A Roadmap for Health Reform in ColoradoRecommendations of theBlue Ribbon Commission forHealth Care Reform

William N. Lindsay III

Blue Ribbon Commission for Health Care Reform

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Starting Point for the Journey

Health insurance costs are rising rapidly for businesses and families

– Average premium for employee coverage in Colorado doubled during the decade between 1996 and 2006

– Colorado families spend 19% of their income on health insurance

Percent of Income Needed forHealth Insurance (Colorado)

Source: Len Nichols, The New America Foundation, using data from the Agency for Healthcare Research and Quality, Kaiser Family Foundation and Current Population Survey

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Starting Point for the Journey

Large numbers of uninsured

– 792,000 Coloradans lack health insurance (17% of the population)

– 180,000 uninsured children

Uninsured are found in all income groups

– 25% of uninsured in households earning $50,000 or more

Most are employed

– 70% are workers or dependents of workers

Average Monthly Uninsured in Colorado by Family Income

Source: The Lewin Group estimates using the Health Benefits Simulation Model (HBSM)

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Blue Ribbon Commission for Health Care Reform

Created in 2006 to study health care reform options and make recommendations to state legislature

– Increase coverage

– Reduce costs

27 commissioners

– Appointed by legislative leaders from both parties, Gov. Owens, Gov. Ritter

– Physicians, hospitals, insurance industry, consumers, businesses

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Process

– Asked public for health care reform proposals – received 31

– Selected 4 for evaluation; developed 5th

• A range of approaches

– Analyzed cost, coverage impacts of all 5

Community input

– Open meetings

– 24 community meetings

– Advisory Task Forces

Developed recommendations, presented to legislature

Our Journey So Far

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Build on what we have – or start from scratch?

Emphasize private markets or public coverage – or find a way to balance both?

Which Direction Should We Go?

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Shared responsibility

One size doesn’t fit all

Some people simply can’t afford private coverage

Preserve the safety net

Protect vulnerable populations

Encourage healthy lifestyles, prevention and wellness

Individual choice

Build on strengths of current system

Maximize federal funding

The Commission’s Philosophy

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Implement the recommendations as a package

– Individual recommendations will not be as effective if implemented without the other recommendations

Implement in stages

– Before you expand eligibility for public programs, you must first bring more providers into the program

– Before you require people to have insurance, you must make it affordable and accessible

The Road to ReformHighlights of the Commission’s Recommendations

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Commission’s Proposal:

Provide health insurance to 694,500 currently uninsured Coloradans (88% of the state’s uninsured)

Assure affordable coverage for low- and middle-income legal residents of Colorado

Improve delivery of services to vulnerable populations

Increase prevention, enhance personal responsibility

Reduce costs systemwide

Where Did We End Up?

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2008 Legislature:

Fifteen specific laws

Two Executive Orders

Incremental but fundamental first step

Where Did We End Up?

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Why We’re Confident of This Path

The recommendations are Colorado-specific

– Build on Colorado’s strong private health insurance market and improve Colorado's public coverage programs

The recommendations are bipartisan

– 24 of the 27 commissioners, appointed by leaders from both parties, support the Commission’s recommendations

The recommendations are from all sectors

– Doctors, hospitals, insurance companies, consumers and businesses developed and support the recommendations

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Next Steps

Legislators and governor

– Act on recommendations

You

– Stay informed

– Tell your elected officials what you think

– Help us spread the word

– Participate in the dialogue and the process

For More Information

www.colorado.gov/208commission

Blue Ribbon Commission for Health Care Reform