Legislature takes steps toward health-care reform

By Cherry Sokoloski
North Forty News

Like the tortoise in the old fable, the Colorado legislature made slow but sure progress toward health-care reform during the session that ended in May.

"We didn't take on comprehensive health-care reform, but we did a number of things that expanded access," said Rep. John Kefalas, D-Fort Collins, who serves on the House Health and Human Services Committee.

Coming up with a comprehensive plan, Kefalas noted, would have meant referring some items to the voters, since new taxes would be necessary for large-scale reform. It's possible that the legislature will be ready to refer a plan to voters in 2009, he said.

Notable achievements this year, Kefalas said, included expanding eligibility for children in the CHP+ program and Medicaid. Senate Bill 160 makes it possible to cover up to 50,000 more children with health insurance through these programs, by increasing eligibility from 205 to 225 percent of the federal poverty level. A companion bill, SB 161, streamlines the process for applying for the programs.

Other bills reduced the waiting time for services for people with disabilities, took steps to reform the private insurance market and made it easier for advanced practice nurses to deliver primary care. A major accomplishment, Kefalas said, was a complete overhaul of the public health system, modernizing it and making it more efficient.

The legislature put $10 million into services for the disabled, Kefalas noted. In addition, people with disabilities who are working can now stay on Medicaid, but they will pay for a portion of their insurance coverage.

In terms of insurance reform, the legislature passed several bills that further regulate the industry. "As long as we have private health insurance, we want to make sure it's a fair and effective system," Kefalas said.

New laws make insurance companies justify rate increases before they can be implemented, hold companies accountable if they unreasonably deny or delay claims, and allow the state insurance commissioner to seek damages on behalf of misled consumers.

In addition, the legislature provided some help to primary care physicians who say that dealing with insurance companies is too cumbersome and costly. Senate Bill 135 increases efficiency by mandating standardized health benefit plan cards, and House Bill 1375 increases Medicaid reimbursement rates for physicians. Kefalas said he hopes that HB 1375 will encourage more doctors' offices to accept Medicaid patients.

Reimbursement rates for community health clinics like Salud were also increased.

Despite differences in health-care philosophies, Kefalas said, the legislature "found some common ground in addressing some of the extraordinary administrative costs" of health care.

Three different bills increase the authority of advanced practice nurses, such as nurse practitioners. "We recognize that we have a shortage of primary care doctors in Colorado, and that nurses play a valuable role," Kefalas said.

In summary, Kefalas said this year's health-care legislation provided incremental change. "It's an incredibly daunting task," he said, to work toward comprehensive reform.

Kefalas plans to meet with community groups this summer to gather ideas and strategies for moving forward with reform.