Comm. Conway: market is “pointed in the right direction” to meet public option benchmarks

Based on some of his initial conversations with carriers, Colorado Insurance Commissioner Michael Conway believes the insurance market is “pointed in the right direction” to comply with benchmarks established by the state’s recently passed “public option” bill. He made these comments during a recent webinar hosted by Colorado Healthcare Strategy and Management (CHSM).

While it was initially a robust bill that would have created a government-run health plan, several months of arguments in the legislature produced amendments that changed the public option bill considerably. The passed version of House Bill 21-1232 — instead of creating a state-regulated plan — will require health plans to meet yearly premium reduction targets over the next several years.

Starting Jan. 1, 2023, health plans are required to offer both an individual and a small group standardized health benefit plan that meets these targets. For 2023, the premium must be at least 5% less than the carrier’s 2021 premium rate. It must be at least 10% less than the 2021 rate in 2024, and 15% less in 2025. After 2026, the premium must not increase more than the previous year’s rate, accounting for medical inflation.

If plans don’t meet these targets, the Colorado Division of Insurance (DOI) will hold a public hearing to hear the plan’s reason for failing to comply. After considering the evidence from the hearing, the commissioner can establish reimbursement rates for the carrier that failed to comply and require hospitals and health care providers to accept patients and these reimbursement rates.

At the CHSM webinar, Conway said:

“It is my sincere hope that we don’t ever have to step in.”

Although he expects health plans to succeed at meeting premium reduction targets, he said he is prepared to step in if needed.

“If they fail at it, though, we do have the ability to really go in and shine a light on why the marketplace failed … It’s that transparency and it’s that ability to be able to control costs on the back end that I think is going to really hold the accountability elements in play.”

The division has begun the process of implementing HB 21-1232 by holding stakeholder meetings to gather input on the standardized plan design. DOI has already held three of six scheduled stakeholder meetings to gather input from the general public and industry stakeholders. It will hold three more on Sept. 24, Oct. 8, and Nov. 4. 

DOI has added additional meetings designed to address specific stakeholder groups. Outside of these meetings, the division also invites individuals to share their input via email. View the recordings of previous meetings and the schedule for upcoming meetings here.

Conway highlighted the importance of these meetings in a statement last month:

“The Division wants to hear from Coloradans with their thoughts, ideas and concerns about the Colorado Option and the standard benefit plan. If we want it to work for people, we need to hear from people and answer their questions.” 

DOI’s Deputy Insurance Commissioner Kyle Brown will speak about the division’s work to implement the public option at our upcoming 2021 Colorado State of Reform Health Policy Conference on Oct. 20. 

He will speak on our “What is next for Colorado’s Public Option?” panel and will be joined by Leah Hole-Marshall, general counsel and chief strategist at the Washington Health Benefit Exchange, Rep. Dylan Roberts, one of the sponsors of HB 21-1232, and Amanda Massey, executive director of the Colorado Association of Health Plans. Register here!