Colorado Bill Would Allow State To Opt Out Of Federal Healthcare Laws

The Healthcare Opportunity and Patient Empowerment (HOPE) Act (HB 1273) was introduced in the Colorado House of Representatives this week, with primary House sponsorship from Reps Nikkel and Stephens (the House majority leader), and primary Senate sponsorship from Senator Kopp.  The idea behind HB1273 is to allow Colorado to legally opt out of the PPACA – not just the individual mandate portion, but the entire law.

Last November, Colorado voters rejected Amendment 63, which would have prohibited any government mandates requiring people to purchase health insurance.  The language in the PPACA that requires nearly everyone to carry health insurance as of 2014 is definitely one of the more unpopular aspects of the law, but was still supported by enough Colorado voters that Amendment 63 did not pass.  Polls indicate that relatively few Americans want to repeal the entire healthcare reform law (although overall support for the law is still very split – many people want to see changes to the law, even if they don’t want it repealed entirely.  And apparently quite a few people think that it’s already been repealed).  So it’s unclear whether a bill that would basically overturn the PPACA – as it applies to Colorado – will be popular with the state’s residents.

The idea behind HB1273 is to allow Colorado to join together with other states to develop a “health care interstate compact” in which the states would opt out of federal healthcare reform laws and instead regulate healthcare on the state level.  The bill emphasizes the sovereign power of the states, and notes that the US Constitution gives rise to a “federal government of limited and enumerated powers” – which does not include the power to regulate healthcare, according to the bill’s creators.

The first hurdle for the bill – if passed – would be getting the US Congress to recognize the interstate compact as a legitimate body, and agree that the states could take over regulatory control of healthcare.  By joining together with other states, the Colorado lawmakers feel that they could present a stronger case than if they were to try to go it alone.  Judging from the slew of healthcare reform lawsuits brought by various states over the last several months, it shouldn’t be hard for the Colorado bill’s sponsors to find other states that would be willing to enter into the interstate compact.

In terms of specifics, the bill would allow the states in the compact to opt out of federal healthcare reform.  But it also would allow

“…each signatory state the right to choose to receive federal funds for the state’s Medicaid program in the form of block grants and to choose to use those federal funds in the manner the receiving state deems appropriate without having to comply with federal law requirements…”

This is more than a little worrisome, as it seems like it would set up a blank check program for the states, allowing them to use Medicaid money however they saw fit – which might not be at all in the best interests of the state’s Medicaid population.

The bill would also allow the signatory states to look into the possibility of setting up programs to allow for the purchase of health insurance across state lines.  This has long been a proposal put forth by opponents of the PPACA, but it’s not as simple as it might sound.

HB1273 was just introduced this week, so it remains to be seen whether it will have legs or not.  Either way, it will be interesting to see what the Colorado constituents think about this bill, as I’m sure lawmakers will hear from a lot of people with strong opinions on both sides.


About Louise Norris

Louise Norris has been writing about health insurance and healthcare reform since 2006. In addition to the Colorado Health Insurance Insider, she also writes for,, Verywell, Spark by ADP, and Boost by ADP, and Gusto. Follow on twitter and facebook.

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