5 Things Colorado: 2022 health bills, BH interim committee, 1332 waiver


Eli Kirshbaum


With this being the last Colorado “5 Things” newsletter of 2021, we want to extend our best wishes to all of you and hope you have a wonderful holiday season surrounded by loved ones and good food!

This month, we cover DOI’s submission of the finalized 1332 waiver amendment—the most recent step in implementing the Colorado Option. We also feature some of the health bills lawmakers have on deck for 2022 and a look at the work of the Behavioral Health Transformational Task Force.

Registration is now open for our 2022 State of Reform Federal Health Policy Conference, which we will host virtually on Feb. 17. This event will be entirely virtual, meaning you can participate from wherever you’d like!

Thanks very much for reading, and happy holidays!

Eli Kirshbaum 
State of Reform

1. Lawmakers prepare 2022 health bills

Over the past few weeks, we’ve reached out to several lawmakers to hear about the specific health bills they will pursue in the 2022 session. Senate Health & Human Services Committee Chair Sen. Rhonda Fields tells us she’s developing legislation to address food insecurity. Fellow committee members Sens. Smallwood and Kirkmeyer are developing bills to better educate citizens on their coverage options and to exempt certain providers from prior authorization, respectively.

Smallwood also plans to reintroduce his legislation to require an actuarial review of any health coverage mandates. Other legislators’ policy priorities include creating a rare disease advisory council, eliminating the requirement for PAs to have physician supervision, and creating a peer assistance program for dental hygienists.


2. BH interim task force and the ‘missing middle’ in behavioral health

The Behavioral Health Transformational Task Force has spent the interim deciding how to allocate $450 million in ARPA funding to improve Colorado’s “failing” behavioral health system. Rep. Michaelson Jenet, a member of the task force, said they’re working to take these funds “as far as humanly possible” to address what she calls the “missing middle” in Colorado’s behavioral health system. Multiple lawmakers have emphasized the importance of the bills that will emerge from this committee’s work.

The task force released its funding recommendations last week, along with those of the presiding subpanel of experts. These recommendations—which include $125.8 million in grants to local communities and $87.7 million to bolster the BH workforce—will be presented to the General Assembly in January to inform behavioral health policymaking for 2022.

3. DOI submits 1332 waiver amendment to implement Colorado Option

After a thorough stakeholder consultation process, DOI on Nov. 30 sent CMS the final version of the 1332 waiver amendment needed to implement the Colorado Option. Deputy Commissioner of Affordability Programs Kyle Brown said DOI expects a final decision from the federal government in July or August of 2022 after CMS holds its own public comment period for the waiver.

The Colorado Medical Society praised DOI’s omission of a waiver provision that would have prevented non-standardized health plans from adjusting their share of actuarial value after claiming it would have unfairly restricted competition in the private marketplace. Brown said the provision’s opponents were confused about its purpose and that DOI removed it from the final submission “for ease,” saying his agency recognizes there are alternative ways to ensure consumers have choice in the health insurance market.

4. 40% of Coloradans lack reliable dental care

Over 25% of Coloradans lack dental insurance, and dental care in Colorado fell 34.4% during the pandemic. Only 28% of the state’s dentists accepted Medicaid as of 2018. Colleen Lampron, owner of AFL Enterprises, said these gaps have caused 40% of Coloradans to lack reliable dental care.

Lampron believes an increased focus on teledentistry could be the solution, pointing out that a remote dentist visit costs half of what an in-person visit costs. She is calling for more investment in teledentistry as well as greater oral health advocacy in the legislature. “With oral health in Colorado, we don’t really recognize [it] as a health concern,” she said.


5. Addressing racial disparities by fostering strong community ties

At our recent 2021 Colorado State of Reform Health Policy Conference, a panel on racial disparities in health care underscored the importance of giving community leaders decision-making power and working with them, not for them. During the panel, Bobby King, VP of DEI at Colorado Access, said Colorado must create “bridges of understanding” between organizations and underserved communities to establish strong, long-lasting ties with these communities.

Panelist Rep. Leslie Herod said the legislature has made considerable health equity progress, pointing to this year’s passage of her bills to implement standards of care for incarcerated pregnant women and extend postpartum Medicaid eligibility as examples. She nonetheless said work remains to be done on the health equity front.