Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH, INSURANCE, & ENVIRONMENT

Date:01/29/2015
ATTENDANCE
Time:01:30 PM to 06:34 PM
Brown
X
Esgar
X
Place:
Humphrey
*
Joshi
X
This Meeting was called to order by
Klingenschmitt
X
Representative McCann
Landgraf
X
Lontine
X
This Report was prepared by
Mitsch Bush
X
Amanda King
Primavera
X
Ransom
X
Ryden
X
Ginal
X
McCann
X
X = Present, E = Excused, A = Absent, * = Present after roll call
Bills Addressed: Action Taken:
HB15-1075
HB15-1059
HB15-1048
HB15-1066		Laid Over
Amended, Referred to the Committee of the Whole
Referred to Appropriations
Postponed Indefinitely

01:30 PM -- HB 15-1075

Representative McCann announced that House Bill 15-1075, concerning the authority for a registered naturopathic doctor to treat children who are under two years of age, would be laid over until Thursday, February 5. The committee took a brief recess.

01:34 PM -- HB 15-1059

The committee came back to order. Representative Garnett presented House Bill 15-1059. Effective July 1, 2015, the bill increases the membership of the Denver Health and Hospital Authority Board (board) from nine to eleven members. The two new members must be appointed by the Mayor of Denver for five-year terms. The bill removes an outdated reference to the now non-existent Denver Board of Health and Hospitals. The bill also creates a new process for removing a board member from the board. Under current law, if a member is found unfit for the position, the member may be removed by the Mayor of Denver or the Denver City Council, pursuant to city ordinance. Under the bill, a member may be removed from the board by a unanimous vote of the board, excluding the member to be removed, and with approval from the Mayor of Denver. The board must also provide written notice to the board member of their removal. Any member removed from the board by a unanimous vote does not have the ability to appeal the board's decision. Representative Garnett responded to questions about the board and House Bill 15-1059.

01:44 PM -- Caz Matthews, Denver Health and Hospital Authority Board, testified in support of the bill. She discussed the role of the board. Ms. Matthews responded to questions about the demographic structure of the board and why the hospital authority was established in state law.



01:49 PM -- Susan Powers, Denver Health and Hospital Authority Board, testified in support of the bill. She discussed the ability of the Mayor of Denver to remove a board member.

01:50 PM -- Cristal Deherrera, Denver Health and Hospital Authority Board, testified in support of the bill.

01:53 PM

Representative Primavera explained amendment L.001 (Attachment A).

150129 AttachA.pdf150129 AttachA.pdf
BILL:HB15-1059
TIME: 01:53:22 PM
MOVED:Primavera
MOTION:Adopt amendment L.001 (Attachment A). The motion passed without objection.
SECONDED:Esgar
VOTE
Brown
Esgar
Humphrey
Joshi
Klingenschmitt
Landgraf
Lontine
Mitsch Bush
Primavera
Ransom
Ryden
Ginal
McCann
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


01:54 PM

Representative Garnett made closing remarks about the bill. Nicole Myers, Office of Legislative Legal Services, responded to questions about why the bill needs a safety clause.
BILL:HB15-1059
TIME: 01:57:29 PM
MOVED:Brown
MOTION:Refer House Bill 15-1059, as amended, to the Committee of the Whole. The motion passed on a vote of 13-0.
SECONDED:Landgraf
VOTE
Brown
Yes
Esgar
Yes
Humphrey
Yes
Joshi
Yes
Klingenschmitt
Yes
Landgraf
Yes
Lontine
Yes
Mitsch Bush
Yes
Primavera
Yes
Ransom
Yes
Ryden
Yes
Ginal
Yes
McCann
Yes
Final YES: 13 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

01:59 PM

The committee took a recess.

02:06 PM -- HB 15-1048

The committee came back to order. Representative Williams presented House Bill 15-1048. The bill enacts National Association of Insurance Commissioners (NAIC) model legislation that requires the Commissioner of Insurance (commissioner) in the Division of Insurance in the Department of Regulatory Agencies to adopt the NAIC Standard Valuation Manual, which uses principle-based reserving (PBR) requirements to modernize the method by which life insurance reserve requirements are calculated. The bill requires the commissioner to promulgate rules regarding actuarial opinions of reserves, minimum standards applicable to the valuation of life insurance plans, and enforcement. The bill also allows the commissioner to employ qualified actuaries to review a life insurance company's PBR assumptions at the expense of the company. Life insurance companies doing business only in Colorado are exempt from the bill.


