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The CHI Weekly Legislative Update: March 9

The CHI Weekly Legislative Update: March 9

The Colorado House on Monday (March 12) approved continuing an innovative health care pilot program in Pueblo County for five years, extending it until July 2017.   Health Access Pueblo is a community-based non-profit that seeks to provide affordable health care for adults who are employed but uninsured.

HAP, as it is called, was started by a coalition of local health care systems, health care providers and the Greater Pueblo Chamber of Commerce. Several foundations provided funding to develop it. The state legislation, first authorized in 2007, permits HAP to operate outside the parameters of the Colorado Division of Insurance.

HAP isn’t an insurance plan. Instead, it is a program that provides access to health care. The employer, the employee and the  community (contributions from hospitals and foundations) each pay $60 a month. Services include preventive care, primary care, authorized specialty care, routine laboratory test and prescription drugs up to $2,000 a year.  Additional services, such as inpatient and outpatient hospital stays and imaging, are limited to $30,000 a year.

Eligibility is limited to those working a minimum of 15 hours a week, earning $25 an hour or less and who don’t qualify for public or private health insurance. HAP’s average enrollee earns $12.33 an hour, or about $25,500 a year.  Participating employers must be located in Pueblo County and have two or more eligible employees.  Eighty-one employers are participating and 267 employees are enrolled.

Enrollment began in August 2008.  A Health Resources and Services Administration (HRSA) grant the next year let HAP develop an outreach and marketing program. Chief Executive Officer Laura Kelly said the goal is to increase enrollment to 500 by the end of the year.  About 16,000 people were eligible in 2010.

HAP is one of two “multi share” health coverage programs in Colorado. The other is CarePoint, which provides coverage in Alamosa, Conejos, Costilla, Mineral, Rio Grande and Saguache counties. Minnesota, Oregon, New York, Texas and Virginia are testing multi share programs as well.

Although each “multi share” program is unique in terms of their services and populations, they have a number of commonalities. They are targeted to the uninsured who are working for small employers; they are grass-root, community-based efforts to provide care for those who find health insurance out of reach; and they require significant community effort to identify the services that employees, employers and health care providers find most valuable and affordable.

These programs will not be qualified health plans in the federal health reform law and it is uncertain whether they will continue if the law’s coverage provisions are implemented in 2014.

HB12-1017, the HAP bill, will next move to the Senate.  House sponsors are Representatives Keith Swerdfeger (R) and Sal Pace (D). Senator Angela Giron (D) is the Senate sponsor.