Colorado Capitol Report

The Colorado Chamber Hosts Health Exchange CEO and Cost Commission Chairs in Pre-session Meeting


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CACI Hosts Health Exchange CEO and Cost Commission Chairs in Pre-session Meeting

Thursday, CACI’s HealthCare Council convened its annual pre-legislative session meeting to discuss the range of health sector issues that may be addressed by legislation or ballot initiatives in 2016.  CACI’s new HealthCare Council Chair, Wes Skiles, Government Affairs Director for CACI member Kaiser Permanente led the discussion with guest speakers, Kevin Patterson, Bill Lindsay, and Cindy-Sovine Miller.

Kevin Patterson is the recently appointed CEO of Connect For Health Colorado, Colorado’s health insurance exchange that was established as part of the implementation of the Affordable Care Act.  Mr. Patterson presented regarding the health exchange’s operations, and the ongoing open enrollment period for individual’s that are in the market to buy or renew their health insurance coverage.   Under the federal Affordable Care Act, all individuals are required to attain or purchase health insurance, or face penalty fees if they remain uninsured.  In Colorado, individuals that do not receive their health insurance coverage from an employer, a spouse’s employer, or via Medicaid, Medicare, or Tri-Care are considered to be in the individual health insurance market.  For those in the individual marketplace, there is a deadline of December 15 to secure health insurance coverage through Connect For Health Colorado, an insurance broker, or directly through a health insurance provider in order to ensure they have active health insurance coverage by January 1, 2016.

Mr. Patterson noted that the open enrollment period is a particularly important time for Connect For Health Colorado.  He explained that leading up to the December 15 deadline to renew coverage, the exchange may receive between 9,000 – 11,000 calls per day, exceeding its average daily call volume of 2,500 calls.  In the past, the initial open enrollment periods were hampered by glitches in the new health exchange’s website and online point of sale system, as well as by the overwhelming number of calls that the exchange phone lines received in the final days leading to the deadline to secure coverage.  Mr. Patterson noted that while challenges still exist, the 2015 open enrollment period has been relatively successful compared to past cycles.  As of this week, nearly 49,000 customers had signed up for qualified health plans via Connect For Health Colorado, which is over double the number of customers who had signed up as of this time last year.

The announcement earlier this fall that the Division of Insurance would not reauthorize Colorado Health-OP’s, the state’s cooperative health plan (see statement here: https://cohealthop.org/health-cooperative-closure-press-release/), ability to sell plans due to a lack of federal funding that was vital to the CO-OP plan’s operation has put additional pressure on Connect For Health Colorado.  More than 80,000 Coloradans had previously secured health insurance coverage under CO-OP health plans they had purchased on Connect For Health Colorado.   Due to the closure, these individuals are not able to simply renew their health insurance coverage, but have been forced back into the marketplace for new individual coverage plans for themselves and their families.  Mr. Patterson referenced that Connect For Health Colorado is currently considering an extended open enrollment period that pushes back the deadline to secure coverage until the end of January or February for Coloradans impacted by the closure of the Colorado Health-Op.

Bill Lindsay, President of the Lockton Employee Benefits Group, and Cindy Sovine-Miller, a political consultant who specializes on health care issues, are the Chair and Vice Chair of the Colorado Commission on Affordable Health Care, or “Cost Commission.”  See here for the Commission’s website: (https://www.colorado.gov/cocostcommission).  Established by Senate Bill – 187 in 2014, the Cost Commission was charged by the General Assembly with investigating potential best practices aimed at keeping the cost of health care affordable.  Referencing the complexity of the health care sector and the size of the issue, Mr. Lindsay framed the task as looking for new policies that impact the operation of one-sixth of Colorado’s economy.  The Commission has a bipartisan makeup, as it is comprised of five republicans, five democrats, and two independents.  In addition to the twelve voting members, non-voting members such as Dr. Larry Wolk, Executive Director of the Colorado Department of Public Health and Environment, and Sue Birch, Executive Director of the Colorado Department of Health Care Policy and Financing are also engaged in the Cost Commission’s efforts.

Since the summer of 2014, the Commission has met twice per month to discuss broad topics such as transparency of health service pricing, workforce issues in health care, payment and health service delivery reform, among others.  The Commission’s list of target issues, potential recommendations, and ideas that will not advance as recommendations can be accessed here.