Under the bill, at least 42 NAIC members (states) or three-fourths of voting members, whichever is greater, representing greater than 75 percent of gross premiums must adopt similar legislation before the bill can go into effect. PBR becomes effective on January 1 of the first calendar year following the first July 1 when the thresholds described have been met. Pursuant to the NAIC Standard Valuation Manual, insurance companies domiciled in Colorado have an additional three years following this effective date to implement PBR for new policies issued after the effective date. Representative Williams responded to questions about the bill.

02:10 PM -- Ellen Poole, United Services Automobile Association, testified in support of the bill. She discussed how the bill would benefit her company's clients. Ms. Poole responded to questions about other states adopting the model legislation. In response to a questions, she discussed how the bill will impact consumer costs.

02:15 PM -- Scott Lloyd, Division of Insurance in the Department of Regulatory Agencies, testified in support of the bill. Mr. Lloyd responded to questions about how reserves are held by an insurance company and the fiscal note. He responded to questions about the current reporting requirements for life insurance companies to the Division of Insurance.

02:21 PM -- John Postolowski, Division of Insurance in the Department of Regulatory Agencies, testified in support of the bill. He discussed modernizing the reserve requirements for life insurance policies. Mr. Postolowski responded to questions about whether a consumer could change policies if his or her premiums are increased.

02:25 PM -- Henry Freaney, Division of Insurance in the Department of Regulatory Agencies, testified in support of the bill.

02:26 PM

Representative Williams made closing remarks about the bill.
BILL:HB15-1048
TIME: 02:27:03 PM
MOVED:Landgraf
MOTION:Refer House Bill 15-1048 to the Committee on Appropriations. The motion passed on a vote of 13-0.
SECONDED:Brown
VOTE
Brown
Yes
Esgar
Yes
Humphrey
Yes
Joshi
Yes
Klingenschmitt
Yes
Landgraf
Yes
Lontine
Yes
Mitsch Bush
Yes
Primavera
Yes
Ransom
Yes
Ryden
Yes
Ginal
Yes
McCann
Yes
Final YES: 13 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS




02:31 PM -- HB15-1066

Representative Joshi presented House Bill 15-1066. The bill repeals the Colorado Health Benefit Exchange Act, effective January 1, 2016, and requires the state treasurer to transfer any unencumbered moneys that remain in the exchange to the General Fund. Representative Joshi responded to questions about the bill and the exchange. Representative Joshi distributed a packet of letters in support of the bill (Attachment B). Three letters of opposition were distributed to the committee (Attachments C through E).

150129 AttachB.pdf150129 AttachB.pdf150129 AttachC.pdf150129 AttachC.pdf150129 AttachD.pdf150129 AttachD.pdf150129 AttachE.pdf150129 AttachE.pdf

02:51 PM

The committee dialogued with Representative Joshi about the bill, the federal Patient Protection and Affordable Care Act (PPACA), and the exchange.

02:57 PM -- Arnold Salazar and Steve ErkenBrack, Connect for Health Colorado, testified in opposition to the bill. Mr. ErkenBrack discussed his role on the board of the exchange and the history of Colorado's exchange. He explained how consumers can check whether their doctors accept certain plans offered through Colorado's exchange, which consumers cannot do on the federal exchange. Mr. ErkenBrack discussed the open enrollment process. He discussed how various issues with the exchange have been resolved.

03:10 PM

Mr. ErkenBrack and Mr. Salazar responded to questions about Colorado's exchange, the federal subsidies to help consumers pay for health insurance, and health insurance plan cancellations. Mr. Salazar and Mr. ErkenBrack responded to questions about the competitiveness of Colorado's health insurance market and Colorado's health insurance premiums.

03:30 PM

Representative Joshi and Mr. Salazar dialogued about Colorado's health insurance premiums. Mr. Salazar stated that the bill would cede control to the federal government and discussed the potential impact the bill would have on Colorado. Representative Brown commented on the exchange and the PPACA. Mr. ErkenBrack responded to additional questions about health insurance premiums. In response to a question, Mr. Salazar referenced the Colorado Commission on Affordable Health Care.

03:48 PM -- Janet Stephens, Colorado Hospital Association, testified in opposition of the bill. She discussed her organization's support of the exchange and the potential impact of repealing the exchange. Ms. Stephens responded to questions about emergency room utilizations since the establishment of the exchange.

03:53 PM -- Charles Ward, Denver Metro Chamber of Commerce, testified in opposition to the bill. He discussed his organization's support for the exchange and the possible disruptions to businesses if the exchange is eliminated.

03:56 PM -- Betty Wytias, representing herself, testified in opposition to the bill. She discussed her experience seeking health insurance through the exchange.


