DENVER — MaryAnne Brown couldn’t be more pleased with the new cost of her health care plan.
The Grand Junction resident saw her plan, which she gets through Rocky Mountain Health Plans right here in town, drop 30% thanks to a new program created by the Colorado Legislature last year.
“I saved like $500 a month,” Brown said. “I have an individual plan with myself and my two kids. We used to pay $1,644 a month, and now we pay $1,160 for the same plan. I got a notice from Rocky saying that our individual plan would drop 30 to 40% this year. I called immediately because I was thinking, ‘This can’t be right.’”
Sure enough, it was.
Brown was able to get that reduced rate, which amounts to $6,000 a year, thanks to the state’s new reinsurance program for individual plans purchased on the state’s health insurance exchange. That program is designed to allow insurance companies to get reimbursed for covering high-cost patients, which allows them to drop the cost of plans for everyone else.
“That’s pretty exciting,” Brown said. “It’s like getting another Christmas present. When your insurance costs more than your mortgage payment, that’s just ridiculous.”
That reinsurance program is only one of several things the Colorado Legislature and governor’s office have tried to do to lower the cost of health care, particularly for rural residents who have seen double-digit increases in their premiums annually for several years.
State policymakers, however, aren’t done with things they want to enact in attempts to help further lower those costs, chief among which is a controversial idea to create a new public option insurance plan for some people who purchase health care coverage on the exchange.
Although a bill hasn’t yet been introduced to create that option, the idea being proposed by the Colorado Department of Health Care Policy and Finance and the Division of Insurance would get all private insurance companies that operate on the individual market to offer this public option, which would impact only about 8% of Coloradans. The bill would allow them to do so at the same time they offer their regular plans.
Hospitals that serve patients who have those plans, however, would see their prices capped at no more than 225% of what Medicare pays. According to a Rand Corp. study of hospital charges released early last year, some are charging 300% to 600% of what Medicare pays.
Democrats who control both chambers of the Legislature and the governor’s office have expressed support for the idea, but Republicans are less sold on it, in part, because of fears that it would open the door to some sort of Medicare for all plan to encompass everyone.
A study released last week by the REMI Partnership, a coalition of free-market conservative groups in the state, said the public option plan won’t do much to help everyone see reduced insurance premiums.
“Focusing exclusively on reducing insurance premiums for some in the individual market via direct government actions could come at the expense of all other health care stakeholders, including patients, employers, insurance carriers, hospitals and others,” said Chris Brown, director of policy and research for the Common Sense Roundtable, one group in the coalition.
“Savings resulting from government-set rates to consumers have to come from somewhere, and by just lowering negotiated rates without truly addressing underlying costs, a public option stands to benefit a few Colorado consumers at the expense of every other stakeholder,” he added.
While some parts of the state are working to lower costs, some lawmakers have introduced bills requiring insurance carriers to cover more, which could help drive up costs for policyholders.
One measure, HB1086, would require insurance carriers to include an annual mental health wellness examination, while another measure, HB1085, would require carriers to provide non-pharmaceutical alternatives to opioids. Both measures limit the amount of co-payments insurance companies can charge.
Beyond that, there are several measures that have been introduced aimed at helping to reduce or at least control the price of prescription medications.
One such measure, HB1160, attempts to do several things, such as requiring health insurers to submit reports to the commissioner of insurance about what they paid in drug reimbursements, and force drug manufacturers to report dramatic increases in what they charge for prescriptions.
Last session, the Legislature approved a bill to find a way to import prescription drugs sold in Canada, which are cheaper than those offered in the United States.
SB119 attempts to open that same program up to other nations. That program isn’t yet in operation, and won’t be unless it receives a waiver from the federal government.