move our state further down the path to a complete takeover of Coloradans’ health care by politicians and bureaucrats in Denver. Those pushing for this redundant study of so-called “single payer” health insurance do so even though nearly eight in 10 Colorado voters overwhelmingly rejected this concept at the polls just a few years ago.

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Leading up to that vote, an analysis by the nonpartisan Colorado Health Institute shed light on the unaffordable costs of such a system, revealing it would more than double the state’s budget, costing Coloradans nearly $65 billion yearly and running a nearly $8 billion annual deficit by 2028. It does not require another taxpayer funded study to understand the costs of this system would necessitate higher taxes beyond anything Coloradans could afford.

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Not to mention we already have a case study for what a state government-controlled health insurance system looks like on a smaller scale, and it is nowhere near living up to what its supporters promised.

Three years ago, the legislature hastily passed legislation to establish the “Colorado Option.” This government-orchestrated plan design requirement was sold by many as a public health insurance plan that would provide a lower-cost option to Coloradans, increase health care affordability overall and strengthen the health insurance marketplace.

Many lawmakers, health care leaders and other stakeholders opposed the bill at that time, warning of the exact consequences Coloradans have seen since its implementation. As we predicted, not only has the Colorado Option failed to achieve its stated goals, it is also worsening the very problems its supporters said it would solve.

The law created new rate-setting mandates in 2021 that required health insurance companies to lower rates by 5% in the first year, 10% in the second year and 15% in the third year. Unsurprisingly, the arbitrary, state-designed price mandates didn’t work.

Three years later, premiums have not gone down. On the contrary, they have gone up. In the 2024 plan year, insurance premiums increased by an average of 10% across individual market plans, following a similar increase from 2022 to 2023. In many counties, the Colorado Option is not the most affordable option for consumers — private health plans are. Accordingly, only a fraction of Coloradans who purchase individual insurance enrolled in a public option plan, along with virtually no small groups.

But wait, there’s more! The Colorado Option’s price mandates are actually hurting the private insurance market in our state, as carriers are unable to meet the unsustainable, arbitrary rate reductions with actuarially sound plans. Four insurance carriers have now exited the individual market, small-group market, or both, leaving Coloradans with fewer choices for health coverage and making it apparently impossible to attract new small-group carriers to our state.

To make matters even worse, decreasing reimbursement rates to health care providers, which any government-controlled system relies on, will force providers to either pass increased costs on to consumers or cut services —another blow to Colorado patients no matter which they choose.

As a business owner, I know a healthy marketplace spurs competition, which, in turn, drives down prices and empowers consumers. As state government interference persists in distorting our state’s health coverage markets, Coloradans will continue to have fewer options and higher prices to pay. Instead of expanding access to high-quality, affordable health care, the lawmakers and government officials in Colorado are doing just the opposite.

Yet despite these obvious (and perhaps deviously purposefully planned) failures, some of my colleagues continue to push our state even further in the wrong direction, taking additional steps toward one-size-fits-all health insurance through a “single payer” system. This reckless approach insists on tearing out Coloradans’ existing coverage and care root-and-branch. There is a better way forward.

I was in the Colorado Senate when lawmakers designed and passed the state’s reinsurance program in a bipartisan fashion. Although I opposed the wealth distribution that I believe the reinsurance program legislated, it has delivered premium relief for some Coloradans in high-cost areas. Just this week, Gov. Jared Polis signed into law a bill I personally worked on with legislators in the majority party in both chambers, to create policy concerning group health insurance to save thousands of employees in Colorado real money. The Colorado Option, conversely, has done the opposite. There is an important lesson to be learned in this.

The Colorado Option has shown a one-size-fits-all, government-controlled insurance system simply does not work. It is true of the Colorado Option today, and would be even more evident if policymakers pushed every woman, man and child in Colorado into a single health insurance system that relies on the foolishly optimistic idea doctors and hospitals will agree to slash their own reimbursement rates because the government asks, “pretty please?”

Coloradans deserve a health care system that ensures access to high-quality care, affordability and the patient’s choice of payers. I urge my colleagues in the state Senate to join me in rejecting this so-called “single payer study” bill and instead pursuing sensible, bipartisan solutions to make real health care a reality for every Coloradan.

Jim Smallwood is the state senator for District 2 in Douglas County, and Ranking Member of the Senate Health and Human Services Committee.

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