In what is expected to be a long evening in the chamber, the House is debating House Bill 1232, the public option bill that intends to dramatically change the health insurance market for those who buy their own insurance and for small businesses.
The original bill is gone, wiped out by a strike-below amendment in the House Health and Insurance Committee on April 27. The most striking difference: sponsors Reps. Dylan Roberts, D-Eagle, and Iman Jodeh, D-Aurora, took out the public option — a quasi-state-run health benefit plan — leaving a state-developed health benefit plan that requires doctors and hospitals to accept or face warnings or massive fines.
The bill also reduced the premium target reduction from 20% over two years to 18% over three years.
HB 1232 is intended to cover another 18,000 Coloradans in the individual and small business market, which is about 15% of the total insured market. In opening comments at the start of debate, the bill's sponsors said the health benefit plan will provide affordable health insurance to people of color and those in rural Colorado, which has the most expensive health insurance in the state due in part to the limited number of carriers in some counties.
"There are constituents in my district and all over the state who are paying absolutely unaffordable premiums for themselves, their families, or their small businesses, and there are far many more who are going without insurance at all, just because of what it costs," Roberts said.
"We can do better in Colorado."
Jodeh, meanwhile, reminded the chamber she had shared her own personal story of what it was like to be diagnosed with epilepsy as a teenager.
"What I didn't tell you was that I remember being the daughter of small business owners and not having insurance, going to visit a neurologist for a 15-minute specialty visit only to look up at my mom in the reception area writing a $350 check," she said.
That experience, she said, was not only traumatic for her but institutionalized for her family generational trauma, an experience she said many minorities and rural Coloradans have also faced.
"Healthcare costs are too high — hard-stop, period," she said. "They are simply too high and it's un-American."
A series of GOP lawmakers followed up that introduction with floor speeches expressing vehement opposition to further government intervention in the health care field, which they said would shift costs onto providers.
"What you're doing is economic warfare on a critical part of our economy," said Rep. Andres Pico, R-Colorado Springs. "We want to lower cost of care, we all do, but you can't have it at the cost of cost-shifting and what you're going to do is drive people out of the business."
Rep. Shane Sandridge, another member of the Colorado Springs GOP delegation, urged the bill sponsors to steer clear of individual anecdotes on health care, which he said "are not answers to our questions and concerns."
"We'd like a conversation; we'd like a response," he said. "Hopefully we can get these answers of why we have so many people contacting us with concerns. And again, a story about a constituent having expensive health insurance is not an answer to our questions."
The fight Thursday will be over amendments, dozens expected from both sides. House Minority Leader Rep. Hugh McKean of Loveland told Colorado Politics that his caucus's biggest objection to the bill is that it is an artificial imposition on the market with arbitrary numbers. The only analysis was done before the pandemic, he said, in advance of the 2019 reinsurance bill.
"We have no analysis of what room there is in the system right now. I would suggest that we don't even know what health care looks like next year because of what we've just been through."
McKean said Republicans will talk about the authority of the commissioner of insurance and question why Democrats want to create something that doesn't exist anywhere else: a mandated reduction and creation of a standardized plan that incorporates reductions that can't be defended, and then a requirement of the acceptance of that plan. The fines proposed — $5,000 per doctor and up to $2.3 million for hospitals — will put rural hospitals out of business, McKean said.
"When we talk about the actual effects of the words of the bill," there's tremendous potential for harm, McKean added.