Q&A: CHA’s Joshua Ewing talks upcoming session, public option and Biden Administration

Joshua Ewing, Vice President of Legislative Affairs at the Colorado Hospital Association (CHA), spoke with State of Reform Friday about the health sector’s COVID-19-dominated priorities, the more than 100,000 vaccines CHA has helped administer so far and how Colorado’s health care landscape could change with the imminent shift in national leadership.



Eli Kirshbaum: What are CHA’s expectations and priorities for this legislative session?

Joshua Ewing: “I don’t know what to expect this session. I think it’s very much going to be a situation where we are, and this is an overused analogy, but building the plane as we fly it. It’s really going to depend on how successful we are at getting a handle on the spread of the virus. I can tell you right now our hospitals and health systems are still very much in the thick of the fight against COVID, and that is dominating everything we do, and so we’re not approaching this legislative session in the way that we typically do. We’re very much focused on the priority at hand, which is taking care of patients and helping to stem the spread of the virus.”

EK: Does CHA foresee a renewed effort at establishing a public option in Colorado this session?

JE: “We know that the legislative sponsors from last year, so Rep. Roberts and Sen. Donovan, continue to meet with stakeholders as well as folks from the Polis Administration. We’ve had some good conversations with both of the sponsors. What we’ve been told is they’re still trying to figure out the details of what they want to bring forward, if they do bring something forward this year. But we have not yet been engaged on specific details around what a public option may or may not look like, because I just don’t think that they’ve made any decisions at this point. I think we’ve made a lot of progress as a state over the last few years, specifically around the topic of affordability.

So we sent a letter jointly with the [Colorado] Association of Health Plans and the [Colorado] Medical Society, just asking, “Hey, we care about affordability too. There’s a lot going on, and we’ve done a lot already in this space, but we’d like to be a part of the conversation.” So we hope to continue to engage in that way, and if something moves forward this year, to be brought in early on to help shape what that looks like.”

EK: Say the details are worked out this year and a public option introduced. Do you think it’s reasonable that it would get passed? Do you think that’s realistic given how red the Legislature is? Or do advocates need to change the way they approach it in order for other legislators to agree with them?

JE: “I think the reality on the ground has changed. COVID is a once-in-a-generation event that’s going to have lasting consequences and impacts to our health care system. It has not lessened the importance of improving affordability in our health care system, but it’s likely changed what policy solutions may look like. I think that’s the biggest challenge and unknown that we’ve faced is we don’t know what the impacts will be to our health care system yet. We don’t know what providers may have to close up shop or what access will look like. We don’t know what the long-term financial implications will be of a global pandemic, so it’s hard to say what a potential public option will look like and how it will be received in the legislature at this point.”

EK: So you think legislators that would normally be opposed to it might potentially be even more opposed to it due to the uncertainty going on, and the unclearness of what it would even look like?

JE: “You know, I don’t know if folks will be more opposed to it or more supportive of it, I think it goes both ways depending on who you are. But I think the reality is that it’s really hard to talk about systemic changes when we are still very much in the throws of fighting this virus.”

EK: Can you speak to CHA’s role in the vaccine distribution process?

JE: “Hospitals and health systems have been at the front line of distributing and administering vaccines at this point in the process. The top tier, or the initial doses, are slated for our frontline health care workers, and I’m really proud of the work that we’ve been able to accomplish in getting those folks vaccinated. It’s not moving as quickly as anyone would like — if there’s one thing we can all agree on, it’s that we want this over with as soon as possible and we want everyone who wants a vaccine to get a vaccine. But I think there’s a monumental task in both developing the vaccine and getting it in the arms of the health care workers. It’s just been an amazing feat to watch, and I’m optimistic that we will continue to play a leading role in helping get Coloradans vaccinated.”

EK: Can you list some specific examples of how CHA has been involved?

JE: “So CHA, as an organization, works very closely with folks at the state Emergency Operations Center, the Governor’s Office, as well as our local public health agencies in planning and carrying out the work around vaccine distribution. It’s really about the work of our hospitals who have stood up, on very short order, on mass vaccination operations. I forget the numbers as of today, but it’s well over 100,000 folks who have been vaccinated at this point, largely from hospitals.”

EK: Will the incoming Democratic leadership at the national level change CHA’s outlook on what is possible for health care progress in Colorado?

JE: “It’s hard to say right now, but I think, first and foremost, we know that we won’t continue to see attempts to overturn through the courts any piece of the Affordable Care Act. We see that as a positive, we’ve been opposed to attempts to overturn the Affordable Care Act. We need to maintain and protect that access to affordable health insurance coverage, to Medicaid expansion, so we see that as a positive development. And then I think President-Elect Biden is assembling a very talented team at the federal level who will make health care a priority, and as someone who has worked in health policy for more than a decade, as someone who represents frontline health care workers across the state, it’s never a bad thing when we’re talking about how we can improve our health care system. So we’re optimistic that both at the federal level and the ongoing conversations at the state level, we’re going to continue to improve access to care and access to high quality affordable care.”

This interview has been edited for clarity and length.