Leadership series: Opponents urge alternatives to Colorado’s public option, drug importation

Senator Jim Smallwood, chair of the Colorado Senate Minority Caucus, said Senate Republicans are prepared to “play a lot of defense” in the Legislature this session. This will primarily entail resisting pushes from the “further left” of the Democratic party to establish a public health insurance option and to import prescription drugs from other countries.


Get the latest state-specific policy intelligence for the health care sector delivered to your inbox.


At State of Reform’s virtual event on Wednesday, “Leadership Series: Health Policy in the 2021 Colorado Legislature,” Smallwood and his fellow panelists discussed these ambitious endeavors and implored stakeholders to consider other pathways to increasing health care affordability.

“I’m working with my caucus to bring forth solutions that work now, rather than a lot of the rhetoric that we’ve heard. A lot of it is going to be playing defense against things like single-payer, which, if you follow Colorado politics, was a campaign promise [from Gov. Jared Polis]. Coordinating efforts against that is a heavy lift.”

Katelin Lucariello, director of state policy for the Pharmaceutical Research and Manufacturers of America (PhRMA), contradicted Colorado’s claim that a prescription drug importation program would save the state money.

According to her, Colorado has spent millions of dollars pursuing the Canadian drug importation program with no evidence that the program is saving the state money. 

She said since Canada has stated it will not import drugs that are in short supply, PhRMA is concerned for the Coloradans who would come to rely on the program for their medications.

According to Amanda Massey, executive director of the Colorado Association of Health Plans, Colorado has the third least expensive benchmark plan in the country. She added that premiums in Colorado have decreased by approximately 30% since 2019.

“So, the question we really have is: ‘Is this proposal feasible?’ Are we just being set up to fail so that we can bring in a government-run health insurance option? I think that’s a big question that we have in terms of what this proposal would look like.”

Massey wants to make sure the state is considering how other health initiatives being discussed — such as coverage mandates, benchmark reductions and federal policy changes like Medicare-X — will interact with Colorado’s public option bill.

“How will all of these policies play into whatever proposal is going to be on the table this year? I don’t think that there’s been a robust discussion around those issues. So we’re just really waiting to see what’s going to be in this draft bill.”

Both Massey and Lucariello emphasized that there is still no draft of this year’s public option bill, raising various questions about the feasibility of — and the data behind — the program.

Senator Rhonda Fields, chair of the Senate Health and Human Services Committee, said her primary apprehension with the bill is its potential to raise premiums for Coloradans who are already insured through the private market. She said last year’s version of the bill would have done this.

Massey discussed alternate ways to reduce health care costs in the state, such as the reinsurance program.

“Premiums are based on the prices of drugs and health care services, which are provided by hospitals and providers. In order to reduce the cost of premiums, we have to reduce those prices. In Colorado, we have found some ways to do that.”

As another cost-saving alternative, Lucariello said PhRMA is urging providers to pass through rebates to patients at the point of sale for prescription drugs. She believes patients need to be benefiting more from rebates.

“Manufacturers pay substantial rebates to insurers and pharmacy benefit managers every year, and while patients benefit from negotiations with hospital costs and physician costs, they’re not always benefiting from those rebate negotiations.”