DENVER – As the negative consequences of a new state government health insurance system become clearer, dozens of witnesses – health care professionals, small business owners, economic experts, union leaders, carriers, and skilled workers – traveled near and far to voice tremendous concerns and opposition to House Bill 21-1232 during a first hearing before the House Health and Insurance Committee. Lawmakers should listen to the calls to slow down, allow for more analysis and work together to build on and improve what’s working in health care – not push forward with a flawed bill without considering alternative solutions.

Dr. Mark Conklin, Orthopedic Surgery Specialist (Golden, Colorado):

For the last two decades now, physicians, hospitals, AFC’s, payers have been working together to cut costs. The reason we’ve been doing that is behind the scenes is that we’ve seen a decrease of 30% in the reimbursement of Medicare based on inflation over the last 20 years. In addition, we’ve seen an increase of 60% and overhead over that same period of time. So in order for us to survive, we’ve had to find innovative ways to reduce costs on our own…But as we work to reduce costs, we always have the patient’s health in mind. We don’t use arbitrary figures or set numbers to reach because we don’t know whether that would affect patient care. So first and foremost, we follow the Hippocratic oath to first do no harm. I and my partners cannot support a cost reduction that has no reassurances, that we will not need to weigh our own livelihood with the outcome of our patient care. Please do not put us in that position.

…The bill calls for a board or an authority where the members would be appointed to make sure that the cost reductions are implemented. Only one member of that board would represent providers. I do not believe that the board has the knowledge and the experience necessary to make those very tough decisions of cutting costs without affecting patient care. I plead to the committee to allow the providers, hospitals, payers to continue to do this very important work that we have been doing and getting results.

Dr. Rob Vissers, President and CEO, Boulder Community Health:

Our caregivers or doctors will have to reduce or stop costly needed services, such as mental health or trauma preparedness…

A few weeks ago, we all watched in horror as the event at King Soopers unfolded just a few miles from our hospital. The waiting was long and painful. There was waiting at the hospital as well, but it was filled with anticipation preparation, assembling teams of experts to ready to provide life-saving care. We would save these people. We were ready, but the ambulance has never came. The 10 victims died in the store. We couldn’t reach them. We couldn’t help them. We could only take solace knowing that we remain ready to serve our community every day as we have for the past hundred years. And I sincerely hope for the next hundred to come.

Dr. Reggie Washington, Chief Medical Officer, Presbyterian/St. Luke’s Medical Center and the Rocky Mountain Hospital for Children in Denver:

I have some concerns about the potential impact this bill will have on the ability to deliver healthcare at Rocky mountain hospital for children, we have the largest level four NICU neonatal intensive care unit in the region. I’m concerned when we have to care for a 20 week premature baby, which can fit in the palm of my hand, these babies in our hospital for three to four months.

Maria Fenwick, Member, SEIU Local 105:

Health care workers see the challenges and barriers every day to cutting health care costs. Workers are tired of taking the brunt of the cuts. Workers are tired of seeing those cuts lead to diminished quality of care. And diminished quality of care is going to lead to higher costs. This bill is like a surgeon taking a bone malate to a knee to beat cancer instead of healthcare provider looking at imaging and strategically figuring out the best precision scalpel cuts to cut out that cancer and prevent it from coming back. Cutting costs 20% without any strategic thought on what or where or how is unrealistic and it is a slap in the face to healthcare workers who strive to provide high quality care to their patients.

Dave Davia, Executive Vice President and CEO, Rocky Mountain Mechanical Contractors Association:

1232 is misguided, from my perspective…Our actuarial analysis shows it will shift $1 million of costs, much like grabbing a balloon and pushing in the middle, those costs will appear in our plan. The Kaiser Family Foundation and others that have gone before me have cited Common Sense Institute saying that we have seen unprecedented decreases in health insurance costs. The closest state to us, Washington, who has done something somewhat similar to what is being fashioned here is shown a 15% increase in those costs even after a state option has been passed. The individual and small markets have two ways in order to compete. They have to compete on price, they have to compete on access. And both of those are not contemplated here. We believe that trying to combat high costs in insurance, 1232 is not the answer to that.

Tony Gagliardi, State Director, NFIB Colorado:

I’m here today on behalf of my membership to oppose House Bill 1232. Colorado State Government Option will put a political appointee in charge of the designing a plan by rule with the ability to manipulate the private health care insurance markets and the small group market.

$1,500 per month? A thousand dollars per month? How do we determine what the premium should be and where do we shift the costs of reducing that premium? House Bill 1232 is not designed to compete with private insurance plans. It’s designed to enforce as many Coloradan families as possible into a new government-controlled health insurance system.

Zack Zaslow, Senior Director of Government Affairs, Children’s Hospital Colorado:

This bill would threaten access to care for children, including, and potentially, especially those who rely on Medicaid and disproportionately harmed their largest provider of care in Colorado…If we were fully carved out of this bill, it would still impact the health system in the state.

And of course we don’t treat kids, in a vacuum or on an Island…And so we care about the impact, not just on us, but on other providers. And if the topline cost reduction goals in the bill are going to be met, but we start carving folks out, other small businesses like pediatric practices and other health care providers that see a real significant percentage of Medicaid in their case mix will have to make tough business decisions, especially if they’re required, under threat of their license to prioritize Colorado option patients over low income, disabled or Medicaid patients.

Lauren Masias, Director, Colorado Competitive Council:

The details of the bill did not provide for a realistic or reasonable opportunity for success. The timeline and process for applying for federal waivers and establishing the new authority suggest there was a foregone conclusion that the Colorado option will be operational as early as 2025. If the arbitrary targets aren’t met, the state would automatically, without further legislative action designed the Colorado option plan to compete with the plans offered by commercial insurers.

Debbie Brown, Colorado Business Roundtable

We’re only starting to understand the impacts of COVID-19 hospital. Finances are heavily strained across the state and they’re projected to lose 4.4 billion in the next 12 months. Putting our most vulnerable hospitals, particularly rural hospitals at risk of closure. We recognize that this is a complex system and we appreciate the lawmakers working on this important issue, but we’re concerned that price setting in the private industry, isn’t the role of government at this time, preserving what works and implementing common sense steps for the future are critical to our future success.

Dennis Doherty, Executive Director, AFL-CIO:

On behalf of health care workers, we urge this committee to ensure this bill does not cause workers to be negatively impacted. When any company faces cost cutting requirements, they go after workers’ pay and benefits first. It is the fastest way to achieve cost reduction, but also the most harmful for working families and the economy as a whole.