What They Are Saying: The State Government Option (House Bill 21-1232) Is A Setback For Patient Health Care Access

May 19, 2021

DENVER – Ahead of today’s hearing before the Colorado Senate Health and Human Services Committee, physicians, providers and health care professionals, economic experts and community leaders voiced serious concerns and strong opposition during a first hearing this week regarding House Bill 21-1232, which would create a new state government-controlled health insurance system, known as the state government option. Lawmakers should listen to the call of medical professionals to slow down, weigh the facts and work together to build on and improve what’s working in health care – not start over with an untested new state government health insurance system.

Dr. Mark Johnson, President-elect, Colorado Medical Society:

We, physicians, also want to solve the problem with exorbitant health care prices and health care access. And we have a vested interest in helping our state achieve that goal in meaningful and sustainable ways. We cannot just cut costs. We need to prioritize better value in our healthcare system. This bill does not do that.

This bill also exacerbates workforce shortages, the cost to the state, the taxpayers and patients, more in the long run than immediately. It also takes unfair advantage of burned out physician workforce that has been on the front lines of a devastating pandemic for over a year. 

Michael Randle MD, FACP – Chief Executive Officer, UCHealth Medical Group:

Colorado now has the 11th lowest hospital prices in the nation. The prices of Colorado’s average benchmark premium have dropped to 28 percent since 2019. Without amending this bill, the financial results to many of our health systems and to our provider groups will be quite negative. And this will have a negative effect on our ability to attract and keep excellent medical providers, including physicians, advanced practitioners, nurses, and pharmacists.

There is a growing national shortage of these providers, especially physicians and nurses. And cutting the revenue to healthcare systems and to medical groups will not only affect the potential compensation for these providers, but also the ability to provide infrastructure and associate workers to help with giving great care. This is a team sport.

We’ve been very fortunate in Colorado, not only to have a great place to live, but also to have a great environment for healthcare. This proposal will drastically change that. Our providers will increasingly look to regions and states with better healthcare environments, we’ll lose our current providers and it will be much more difficult to recruit new ones, and in many instances, the highest performing providers will probably be the first to leave. And we’ll be left with the system that will struggle greatly to continue to have quality and access.

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

I think any opportunity to discuss access to health care, affordability, quality, social determinants of health and racial inequities is very important… However, I must oppose House Bill 1232, because it only, and I say only decreases payments that a person must make for their insurance. It doesn’t address the other issues. And I think it’s grossly unfair to the hospitals that have to bear the majority of the cost of the bill, where we only attribute one third of the costs, it leaves out pharmaceuticals and others. You’ve heard from our other colleagues how our hospital systems take care of the sickest patients so I won’t review that for you today. I also want to review for you some of the services that would be at risk if this bill were to be enacted such things as outreach clinics to the various communities on the Western Slope, the Plains and the North Front Range. I also won’t mention our mobile training center, which allows educational opportunities for physicians and nurses throughout the state. But is it no cost to them? 

Ryan Simpson, President and Chief Executive Officer at The Medical Center of Aurora:

Unfortunately, however, this bill does not meet its mission to achieve lower costs, nor does it address increased access or improved quality. In fact, the unintended consequences of this legislation will have far ranging adverse impacts on access, quality, and even costs. I’d like for you to consider the cost of care.

A lot has been said about hospital profit margins, somewhat inaccurately. The reality is margins equal our mission. Hospitals need financial reserves to adequately respond to the growing healthcare demands of our communities, whether chronic or in times of crisis. Financial reserves also are essential to hospitals to have the resource to respond in the case of a public health emergency, like COVID-19, while at the same time, supporting Colorado’s 75,000 frontline hospital employees with lifesaving PPE, childcare and paid leave, and avoiding furloughs, pay decreases, and layoffs.

Dr. Jeff Krawcek, Pediatrician and Executive Medical Director-elect, Kaiser-Permanente Medical Group: 

This legislation relies on an outdated fee-for-service rate setting model, which drives volume of care. More unnecessary tests and procedures, which we know drives costs…It’s not the model that drives affordability and it’s not the model that drives the best quality of care or outcomes.

This proposal would drive health plans, physicians and hospitals out of the state, shrinking our state’s medical community. This will be felt by Coloradans in the form of reduced access and reduced care. Furthermore, the actual cost of care is not decreased under this proposal. This bill sets rates for doctors, but does nothing about the underlying costs of providing care. 

Stuart H. Myers, MD – Colorado Orthopedic Consultants:

This legislation will make private practice less viable, drive physicians into early retirement or into opportunities in adjacent states and we’ll make new physician recruitment more difficult. It will also push providers into hospital employed arrangements, which will increase costs further. I realize this statement could easily be seen as a plea for orthopedic surgeons to make more money. It is not. It’s a plea to avoid legislation that will deal a severe blow to our relatively low cost, high-value mode of taking care of patients.