State's health-reform commission studies five plans

By Cherry Sokoloski
North Forty News

Colorado's 208 Commission is now considering the merits of five different health-care reform proposals.

The commission's primary goals are to increase the number of Coloradans with health care coverage and to reduce health care costs. Its recommendations to the state legislature are due by Jan. 31.

Two of the plans were authored or promoted by Larimer County groups, one by officials with the Health District of Northern Larimer County (A Plan for Covering Coloradans) and the other by Health Care for All Colorado, which has a northern Colorado chapter (Colorado Health Services Plan).

While four of the five plans would still involve private insurance companies, the fifth--a single-payer financing approach--would eliminate private insurance and have everyone covered by a state insurance plan, similar to Medicare, the federal health insurance program for people who are 65 and older, or who meet other special criteria.

One point of comparison among the plans is what types of "mandates" they have--that is, whether individuals, employers or both are required to purchase health insurance. This requirement has been compared with the state requirement to have vehicle insurance.

Another difference in the plans is the level at which subsidies would be given to help individuals purchase health insurance. Levels relate to the federal poverty level (FPL), which currently is set at an annual income of $20,650 for a family of four. Plans offering subsidies to families up to 300 percent of the FPL would cover more people than plans offering subsidies up to the 250 percent FPL level.

Plans compared

The following is a brief description of each plan, including features, the number of Coloradans who would remain uninsured and the total cost.

Currently, health-care costs in Colorado total $30.1 billion annually. Those costs include insurance premiums paid by employers or individuals, out-of-pocket health expenses, and government health programs such as Medicare, Medicaid and the Child Health Plan Plus (CHP+).

The most expensive of the five plans is "A Plan for Covering Coloradans." Only one plan--"Colorado Health Services Plan" or single-payer - would reduce health-care costs in the state. The plan leaving the greatest number of people uninsured is "Better Health Care for Colorado." The only plan that covers everyone is the single-payer plan.

All plans would require increased expenditures by the state, meaning increased taxes. (See related TABOR article.)

Better Health Care for Colorado: No mandates. Coloradans remaining uninsured: 467,200. Increase in health spending in the state: $595 million. Premium subsidies for families with incomes up to 300 percent of the FPL. Core benefit plan would be guaranteed. Both Medicaid and CHP+ would be expanded to cover more Coloradans.

Solutions for a Healthy Colorado: Carries an individual mandate for purchasing health insurance, but not an employer mandate. Remaining uninsured: 133,400. Increase in health spending in the state: $271 million. Premium subsidies for families with incomes up to 250 percent of the FPL, with a core benefit guaranteed. Both Medicaid and CHP+ would be expanded.

A Plan for Covering Coloradans: Mandates for both employers and individuals to purchase health insurance. Remaining uninsured: 106,500. Increase in health-care spending in the state: $1.3 billion. Again, government low-income programs would be expanded. Premium subsidies for families earning up to 400 percent of the FPL, with guaranteed issue of insurance.

Colorado Health Services Plan (single-payer): Financing for the plan would come from income taxes and a 6 percent payroll tax. All Colorado taxpayers would pay increased income taxes instead of health insurance premiums. Remaining uninsured: 0. Decrease in health-care spending in state: $1.4 billion. Residents currently covered under Medicare, Medicaid and other federal/state programs would be covered under the new plan.

Proposal by 208 Commission: This proposal calls for an individual mandate to purchase health insurance, with an exception for those deemed not able to afford it; it has no employer mandate. Premium subsidies up to 400 percent of the FPL. Both Medicaid and CHP+ would be expanded to cover more people. To date, analysis of cost and coverage has not been completed for this plan.