Q&A: Rep. Roberts and the fight for a Colorado public option

After seeing firsthand the high cost of health care in his state, Rep. Dylan Roberts has been leading the Colorado Legislature’s efforts to establish a state-wide public health insurance option for the past couple of years. Along with Sen. Kerry Donovan, Roberts introduced a public option bill last year that was overshadowed by the unexpected arrival of COVID-19.

This year, Roberts and Donovan are renewing their efforts, and this time around, Roberts believes that the struggles of the ongoing pandemic make the case for a public option clearer than ever. He represents House District 26 in Eagle and Routt Counties and has served in the Legislature since 2017.


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Eli Kirshbaum: What influenced you to get involved in health policy and to push for accessible public health insurance?

Rep. Dylan Roberts: “This is my second year in the Legislature, and I never really planned on being in politics or elected office this early on in my career, but an opportunity became available to run for this seat when my predecessor decided to run for Congress three years ago. Having interned at the state Legislature when I was in law school and sort of following local Colorado politics, I knew that the state Legislature, as opposed to the U.S. Congress or some other place like that, is a place where things actually get done and have an impact on peoples’ daily lives.

When I ran and when I was knocking on doors and campaigning, the number one issues I heard from constituents was the cost of healthcare, the lack of choices that they were experiencing on the individual market, the high deductibles and just an overall sense that health insurance costs were a large stress for people and families in my district, and actually one of the reasons that people weren’t able to remain living here — because it was just becoming so expensive. So I heard that, and I hear that every day, from my constituents, and that’s why I work on health care issues and trying to find ways to lower the cost of care.”

EK: Can you talk about the history of Colorado’s fight for a public option?

DR: “Senator Donovan and I, as well as many other legislators and advocates, have been working on the concept of bringing a public health insurance option to the state of Colorado — we call it the Colorado Health Insurance Option — because the two counties I represent are two of the ten counties in the state of Colorado where there is only one option for insurance on the individual market right now. So my constituents and thousands of Coloradans across the state only have one choice when they go shopping for insurance, and due to that lack of competition, the prices just keep going up and up and up.

So the idea that we’ve had for several years is ‘Can we find a way to bring a new option into that market so we create competition, give consumers a choice and lower prices?’ We started this process back in 2019, when we passed HB 19-1004, which initiated this process of instituting a Colorado health insurance option, and it directed the state to go on a listening tour across the state to consult with experts and stakeholders on what a viable Colorado health insurance option should look like. They prepared a report back in the fall of 2019 and gave that back to the Legislature. We took that report, we made some changes and then came up with a bill we introduced last year, HB 20-1349, and that was what we thought was going to be the bill that would create a Colorado health insurance option. We introduced that in the first week of March, and then the next week, the world came to a startling halt, the Legislature went into adjournment and that bill wasn’t able to move forward.

So we still want to pursue a Colorado public health insurance option, but we’ve gone back to the drawing board because we know the world has changed since March of last year, and when we return to the Legislature, we’re hoping to introduce a new bill that has some significant changes due to COVID, but will still ultimately get Coloradans a lower-cost insurance product and help lower prices across the state and increase competition.”

EK: Do you think COVID-19-related responsibilities will dominate the Legislature again, lowering other legislators’ prioritization of this bill? Will you and Sen. Donovan need to advocate even more for its importance in the midst of the legislative response to the pandemic?

DR: “I think that a global health pandemic actually increases the need for a bill like this because when we have a pandemic, and when we have the economic fallout that we did where thousands and millions of people across the country lost their jobs, that means they lost their health insurance coverage. So we need new ways to cover people with the security of health insurance that’s separate from their employment status, and I think that the pandemic we’re going through right now only heightens the need for a bill like this. 

However, we don’t want to do anything that hurts our hospitals and health care providers while they’re in the midst of this pandemic. So one of the biggest changes that we made between last year’s bill and this year’s coming bill is going to be a delay in the implementation of all of this. So we are going to give some significant time to allow hospitals and health care providers to get out of this pandemic before any of the new rules go into effect, and we’re also going to allow a two year period of goal-setting where the health care industry can voluntary work together to negotiate lower prices for consumers without a mandate or rules from the state. If they do that, then the state won’t need to offer a Colorado health insurance option because it will be being offered by the health care industry itself.

So we’ve heard the hospitals, we’ve listened to them, we’ve listened to all of the major stakeholders in the health care industry, so I believe we’ve made significant and appropriate changes to address COVID as we move forward.”

EK: How does the Biden Administration’s assumption of leadership change your view on this bill’s potential?

DR: “I think that portends two positive things. First, we expect to apply for several federal waivers through the health and human services department to help us finance this plan and we believe with a Biden Administration, as opposed to a Trump Administration, we are much more likely to get those waivers in order to help us cover these costs, which means we won’t need to use the Colorado General Fund and certainly won’t need to raise taxes in Colorado.

Long-term, I think the U.S. Congress and the Biden Administration are very likely to entertain a national public option, and if they are able to pass that through the Senate, I’m confident that President Biden will sign it, and then we could have a national public option, which means our Colorado effort could just fold right into that. So those are the two things I’m looking for. With such a tight U.S. Senate margin, I’m not sure how likely that is, but it’s certainly something that’s on the radar.”

EK: Are there any foreseen plans to build off of the public option, if passed, in the form of some sort of universal health care effort in Colorado?

DR: “I don’t have any legislation to that effect. I think, when you’re talking about reforming the health care system on a state level, you have to go in steps, because we have such limited resources as a state. We have to pass a balanced budget every year. We can’t raise taxes in Colorado without approval of the entire electorate. So I don’t think that’s realistic for Colorado. I think a plan like this, the Colorado Health Insurance Option, is much more realistic and fiscally responsible. Since I’m not in Congress, I’m not sure what their plans are, but I think if we’re ever going to go there, that would have to be the U.S. Congress’ job and not the state Legislature.”

This interview has been edited for clarity and length.