04:02 PM -- Tamera Sakotas, representing herself, testified in opposition to the bill. She discussed her experience seeking health insurance through the exchange. Ms. Sakotas responded to questions about losing her health insurance coverage prior to enrolling in coverage through the exchange.

04:08 PM

Ms. Wytias and Ms. Sakotas responded to questions about the assistance they received from the exchange staff in enrolling in health insurance.

04:10 PM -- A.W. Schnellbacher, Jr., representing AARP Colorado, testified in opposition to the bill. He discussed his organization's support of the exchange and referenced the Blue Ribbon Commission for Health Care Reform that was established by Senate Bill 06-208. He referenced an article in Health Affairs magazine concerning exchanges. Mr. Schnellbacher relayed data concerning health insurance provided through the exchange and Colorado's uninsured rate. Mr. Schnellbacher responded to questions about his organization's members utilization of private health insurance coverage.

04:21 PM -- Michael Lott-Manier, Mental Health America Colorado, testified in opposition to the bill. He discussed the impact the exchange has had on persons with mental health care needs. He referenced the 2013 Colorado Health Access Survey. He discussed Colorado's efforts to address behavioral health and the Blue Ribbon Commission for Health Care Reform.

04:32 PM -- Mizraim Cordero, Colorado Competitive Council, testified in opposition to the bill. He discussed his organization's support of the exchange. He responded to question about whether organization supports the PPACA.

04:36 PM -- Allison Neswood, Colorado Center on Law and Policy, testified in opposition to the bill. She discussed the exchange, the number of health insurance plans offered by the exchange, and the number of persons who have enrolled in health insurance coverage through the exchange.

04:42 PM -- Ryan Biehle, Colorado Consumer Health Initiative, testified in opposition to the bill. He discussed how the exchange has impacted consumers' ability to purchase health insurance.

04:46 PM

Ms. Neswood and Mr. Biehle responded to questions about their personal experiences getting health insurance coverage through the exchange. Mr. Biehle responded to questions about impact federal penalties could have on enrollment.

04:49 PM

Representative McCann read a letter from Ben Price, Colorado Association of Health Plans (Attachment F). The committee dialogued about the number of people who received health insurance policy cancellation notices after the enactment of the PPACA.

150129 AttachF.pdf150129 AttachF.pdf


04:55 PM -- Dr. Mary Zennett, representing herself, testified in support of the bill. She discussed her experience providing health care, the shortage of primary care and mental health providers, and her concerns about the health care system. Dr. Zennett responded to questions about her experience providing patient care and Medicaid.

05:23 PM -- Joan Mills, representing herself, testified in support of the bill. She discussed her experience as a nurse and expressed her concerns about the health care system. Ms. Mills responded to questions about the exchange and health insurance.

05:32 PM -- Jeanie Stutts Blucher, representing herself, testified in support of the bill. She discussed her experience obtaining individual health insurance coverage. She responded to questions regarding health sharing organizations.

05:47 PM -- Scott Rankin, representing himself, testified in support of the bill. He discussed the difference between health care and health insurance. Mr. Rankin responded to questions about the federal exchange. In response to a question, he expressed his concerns about health care costs.

06:01 PM -- Aaron Gartrell, representing himself, testified in support of the bill. He discussed his experience as a small business owner providing health insurance.

06:03 PM -- Don Rodgers, representing himself, testified in support of the bill. Mr. Rodgers discussed the federal exchange.


06:07 PM

Representative Joshi made concluding remarks about the bill.
BILL:HB15-1066
TIME: 06:32:35 PM
MOVED:Joshi
MOTION:Refer House Bill 15-1066 to the Committee on State, Military, and Veterans Affairs. The motion failed on a vote of 6-7.
SECONDED:Landgraf
VOTE
Brown
Yes
Esgar
No
Humphrey
Yes
Joshi
Yes
Klingenschmitt
Yes
Landgraf
Yes
Lontine
No
Mitsch Bush
No
Primavera
No
Ransom
Yes
Ryden
No
Ginal
No
McCann
No
YES: 6 NO: 7 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:HB15-1066
TIME: 06:33:32 PM
MOVED:McCann
MOTION:Postpone House Bill 15-1066 indefinitely. The motion passed on a vote of 7-6.
SECONDED:Ginal
VOTE
Brown
No
Esgar
Yes
Humphrey
No
Joshi
No
Klingenschmitt
No
Landgraf
No
Lontine
Yes
Mitsch Bush
Yes
Primavera
Yes
Ransom
No
Ryden
Yes
Ginal
Yes
McCann
Yes
Final YES: 7 NO: 6 EXC: 0 ABS: 0 FINAL ACTION: PASS

06:34 PM

The committee adjourned.