Colorado Representative Janak Joshi (R, Colorado Springs) is continuing his efforts to get government out of healthcare, but his latest bill died in a 9-2 vote in the House Health, Insurance and Environment Committee, with the no votes coming from both political parties. Joshi’s defeated bill would have repealed the 2011 law that created Colorado’s health insurance exchange/marketplace (now called Connect for Health Colorado). Joshi claimed that the law to establish the exchange was created “in a very hurried way without having due thought process on it”, but Republicans and Democrats on the Committee rejected his portrayal and voted to keep the exchange – which has already made a lot of progress towards an opening date this fall – and the law that created it on the books.
Rep. Joshi has introduced other healthcare legislation over the past few years. Two notable ones (neither of which passed) include an effort to repeal the Healthcare Affordability Act of 2009 (that Act created the Hospital Provider Fee system, which generates funds that the state uses to expand Medicaid, CHP+ and the Colorado Indigent Care Program) and legislation that would have removed the caps on HSA contributions (as I noted at the time, such a law would have primarily served to create a tax shelter for wealthy Coloradans, but would have done little or nothing to help people in Colorado who struggle to afford or access healthcare).
Rep. Amy Stephens, who was a co-sponsor of the exchange creation legislation, pointed out that not only was the exchange law crafted with a lot of thought and input from Colorado businesses, the alternative was to have Colorado’s exchange run by the federal government in a generic one-size-fits-all manner that would not have involved much state-level input. The states on this map that are labeled as “default to federal exchange” are the ones that didn’t choose to set up their own exchange. That doesn’t mean that they get a pass on ObamaCare. It doesn’t mean that everything will continue with the status quo. Those states will still have exchanges/marketplaces, and their health insurance plans will be regulated under all of the same ACA provisions. But their exchanges/marketplaces will essentially be created by HHS rather than by local people who are aware of the specific needs of their state.
Given all of that, and given the progress that Colorado has made over the past two years in creating the state’s marketplace and implementing various other healthcare reforms (both state-based, like maternity coverage and gender-neutral premiums, and ACA-related, including the recent push to expand Medicaid), I would say that Colorado is on track to greatly improve its overall healthcare outcomes. Efforts to set the state back to square one in terms of reform efforts are probably politically motivated rather rooted in any real attempts to bring about real healthcare improvements for the people of Colorado.