5 Things Colorado: Katherine Mulready, Public Option, Legislative update

Monte Whaley is our new State of Reform reporter covering health policy in the Colorado legislature. He won a Pulitzer for covering the Aurora shootings while a journalist at the Denver Post, and is now directing his talents at health care. If you see him at the capitol or at events around town, don’t hesitate to introduce yourself.

Now, onto 5 Things We’re Watching in Colorado health care and health policy¬†for the month of February.

 

 

With help from Michael Goldberg

 

 

1. Bills picking up steam one month into session

At the capitol today, reporter Monte Whaley says there is “a huge presence here lobbying from both sides” on vaccination legislation. A senate bill geared toward increasing the youth vaccination rate in the state has drawn both outspoken support and outspoken opposition. Sen. Julie Gonzales‘ legislation would increas requirements for parents seeking vaccine exemptions. The bill aims to bring vaccination rates in schools to, or above, the 95 percent “herd immunity” threshold.

Prescription drug costs are taking center stage in the House via the “Colorado Prescription Drug Transparency Act.” It would direct the Division of Insurance to report on the effect of prescription drug costs on premiums. The bill would also require health insurers to reduce premiums to adjust for rebates insurers receive for prescription drugs.

2. What They’re Watching: Katherine Mulready

Katherine Mulready is the Senior Vice President & Chief Strategy Officer at the Colorado Hospital Association (CHA). She joins us in this edition of “What They’re Watching” to discuss the CHA’s preferred alternative to the state public option. CHA says it is working with its member hospitals on an alternative model that is rooted in total cost of care and expects a draft bill to be introduced before the end of the month.

“On behalf of the CHA, we’re focused on considering alternatives to the state option proposal. We think it’s a little too narrow and doesn’t meet the objectives that HB 1004 from last year really set on the table. We’ll be proposing a total cost of care alternative that looks much broader and achieves the same level of affordability, if not more.”

3. Governors recount Public Option battles

In a conversation between the first Governor to get a state public option passed and a Governor vying to become the second, Colorado Gov. Jared Polis relayed to Washington Gov. Jay Inslee the fight he’s waging with Colorado hospitals to implement the final phase of his public option plan. Citing profit margins that exceeded $2 billion in 2018, Polis said the hospitals are lobbying hard to defeat the plan.

The state option’s primary cost saving mechanism would consist of limiting payments to hospitals to between 175% and 225% of Medicare rates. According to the draft proposal, this could lower premiums by 10% to 18%. A cost shift analysis report based on the draft proposal estimates that anywhere between 4,600 and 9,200 people will enroll in the state option in its first year.

 

4. Hospital accountability measure affirmed in new report

A new report by the Colorado Health Institute (CHI) suggest that increased scrutiny of community health programs provided by nonprofit hospitals could spur increased spending for underserved populations. Due to legislation such as HB 1320, nonprofit hospitals are now required to submit community benefit activity reports to the Colorado Department of Health Care Policy and Financing revealing how much they intend to spend on specific benefits.

CHI says the new emphasis on public accountability will bring about heightened scrutiny of a hospital’s community work by the public and legislators; incentivizing new spending on community health needs in excess of $120 million. The report also provides tangible examples of hospitals engaging with the community in substantive ways, such as the development of affordable housing units and screening for food insecurity.

5. Lessons from the coronavirus

The coronavirus has transfixed me these last few weeks, causing me to have a range of conversations with folks about our ability to respond to the outbreak here. I’ve learned about a central paradox in public health: we probably aren’t ready for a pandemic, but being honest with the public about not being ready may cause more harm than good. So, it’s better to convince ourselves we’re ready, I guess, and not ask tough questions in public. (What?!)In the Washington State case, we learned that anti-viral drugs first developed to ward off AIDS appear to have efficacy. We have learned that it’s increasingly possible we’ll just start to catch pneumonia like we catch the flu. From Hong Kong we’ve learned to expect a run on toilet paper if the virus hits here.

And, we know that Colorado’s rate of hospitalizations from the flu this year is widespread. There have been 2,095 hospitalizations in the state since flu season began and the flu has already killed 10,000 Americans this year alone. Nevertheless, new threats are scarier than existing threats, even if mortality rates are the other way around.