In front of a packed room of healthcare professionals, Colorado legislators who led health reform efforts over the past several years followed up their virtual conversation in 2021 with an in-person panel at the 2022 Colorado State of Reform Health Policy Conference in Denver last week.
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The panel consisted of Colorado Sen. Jim Smallwood (R – Castle Rock), Chair of the Senate Minority Caucus, Sen. Rhonda Fields (D – Aurora), Chair of the Senate Health & Human Services Committee, and Rep. Dafna Michaelson Jenet (D – Aurora), Chair of the House Public & Behavioral Health & Human Services Committee.
The panel shared their thoughts on the progress made last session and the work ahead.
Thanking everyone in the room for successfully navigating the state through the COVID-19 pandemic, Fields spoke to the health disparities that continue to plague the health system.
“The reason I’m passionate about healthcare [is] this whole issue regarding equity,” Fields said. “Growing up, I could see disparities in my community. I saw that in my church, I saw that in my neighborhood, there was a pattern of healthcare issues that range from diabetes and hypertension to just a whole bunch of trends that we can understand are happening in the Black community. I wanted to lend my voice to some of those things.”
The senator highlighted housing, transportation, and access to fresh fruits and vegetables as some of the social determinants of health that legislation can address to eliminate and reduce health disparities for her constituents. She said there needs to be more policy conversations around preventive measures to keep people engaged with their health and out of emergency departments.
While Michaelson Jenet shared Fields’s sentiments about the legislation, she recognized the challenges that Colorado continues to face with regards to healthcare access and workforce.
Michaelson Jenet worked closely with officials from the Department of Health Care Policy and Financing to determine how to spend the $450 million the state received in ARPA funding to address behavioral health.
The investment has been directed to a variety of issues affecting the behavioral health delivery system, including a temporary program to facilitate youth mental health services, enhancing residential services for youth and families with behavioral health concerns by bringing more beds online, and building the state’s first neuropsychology facility for children.
“We’re still watching and waiting as we see those beds come online because part of the problem with beds is [that] a bed is not simply a mattress on a metal frame,” Michaelson Jenet said. “A bed includes a nurse, a doctor, a tech, [and] a physical floor print. There are so many elements that go along with making that bed available.”
She also discussed how some of this funding will be directed to support the behavioral health workforce.
“We are focusing right now on, ‘How do we build that workforce?’ And workforce is the number one issue I hear about from business owners in my community, and especially that I hear about from the medical community.
We did put a significant amount of the ARPA funding towards building workforce and specifically building workforce in the medical arena. And I am hoping that we start seeing the fruits of those dollars as they begin to go out into the community.”
Healthcare reform was the reason Smallwood, who is nearing the end of his time in the Senate, got into politics. He co-sponsored Senate Bill 081 last session, which implements a campaign to educate consumers about the state’s multitude of health exchange plans, providing comprehensive information on continuum of care coverage and services.
He highlighted the progress the legislature has made on simplifying the complexities of healthcare for everyday Coloradans.
“We made several contract changes for health plans that I think are gonna make things more accessible for our citizens,” Smallwood said. “Hospital transparency, physician transparency, we’ve seen a lot of rules around that. When I first came into office, there were huge arguments that many of us in the room had around freestanding emergency departments and whether they were simply increasing access to care or if they were too complicated for the layperson to understand and end up walking out and paying more than you wanted that day.”
Smallwood continues to be critical of the Colorado Option and the state’s Prescription Drug Affordability Board, arguing these policies promote the departure of private health plans and drugs from the local market.
“[The] Colorado Option was built with the goal of failure so that once it fails, we can move forward towards the single-payer system that this administration promised,” Smallwood said. “So of course, it was set up to fail. Of course, it had unrealistic metrics in it. And of course, it will set the administration up to rate-set hospitals, which was, in my opinion, the overall goal.”
He nonetheless expressed his relief that the initial, unsuccessful effort to establish a public health insurance option in the state was reformed into the successful 2021 effort, which eliminated the provision for the plan to compete with private plans on the market.
“I’m just thrilled that the bill was changed to where the state of Colorado didn’t become a health plan, competing against the private insurance companies.
And for those of you who haven’t had a chance to grab that introduced bill and read it, the introduced bill said that the State of Colorado becomes a health insurance company and the only health insurance company that can rate-set every doctor and hospital in our state, and every doctor and hospital will take that plan at that fee structure or lose their license or at least be subject to disciplinary action, which means you lose your license.”
Believing that healthcare should be nonpartisan and offer patients a choice in where and how they access it, Smallwood said he will continue to push against the administration’s single-payer agenda.
Fields said her focus will continue to remain on health equity and fighting for the most vulnerable populations in the state. Both Democrats on the panel expressed concerns for Black maternal health and said that additional reforms to support mothers and children will be pursued in the next session.
“We have some very poor black maternal health outcomes in Colorado,” Michaelson Jenet said. “We need to be focusing on that and then additionally to the black maternal health outcomes, our maternal mental health outcomes, which are also for our general community very poor right now.
So we need to be looking at what are the ways that we can get people through pregnancy alive and healthy and mentally healthy. Those are some things that I’m looking forward to working on [during] the legislative session.”
Colorado’s 2023 legislative session begins on January 9th.