Legislation in Review: Advancing Health in Uncertain Times

The break between legislative sessions offers a good time to step back for some historical perspective.  Are there trends that form a pattern, a theme or consistent approach? And can those trends predict what may come next or teach us which strategies may be most effective?

CHI, which provides information and analysis to Colorado policy leaders, has written a report to help understand the legislature’s health policy work. Legislation in Review: Advancing Health in Uncertain Times, first published on CHI’s web site Wednesday, reviews the major health policy legislation passed by the 2011 General Assembly and looks ahead to potentially big issues in the 2012 session. The report follows on the heels of last spring’s Legislative Opportunities and Trends 2011, which discussed major health policy legislation in the state over the past five years.

Our reviews show an interesting pattern. As Colorado began to wrestle with rapidly increasing health care costs and the growing number of uninsured Coloradans, the legislature created the Blue Ribbon Commission for Health Care Reform in 2006. The result, a road map for health reform, included many recommendations that were similar to measures later appearing in the national reform legislation. The commission showcased two of Colorado’s strengths: foresight on pressing issues and an ability for diverse stakeholders to create solutions to complex problems.

Past legislation also reveals that Colorado approaches complex problems incrementally. This approach enables progress while mitigating risks.  Instead of one comprehensive bill, over the past five years the General Assembly has passed individual bills that:

• Promote healthy communities
• Improve access to private and public insurance
• Increase quality and reduce costs through transparency and accountability
• Improve scope of practice issues and develop a state-wide health care workforce

The 2011 legislative session continued that incremental trend despite the challenges of a daunting budget deficit, a new administration and a politically divided legislature with philosophical differences over national health reform.  More than 26 health-related bills were passed.

Colorado, like the nation, has significant fiscal challenges ahead.  The Center for Colorado’s Economic Future at the University of Denver projects the general fund expenditures for the Department of Health Care Policy and Financing – which administers the state’s Medicaid and Child Health Plan Plus programs - will more than triple by FY 2024-25.  It is important for Colorado to continue to implement key reform measures like those outlined by the Blue Ribbon Commission’s diverse stakeholders in its 2008 report.

There are a number of programs underway in Colorado that demonstrate policy makers have the commitment and stamina to advance public health one program at a time. Some of those programs, which CHI is monitoring, include:

• The All-Payer Claims Database, a data collection system of health care claims to enable consumers to compare quality and cost
• Patient protections in insurance programs such as coverage of preventive care
• Pilot programs for payment reform such as the Medicaid Accountable Care Collaborative

One of the most significant health care bills enacted in 2011 created the Colorado Health Benefits Exchange, a nonprofit entity which will serve as a new insurance marketplace for individuals and small businesses. The exchange is one more investment to improve quality and reduce health care costs for Coloradans - even in uncertain times.