After a long and winding path, Gov. Jared Polis on Wednesday signed into law two of the 2021 General Assembly session’s signature pieces of health care legislation that aim to make health insurance and prescription drugs more affordable.
“Saving people money on health care is really core to our goals and our needs as a state,” Polis said during the bill signing ceremony. “It's more than just health care, it's the well-being of our communities. It's economic security for ourselves, our families, and our small businesses.”
Under House Bill 1232, insurers, health care providers and hospitals would have three years to reduce premiums by 15%. The commissioner of insurance will create a standardized healthcare plan for the individual and small group market that insurance companies will be mandated to offer and doctors and hospitals mandated to accept.
The legislation from Reps. Dylan Roberts, D-Avon, and Iman Jodeh, D-Aurora, and Sen. Kerry Donovan, D-Vail, also sets fines for hospitals that refuse to participate, at $10,000 per day for 30 days and $40,000 a day after.
Speaking just ahead of the bill signing, Donovan said the event marked a "momentous day, not only in the history of Colorado, but in the advancement of progressive health care."
"As Colorado always does, we don't shirk away from the big issues," she said. "Instead, we say failure is not an option and that's what we did with this bill, even though it has taken years for us to get here."
The bill at one point included fines for doctors as well, though those were amended out. Under the final version of the bill, the commissioner would monitor for problem areas where health care providers are not participating.
Fines for doctors weren’t the only element of the bill to see changes, though. The legislation was originally envisioned as a "Medicare for All"-type public option health insurance plan that was to be developed and operated by the state government if health insurers, doctors and hospitals could not find a way to reduce premiums in the individual and small group market by 20% over two years.
But major opposition, including a multimillion-dollar ad campaign, drove Polis and the sponsors to the table to negotiate, yielding a bill that saw a handful of rewrites and amendments at nearly every stage of the legislative process. Both Polis and Roberts noted that flurry of lobbying while speaking ahead of the bill signing.
"We knew we were going up against the most well-funded opposition and I think this is going to go down as the most lobbied-against bill in Colorado history," the Eagle Democrat said. "But we always knew that patient stories and the reason we were doing this work was going to win the day and it did – we're here today and we beat it back."
For Polis, the lobbying efforts against the bill represented progress.
"When you're really getting close to solving an issue like the high cost of healthcare, the temperature in this building starts to rise – there's a lot more lobbyists out to stop it, there's a lot more outside communications demonizing our hardworking public servants that are trying to save people money," Polis said. "When that starts happening, you know that they're getting close to a real solution will work for everyday Colorado and by that measure, I'm confident that this Colorado Option will get the job done."
The final product cleared the Senate on a 19-16 vote. Sen. Rachel Zenzinger, D-Arvada, was the only Democrat to vote against it, though her colleagues Sens. Rhonda Fields, D-Aurora, and Joann Ginal, D-Fort Collins, both expressed skepticism before casting “Aye” votes. In the House, the bill was initially passed and subsequently repassed with Senate amendments along party lines.
Polis also signed into law Senate Bill 175, a measure that would allow an upper payment limit to be set for a dozen of the most expensive prescription drugs per year for three years.
"Coloradans are sick and tired of getting ripped off on the high cost of prescription drugs," Polis said ahead of signing the bill. "There's no silver bullet to fix it all, but this bill is a big step forward in helping reduce the cost of prescription drugs and save Coloradans money."
The payment limits established by the bill would be set by a new five-member Prescription Drug Affordability Review Board to be appointed by the governor no later than Oct. 1 and confirmed by the state Senate. Beginning Jan. 1, 2022, the bill from Sens. Sonya Jaquez Lewis, D-Longmont, and Julie Gonzales, D-Denver, and Reps. Yadira Caraveo, D-Thornton, and Chris Kennedy, D-Lakewood, would make it illegal to buy a prescription drug at a cost that exceeds the price cap established by the board.
While the fight over the Colorado Option was often front-and-center, negotiations on the prescription drug bill were similarly intense. The final version of the bill signed by Polis was significantly amended, with changes that took out items such as fines for pharmacies or insurance companies that buy drugs at prices that exceed state-mandated caps.
Jaquez Lewis, a pharmacist by trade, said ahead of the bill signing her work on the legislation "has been a true labor of love."
"There was not a day that went by in my career as a pharmacist where we didn't have patients coming into the pharmacy who could not pay for their prescription drugs," she said. "It was a struggle between basic living costs and paying for life-saving drugs."
Caraveo said she has seen the results of that struggle firsthand.
"I've seen far too many patients who come back weeks or months later, their condition has worsened and I say, 'What happened?' And they say, 'Well, I couldn't afford my prescription so I decided not to take it,'" said the Thornton Democrat who is the legislature's only physician.
"I think that we have made an incredible stride this year... in protecting the patients that I see in clinic every day so that doctors don't have to have those conversations. We can go back to having medical decisions and talks about what is going to make you better, not 'Can you afford it?'"