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Governor Polis Unveils Grand Plan for Health

For the past several years, the big question in U.S. health policy was what comes after the Affordable Care Act?

The answer might be shaping up right here in Colorado.

The Affordable Care Act (ACA) did a great job of expanding health coverage and launching innovative new ideas. But it didn’t do much to improve affordability — or care. People have noticed — especially those stuck in rural Colorado’s expensive individual insurance market.

Gov. Jared Polis campaigned on tackling high health care prices, and on Thursday, he unveiled his grand plan: the Roadmap to Saving Coloradans Money on Health Care.

Polis noted that Congress and President Trump have no plans for fixing the health care system.

“What that means is it’s time for states to take the lead on saving people money on health care,” Polis said.

His roadmap is an ambitious mix of short-term and long-term actions, from passing a public insurance option this year to expanding the health workforce and increasing access to healthy food.

It attempts to answer many of the major challenges in health: the high price of medical care, the troubled individual insurance market, the cost of prescription drugs, access to behavioral health care, and social factors such as access to healthy food.

Polis and Lt. Gov. Dianne Primavera unveiled the roadmap at a press conference on the Denver Health campus Thursday. “Unveiled” might overstate the case — many parts of the roadmap have been public for months and are working their way through the legislature.

In fact, Polis has already signed into law the roadmap’s first item, House Bill 1001, which requires financial transparency at Colorado hospitals.

Polis said he’s “cautiously optimistic” that most or all of the health bills in his roadmap will pass as the legislature enters the final month of its session. Those bills are:

  • A reinsurance program for the individual market (HB 1168).
  • Granting the power to consumer groups to negotiate their health insurance plans (Senate Bill 4). (This bill would help the new Summit County Peak Health Alliance.)
  • A ban on surprise out-of-network billing (HB 1174).
  • Asking federal permission to import prescription drugs from Canada (SB 5), and improving price transparency of prescription drugs (HB 1131).
  • Creating a state-run public option for insurance (HB 1004).
  • Requiring insurers to invest more in primary care (HB 1233).
  • Making greater use of physician’s assistants (HB 1095) and emergency medical service providers (SB 52).

That alone makes for an ambitious health agenda. (Learn more about its prospects by signing up for CHI’s legislative home stretch webinar on April 17.) But there’s a lot more action happening outside the legislature.

The idea of a health care affordability roadmap predates the Polis administration. Kim Bimestefer, director of the Department of Health Care Policy and Financing, crisscrossed the state last year to promote a suite of cost-saving reforms. A key part of that plan is the Hospital Transformation Program, which will channel around $1 billion in payments to hospitals into incentives to improve care and reduce costs.

Polis included the Hospital Transformation Program in his own roadmap. (CHI will publish a deeper look at this program later this month.)

The governor also announced that he will create a behavioral health task force this month that will craft a statewide strategic plan for behavioral health by June 2020.

“You can’t separate behavioral health from physical health,” Polis said.

Other long-term initiatives include improving vaccination rates and boosting enrollment in food security programs, such as Supplemental Nutrition Assistance Program, commonly known as SNAP, and Women, Infants, and Children (WIC).

Will all of the bills pass? Will they help reduce costs, improve the quality of care, and improve the health of Coloradans? We don’t know yet. But all in all, it’s the most comprehensive agenda for health that a Colorado governor has put forward in many years.

Read the 10-page Roadmap to Saving Coloradans Money on Health Care here.

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