Polis health care package 2023

Gov. Jared Polis, joined by more than a dozen Democratic lawmakers, announces a package of health care bill, March 2, 2023. 

Gov. Jared Polis, joined by 14 Democratic lawmakers, announced a package of five new bills intended to reduce the cost of health care for Coloradans.

The package also includes four measures already moving through the legislative process.

As first reported by Colorado Politics early Thursday, a bill to modify the state's prescription drug affordability board, created under Senate Bill 21-175, is among the bills. The measure would allow the board to annually review any number of expensive drugs, instead of the dozen capped by the legislation.

The board hasn't actually conducted those reviews yet nor has it reported its progress to the governor or the legislature. That report isn't due until July 1.

However, according to Commissioner of Insurance Michael Conway, each drug being reviewed may have different dosage levels and hence different costs, so the board needs authority to look at more than a dozen. 

House Bill 1201, which was introduced on Feb. 14, would bar pharmacy benefit managers (PBM), which act as go-betweens with health insurers and drug manufacturers, from charging employers more for a drug than what the PBM pays a pharmacy for the same drug. It's known as "spread pricing," and allows the PBM to keep the difference.

Another bill that has not yet been introduced would increase oversight and transparency over PBMS "by requiring them to register with the state," as well as "bolstering enforcement" of practices prohibited by law.

The hospital community benefit legislation would hold nonprofit hospitals accountable for their investments in community needs as a condition for nonprofit status, although that's a status granted not only by the state but by the Internal Revenue Service.

During the Thursday news conference, the governor repeatedly claimed hospitals overcharge patients, which has been based on reports by the Colorado Department of Health Care Policy and Financing. The Colorado Hospital Association has pointed out that the data from the state is based on profits pre-pandemic that no longer exist. 

Denver Health, a nonprofit, safety net hospital, recently sought $5 million from the General Assembly in an effort to keep its door open. The hospital said it had less than 100 days of operating funds when it made the request in January. 

Out of the 108 hospitals in Colorado, 42% are nonprofit.

A bill on Colorado Option, the state-designed health insurance plan, seeks to "limit excessive profit and administrative expense," and put more teeth into the 2021 law's requirement that private health insurance providers cut premium costs by 5% per year over three years.

On the issue of hospital transparency, lawmakers will introduce legislation to "shed light on the underlying drivers of high hospital costs," including improved data collection on the financial health and performance of Colorado hospitals. 

Policymakers also identified three other bills, including measures introduced on the session's first day back in January, in the package, including Senate Bill 2, which seeks authorization from the Centers for Medicare & Medicaid Services to provide Medicaid reimbursement for community health worker services; Senate Bill 4, which makes it easier for health professionals to work in schools; and Senate Bill 93, which deals with medical debt. 

While no Republican lawmakers attended Thursday's press conference, four of the bills announced Thursday received bipartisan sponsorship.

(0) comments

Welcome to the discussion.

Keep it Clean. Please avoid obscene, vulgar, lewd, racist or sexually-oriented language.
Don't Threaten. Threats of harming another person will not be tolerated.
Be Truthful. Don't knowingly lie about anyone or anything.
Be Nice. No racism, sexism or any sort of -ism that is degrading to another person.
Be Proactive. Use the 'Report' link on each comment to let us know of abusive posts.
Share with Us. We'd love to hear eyewitness accounts, the history behind an article.