Colorado health care will change in 2023 if the Health Insurance Option bill (HB21-1232) is passed into law, and change is an understatement. Deputy Director of the Colorado Consumer Health Initiative, Adam Fox, says, “What this bill is really about is controlling the underlying cost of care as the mechanism to really bring down health insurance premiums.”

Starting in 2023, health insurance costs would be cut down almost 20% by 2025, forcing hospitals and staff to cut their costs, but one lawmaker says hospitals can only cut costs one way and it’ll hurt the quality of care. State Representative for District 54 (R), Matt Soper, says, “I really fear what’s going to happen next. It’s really easy to cut doctors, cut nurses because human capital is the biggest part of a hospital’s budget.”

Part two of the bill reimburses hospitals 155% for taking a loss for taking Public Option Plan patients. “Right now, the health care industry can really decide how they want to meet those cost reductions, and those rates really only come into play if they don’t,” said Fox.

But, Soper says most hospitals on the Western Slope need 270% to break even because of the pandemic, and he’s not alone. Community Hospital CEO, Chris Thomas says, “If they force and mandate rates, and mandate participation; are we going to have providers that are willing to take patients that have this particular insurance plan?”

Community Hospital will build a big, brand new $76 million, 130,000 square foot building and add it to its base of operations, but if the biggest health care bill in Colorado passes, they might struggle to hire the staff to support it. “Recruiting primary care to this community, that’s been such a challenge for us for the last decade, and we’ve been very successful in increasing that. I’m just worried about what that’s going to do if physician reimbursement is such that we’re not going to be able to attract the best and the brightest to the Grand Valley,” said Thomas.

Providers can be fined $5,000 for not seeing standardized patients, but hospitals will pay $10,000 a day for the first 30 days, and $25 grand a day after that. “I’m not sure it’s going to help anyone. We’re really concerned about the public option and what it’s going to do to access to care,” said Thomas. “Health care costs have continued to increase and they’re at an unsustainable level already and if we don’t do something to control that, we’re going to be in a much worse situation down the road,” said Fox.

After being asked where the bill goes next, State Representative Soper says the bill will go through Appropriations and then the House for Debate. “And, I can tell you this is going to be a very long debate,” said Soper.

Soper says you can’t lower insurance costs, increase hospital reimbursement and still balance the Colorado health care system.

Deputy Director Fox says the cost of health care keeps going up and has for years and this will balance the equation for small businesses and rural providers.