SB 168 Introduced With Goal Of Creating Colorado Health Care Cooperative

by Louise on February 18, 2011

In a continuation of the string of healthcare-related legislation we’ve seen recently, Colorado Senate Bill 168 was introduced earlier this week. SB 168 would create a nonprofit healthcare cooperative to act as the benefits administrator and payer for health care services in Colorado.  Similar to several other healthcare bills we’ve seen over the years, this one would implement change in a multi-step process:  first by creating a proposed Colorado Health Care Authority, which would design the cooperative and take it to the legislature and then voters for approval.

SB 168 notes that although the PPACA will likely reduce the number of people who are uninsured, it will do little to address a range of other problems, including rising healthcare costs, the unaffordability of healthcare even for people who have health insurance, over-utilization of care, and the problems created when we link health insurance to employment.  After reading through the description in the bill of how the cooperative would function, it appears that it would basically be a non-profit health insurance program (which would be secondary to any other health insurance a member has) that emphasizes the use of medical home style “integrated health care delivery systems”, patient-physician shared decision making, electronic health records, and overall transparency.

The bill also addresses funding for the cooperative, including coordination with federal and state health care funding source – both existing and anticipated as a result of the PPACA and other health care reform legislation.  Initially the benefits package offered by the cooperative would be modeled on benefits offered by Medicare, but could expand (as funds allow) to include coverage for dental, vision, chiropractic, hearing, and long-term care services.

So far, the 2011 legislative session in Colorado has seen several health care bills introduced, and 2011 marks the implementation of the gender equality and maternity coverage legislation that were passed in last year’s session.  As the federal debate surrounding health care marches on – both in the legislature and the court system - Colorado continues to make health care reform a priority on a state level as well.  It will be interesting to see if SB 168 is successful in creating its proposed Health Care Authority and ultimately a non-profit health care cooperative.

{ 11 comments… read them below or add one }

Don Levit February 19, 2011 at 3:52 pm

Louise:
Because the coop is a non-profit insurer, does that mean it can design plans that are typically not sold by commercial insurers, in order to maintain their non-profit status?
Why would the authors of the legislation make this insurance secondary?
If they made it primary, they could offer distinctive ways to get to $25,000-$50,000 of coverage, thus shaving 50-70% of the premiums off of the secondary employer plan.
If you can provide the author’s E-mails and phone numbers, I would be happy to contact them.
Don Levit

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John Shapiro February 20, 2011 at 12:13 am

Louie & Don,

I believe there is a fair amount of misinterpretation/misunderstanding in your posts. Remember that the bill creates the Authority that would create a blueprint for a Cooperative that would address the issues of rising costs, affordability, over-utilization and employment links. Additionally, insurance provided by the Cooperative would actually be intended as primary insurance. People could still chose purchase secondary insurance.

There is more information available at:

http://www.cohealthcoop.org/

And Don, relevant contact information can be found at:

http://www.cohealthcoop.org/contact

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Louise February 21, 2011 at 12:12 pm

John,
Thanks for your comment, and for providing the contact info for Don. But I’m a bit confused by your statement that the insurance provided by the Cooperative would be intended as primary insurance. On page 19 of the bill, section 10-016-1112 states that “The Cooperative shall serve as a secondary insurance payer to any other health insurance coverage plan in which a member is enrolled.” This point is also specifically noted in the bill summary on page 2.
I do understand that the bill would create the Health Care Authority, which would then be tasked with creating the Cooperative. But could you explain the discrepancy in terms of primary versus secondary insurance?

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Don Levit February 21, 2011 at 12:32 pm

Louise and John:
Thanks for your help.
I’ll get back with you regarding what I find out.
And Louise, I did get your E-mail for the sponsors inn the House and Senate.
Thanks a lot.
Don Levit

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Jay February 21, 2011 at 12:49 pm

John:
You say “[...]insurance provided by the Cooperative would actually be intended as primary insurance. People could still chose purchase secondary insurance.”

Obviously, the term “primary insurance” is only used when there are two policies involved (a primary and secondary insurance policy). But the bill, the cohealthcoop website, and the Coloradoan article all say that the Coop will be secondary whenever an insured has two policies. Louise’s posts look to interpret that information accurately. I couldn’t find anything saying that the coop would be primary in any situations where an insured had another policy.

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Don Levit February 21, 2011 at 1:19 pm

Folks:
I just E-mailed Ivan Miller who is Senator Aguilar’s assistant.
I could not find a similar assistant for Rep. Kefalas.
If anyone could provide an E-mail for his assistant, I would appreciate it.
Louise and Jay:
If you could send me your E-mail again, I can send to you the letter I just sent to Ivan Miller.
Don Levit

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Jay February 21, 2011 at 1:29 pm
John Shapiro February 21, 2011 at 2:24 pm

Jay, Don and Louise,

I apologize. I think I could have responded to the original post a bit more succinctly in saying that:

I believe that the INTENT of forming the Cooperative is that it would become most Coloradan’s primary insurance, and they would choose to drop any other coverage they had. And I believe you are right that, if someone has another policy, the Cooperative insurance would become secondary. My intention was to point out the intent piece, and again, sorry for not being more clear.

Don: Ivan is definitely the person to contact. I was planning on providing you with his email address, but it looks like you found it.

Cheers,
John

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Louise February 21, 2011 at 4:10 pm

Don – Thanks for the email of the letter you sent to Ivan Miller. Please let us know what you find out.

John – Thanks for clarifying the issue of the coop being secondary insurance. From reading through the bill, it does indeed look like the goal is to create a very comprehensive insurance policy that could stand alone as a member’s only coverage. We look forward to hearing more details as time goes by.

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Don Levit February 21, 2011 at 5:18 pm

Folks:
Let’s keep this coop out front as time goes by.
Wouldn’t it be cool if this could be actually a distinctive insurer to really make all the insurers better in Colorado – sort of a private/public option?
John, if you can get the contact person for Rep. Kefalas, I will send him (or her) the same letter I sent Ivan.
Louise:
Feel free to send the letter I sent Ivan to John (or any one else who comes to mind).
Don Levit

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John Shapiro February 22, 2011 at 12:45 pm

Don,

I don’t have the contact information for Representative Kefalas.

Also, if you are interested in helping to keep the Cooperative “out front” as you mentioned, please contact me. Letting folks know about the Cooperative is something we are working on; you could help us or I could get you in contact with other groups that are working on it. Because I don’t want to post my email address to be picked up by spam-bots, please go to the contact page of my organization:

http://www.oneplanmakessense.org/contact

Cheers,
John Shapiro
OnePlanMakesSense.org

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