Colorado Rep. Matt Soper (R – Delta) recently spoke to State of Reform about his health policy outlook on the 2023 general session which kicked off on Monday and said as ranking member on the Health and Insurance Committee, he expects a more thoughtful session on health reform compared to previous years.
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The legislature passed a range of large measures that address healthcare access, affordability, and response to the pandemic over recent sessions, including the Public Option and the Prescription Drug Affordability Board.
“One thing that you’ll see from what we’re working on really is going to be a focus back towards affordability,” Soper said. “There’s also going to be a focus on transparency. But you’re not going to see the big bills like you saw a couple of years ago, because we’re at a point in time where we’ve just been through a global pandemic.
We need to step back as the legislature and say, ‘What are these impacts? What’s the effect?’ Because it’s only this year that we’re just starting to see the first wave of those bills come into force. And then the full force of those bills, of course, won’t be known for a couple of years yet. Sure. But that’s why it’s so important that the legislature not take drastic steps in the healthcare arena this year.”
Soper plans to introduce a hospital transparency bill that improves upon House Bill 1001 that passed in 2019. HB 1001 requires the Department of Health Care Policy and Financing (HCPF) to prepare an annual hospital expenditure report detailing various expenditures and uncompensated costs incurred by providers in the state. The new proposal would disclose how much hospital executives earn as a matter of public record to give Coloradans an idea of where their healthcare dollars are being spent.
“It’s really important that that be disclosed in a newspaper of record within the hospital’s jurisdiction, so that the taxpayers who are also the patients, who also are paying premiums, who are also utilizing that healthcare system, know where that money is going back [to],” Soper said. “Likewise, we also want to know, ‘Are Colorado profits staying in Colorado?’ and to be able to determine from bigger systems, ‘Will we be seeing a big transfer of revenue from Colorado to other states?’ because we shouldn’t be the cash cow in Colorado for subsidizing healthcare in other states.”
Soper said transparency has a direct tie to affordability and would help hospital systems, which are reporting financial hardships in 2023, better make that case by disclosing what executives are making to the public. Soper added that the visibility would also help the community determine if those publicly elected hospital board members are supporting local health needs effectively.
HCPF has submitted a $14.8 billion request for its FY 2023-24 budget to the legislature for approval, $700 million more than the previous year. Soper said the rising healthcare costs are concerning for Coloradans.
“Medicaid is slowly eating up the public dollars available to the legislature, which means that we have fewer dollars for transportation, fewer dollars for corrections, fewer dollars for education,” Soper said. “Every element of the budget is being affected as Medicaid spending goes up. And the reason why Medicaid spending is going up is because the cost of delivering healthcare has been going up.
However, the number of lives that are covered by Medicaid is actually going down. So that means that the price per case for Medicaid to cover is more expensive now than it’s ever been, at least here in Colorado, and I believe we’re one of the most expensive states when it comes to healthcare costs.”
Soper returned from an overseas tour of Scotland and Taiwan late last year where he met with officials in the healthcare sector of each country to learn what they’re doing successfully in hopes of applying it in Colorado healthcare. Accompanied by the Denver Metro Chamber of Commerce in the Economic Development Corporation, Soper toured parts of the healthcare system and bioscience industry in Scotland.
“What [the Scottish officials] have done is they’ve created clusters with hospitals [and] industry to help develop the next generation of drugs or procedures or devices,” Soper said. “Then they’ve partnered with academia, and it’s not just clusters in the big cities next to a teaching hospital. You saw clusters all throughout Scotland. That was something that’s quite unique and so they were basically helping incubate and accelerate the next generation of medical devices, procedures, diagnostics, pharmaceuticals, right next to the hospital setting and right next to academia.”
Hoping to emulate Scotland’s success with promoting bioscience, Soper will sponsor a bill this session to study the effectiveness of incentives and tax credits in developing the bioscience and clean technology industries in Colorado.
When Soper met with top public health administrators in Taiwan, he toured the Taipei Medical University Teaching Hospital and a healthcare clinic. According to Soper, there were many lessons to be learned from the Taiwanese on healthcare including how they promote affordability and medical tourism.
“Taiwan is on the cutting edge of multiple things,” Soper said. “One is they’ve automated the check-in and check-out, so instead of walking into a clinic and actually seeing someone at a reception desk, you may still see one person there, but really the patient, as they’re going into the hospital or the clinic for some sort of regular procedure, will take their own blood pressure, their own temperature, their own EKG, their own weight, their own height, and it’s saved onto their insurance card. And then they’re told where to go so they have direct access to the actual specialist and that’s something we don’t have in our healthcare system here in Colorado.
Taiwan doesn’t utilize their primary care providers as gatekeepers, and I asked [officials there] why, and [they said it’s] to cut costs in healthcare. Why spend money seeing a primary care provider when you know the problems with your knee? You should be able to go to an orthopedist right away. And I think that is something that we could try to incorporate here into the Colorado model a little bit more, automation on the front end.”
Soper said such improvements allow care providers to better utilize their workforce toward directly treating patients. He will be working with departments in Colorado on developing measures, not for this session but possibly next year, that ease state regulatory burdens and allow investments in cutting edge technologies.
“I toured [Taipei’s] proton beam, which is right now the smallest in the world and the first one underground,” Soper said. “It was a $50 million piece of equipment. And yet, this is very effective in treating cancer and I would love to see a proton beam here in Colorado.
There’s 42 in America and not a single one of them in the Rocky Mountain region. So Colorado could be posed for being able to make investments and to learn from other nations, because a lot of what I just described is going to come from the hospitals and the insurance companies and the physicians themselves.
These are not necessarily rules for the state to be involved in. The state can clear the way if there’s a regulatory burden that’s stopping a proton beam from coming to Colorado. It’s time we clear that if there’s a curveball to automating some of the routine things that help with patient safety and ease of checking in, we should be able to clear those regulatory burdens as well.”
House Republican membership fell from 24 to 19 representatives and a third of the Republican caucus are new to the legislature. Soper stressed the importance of building working relationships with Democrats if the Republicans are to make any progress this session.
“If you want to get anything done, if you want to stop anything, if you want to work on anything, you need to walk across the aisle and make a friend with a Democrat,” Soper said. “Because right now we have to work together. Otherwise [Republicans] don’t even have the numbers to begin to fight because there’s just so few of us. So I think that there’s that sense of frustration after the election.
I am optimistic that this is going to be a good session. I feel like I’ve had a lot of good conversations with my caucus and with the opposing caucus, with the speaker, and the incoming majority leader, and I think everyone has a sense [that] they don’t want to see extreme bills. They don’t want to see bills that are over the top. So I do think it’s going to be a calmer session. At least I’m crossing my fingers and hoping so in the healthcare arena.”