Based on some of his initial conversations with carriers, Colorado Insurance Commissioner Michael Conway believes the insurance market is “headed in the right direction” to meet the criteria set out by the bill. âPublic optionâ recently adopted by the State. He made these comments during a recent webinar hosted by Colorado Healthcare Strategy and Management (CHSM).
While it was initially a strong bill that would have created a government-run health plan, several months of arguments in the legislature produced amendments which significantly amended the public option bill. The past version of Bill 21-1232 – instead of creating a state-regulated plan – will require health plans to meet annual premium reduction targets over the next several years.
Effective January 1, 2023, health insurance plans are required to offer both a standardized individual and small group health insurance plan that meets these goals. For 2023, the premium must be at least 5% lower than the carrier’s 2021 premium rate. It must be at least 10% lower than the 2021 rate in 2024, and 15% lower in 2025. After 2026, the premium must not increase more than the rate of the previous year, taking into account the medical inflation.
If the plans do not meet these goals, the Colorado Division of Insurance (DOI) will hold a public hearing to hear the plan’s reason for not complying. After reviewing the evidence from the hearing, the Commissioner can set reimbursement rates for the carrier that did not comply and require hospitals and health care providers to accept patients and those reimbursement rates. .
During the CHSM webinar, Conway said:
“I sincerely hope that we never have to intervene.”
While he expects health plans to succeed in meeting premium reduction targets, he said he was ready to step in if necessary.
âIf they fail, however, we have the ability to really come in and shed light on why the market has failedâ¦ It’s that transparency and it’s that ability to control downstream costs that I think, is going to really keep the elements of accountability in play.
The division began the process of implementing HB 21-1232 by organizing meetings with stakeholders to gather feedback on the design of the standardized plan. DOI has already hosted three of the six planned stakeholder meetings to gather feedback from the general public and industry stakeholders. There will be three more on September 24, October 8 and November 4.
The DOI has added additional meetings designed to address specific stakeholder groups. Apart from these meetings, the division also invites individuals to share their contribution via E-mail. View recordings of previous meetings and schedule of upcoming meetings here.
Conway underscored the importance of these meetings in a statement last month:
âThe division wants to hear from the Coloradans with their thoughts, ideas and concerns about the Colorado option and the standard benefit plan. If we want this to work for people, we need to hear from people and answer their questions. ”
DOI Assistant Insurance Commissioner Kyle Brown will talk about the division’s work to implement the public option at our next Colorado Reform State Health Policy Conference 2021 October 20.
He will be talking about our “What’s next for the Colorado public option?” Panel and will be joined by Leah Hole-Marshall, General Counsel and Chief Strategist of the Washington Health Benefit Exchange, Representative Dylan Roberts, one of the sponsors of HB 21-1232, and Amanda Massey, Executive Director of the Colorado Association of Health Plans. Register now here!