In a final report to the state Legislature last week, the 208
Commission on Health Care Reform proposed solutions to expand
coverage and lower costs.
The proposals include mandating insurance for Colorado residents
and expanding and restructuring the Colorado Children’s Health
Program and Medicaid while emphasizing personal
responsibility.
In addition, the commission recommended requiring insurance
companies to cover everyone. The plan was supported by 90 percent
of the commission’s 27 members.
A key component of the report is the requirement for all
residents to be insured, thus strengthening the pool with the
healthy and the young.
The proposals range in cost from $15 billion for universal care
to $1.2 billion to implement the commission’s 32 recommendations
that include streamlining the administration process.
The report states that, of the 792,000 who are uninsured in
Colorado, about 40 percent are between ages 19 and 34, 20 percent
are children and 57 percent are white.
Seventy-five percent of the uninsured have family incomes of
$50,000 or less, 32 percent earn $20,000 or less, and 13 percent
have family incomes of $75,000 or more. Seventy percent of the
uninsured are in the workforce or are the dependent of a
worker.
While Gov. Bill Ritter has all but squashed a tax increase for
healthcare on this year’s ballot, at least some of the commission’s
recommendations are not necessarily based on spending more
money.
“Maybe not,” said Clarke Becker, member of the commission and
executive director of Rural Colorado Economic Development Council
who lives in Woodland Park. “Think about it. What I think is missed
is that $31 billion is spent on health care today in
Colorado.”
With better administration, more consistency and strengthening
the insurance pool with healthy people, that $31 billion could be
repositioned and costs reduced, Becker said.
“But it takes time because we will have to change the way we do
business,” he said.
The mandate for insurance carries a penalty through the income
tax system while providing sliding-scale subsidies for low-income
workers to purchase private coverage.
For the Medicaid program, the commission recommends increasing
fees paid to physicians.
“A lot of doctors won’t take Medicaid because of the low
payment, 20 cents on the dollar,” Becker said. “We need to make
that system stronger so that we get more people into the
system.”
While Becker isn’t expecting the plan to be adopted this year,
or even next year, he views the commission’s suggestions as a
seed.
“The real secret to this is what the legislature will do with
this,” Becker said. “I was real pleased to hear Gov. Ritter make it
clear that there’s not going to be a major tax or healthcare
proposal on the ballot.
“It’s just not practical,” Becker said. “My own opinion is that
there will be legislators, because this is an election year, or
because they think it has to be done, who will push components of
the recommendations.”
With the federal government in flux on issues that include
health care, the commission’s recommendations won’t be discarded,
Becker said.
“Whatever comes out of the federal government will blend nicely
with our recommendations,” he said. “We also want to be careful
that we don’t become a magnet for people, so our recommendations
require a three-month residency to be eligible.”
Asked if the commission is concerned that its report may be
ignored or superseded by legislative bills, Becker said, “If I’m
concerned, it’s that somebody has had their mind made up as to how
they need to fix the system. And in a knee-jerk reaction, go off
and do their own thing without considering the tremendous work that
has been done here, the work that is supported, been validated and
can provide such clear direction for future decisions,” he said.
“This should be a road map to the future of healthcare in
Colorado.”
The Legislature’s challenge is to create a sense of unity and
bipartisan direction that gives the voters confidence that their
money will be responsibly spent, Becker said.
“That’s what it’s all about. Our plan is bold and realistic but
it’s going to take time and persistence.”
Former Gov. Bill Owens initiated the commission and appointed
its members in 2006. Twelve commissioners were appointed by
Republicans while 15 were appointed by Democrats.
“We had 27 people with 27 ideologies and for the most part we
listened, set our differences aside and truly came together to
create an incredible document that elevates the discussion that has
never been done before and like no other state has done,” Becker
said. “From what I’ve seen and heard Colorado is on the leading
edge of healthcare reform.”