It remains to be seen as to how the Commission will refine its broad recommendations into the annual report it is required to deliver to the Colorado legislature.  Furthermore, it is unknown at this point whether the Commission’s funding will be renewed in order to support the continued work of the Commission beyond the current 2015 fiscal year.  While the Cost Commission has partnered with some local philanthropic foundations to ensure its work can continue through the 2015 fiscal year, the state’s prevailing budget uncertainty has clouded talks regarding ongoing future funding for the Cost Commission.

Finally, CACI’s HealthCare Council discussed a list of potential issues that may be addressed by legislation or ballot initiatives in 2016.  ColoradoCare, which will appear on the 2016 statewide ballot in Colorado as Amendment 69 was the initial issue up for discussion.  This effort seeks to essentially end the existing health care delivery system that relies on a mix of private and nonprofit health insurance plans, and government subsidized programs such as Medicare and Medicaid and then adopt a single payer health system that would be entirely government-run.  The system would require nearly $25 billion annually in taxes.  CACI’s Board of Directors has adopted an official position to oppose the ColoradoCare initiative.

While CACI does not take positions on state legislation until it is officially introduced, the Council discussed issues of importance that are likely to receive attention in the 2016 legislation session.  Lawmakers have held recent stakeholder meetings regarding efforts to increase transparency around prescription drug pricing and formulary rules and procedures.   Furthermore, issues around network adequacy that impact the complex system of rules, regulations, and health system practices that determine where and how patients access certain types of health service providers and specialists have also generated interest among CACI’s HealthCare Council membership.  CACI will certainly continue to work with its impacted members to monitor conversations regarding these, and other issues.


Doug Friednash, Chief of Staff for Governor John Hickenlooper, met with the CACI Board of Directors

On Thursday, Doug Friednash, Chief of Staff for Governor John Hickenlooper, met with the CACI Board of Directors. Friednash, right, discusses the Governor's policy agenda and the state of the Colorado economy while Travis Webb, CACI Board Chair and Managing Partner, BKD Advisors, LLP, and Keith Pearson, CACI Board Chair-Elect and President, McLane Western, listen. Friednash discussed the Governor's 2016-2017 proposed budget, TABOR refunds, the hospital provider fee, Amendment 69 (the single-payer, health-care system known as ColoradoCare), education and workforce development, affordable housing and construction defects reform, and the politics of 2016, an election year.

On Thursday, Doug Friednash, Chief of Staff for Governor John Hickenlooper, met with the CACI Board of Directors. Friednash, right, discusses the Governor’s policy agenda and the state of the Colorado economy while Travis Webb, CACI Board Chair and Managing Partner, BKD Advisors, LLP, and Keith Pearson, CACI Board Chair-Elect and President, McLane Western, listen. Friednash discussed the Governor’s 2016-2017 proposed budget, TABOR refunds, the hospital provider fee, Amendment 69 (the single-payer, health-care system known as ColoradoCare), education and workforce development, affordable housing and construction defects reform, and the politics of 2016, an election year.


Federal Policy News

Congressional News In Brief:

  • Education: On Wednesday, the Senate passed a bipartisan re-write of No Child Left Behind by a vote of 85-15.  The “Every Student Succeeds Act” changes prior standards to include greater state and local school flexibility, while much of the original bill’s testing components remain.
  • Hope For the Tax Extenders Package?: Momentum and progress continues to grow for both a short-term, two-year bill, as well as a permanent tax extenders package.  The bills are being dual-tracked in negotiations, as large factions of both parties had sticker shock from the $700 billion-$800 billion price tag (over  10 years)  on the permanent provisions bill.
    • Measures to be included are: 179 expensing and small business expensing, Earned Income Tax Credit (EITC), the Child Tax Credit (CTC), and removing the “Cadillac Tax” from the Affordable Care Act (ACA).
    • One sticking point: Democrats want the CTC indexed for inflation and, for many fiscal hawks, there is overwhelming support for removing the Cadillac Tax but this repeal will also remove a $98 billion revenue stream.
      • Last week, the Senate voted to remove the Cadillac Tax (90-10); that amendment is attached, however, to a separate bill that President Obama has promised to veto because the bill would repeal the ACA.
  • Congress will likely work through next Wednesday, December 16th, to address the Omnibus funding bill, as well as potentially the tax extenders packages.  Senate Majority Leader Mitch McConnell (R-KY) and House Speaker Paul Ryan (R-WI) have previously announced work would be completed today or early tomorrow.