Health Care Exchange (07/15/2015)

Final
STAFF SUMMARY OF MEETING

HEALTH CARE EXCHANGE

Date:	07/15/2015	ATTENDANCE

Time:	09:02 AM to 03:00 PM	Aguilar	X
		Kefalas	X
Place:	RM 271	Landgraf	E
		Lundberg	X
This Meeting was called to order by		Martinez Humenik	X
	Senator Roberts	Primavera	X
		Ryden	X
This Report was prepared by		Sias	*
	Bill Zepernick	McCann	X
		Roberts	X
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Call to Order and Opening Remarks Discussion with CHI about Questions Raised at June 5 Meeting Presentation by OLLS about the King v. Burwell Decision Discussion of Changes to Current System with Section 1332 Waiver Discussion of Marketplace for Next Open Enrollment Period Board Policy and Procedures - Conflict of Interests/Fiduciary Duty Discussion with DOI about Questions Raised at June 5 Meeting Discussion with HCPF about Questions Raised at June 5 Meeting Public Comment Adjourn		Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only

09:02 AM -- Call to Order and Opening Remarks

Senator Roberts called the committee to order and discussed the plan for the day's meeting. She outlined the process for the 1332 waiver discussion. The meeting agenda was distributed committee members (Attachment A), along with a memorandum from Legislative Council Staff concerning public feedback received about Connect for Health Colorado (Attachment B).

150715 AttachA.pdf

150715 AttachB.pdf

09:05 AM -- Discussion with CHI about Questions Raised at June 5 Meeting

Jeff Bontrager, Colorado Health Institute, came to the table and began his presentation. He provided a memorandum to the committee (Attachment C) and responded to questions raised at the June 5, 015, committee meeting. Mr. Bontrager discussed how the health exchange could be improved in terms of efficiency, health care coverage, and financial sustainability. He stated that the first step is to identify the problem to be solved, and then consider how a 1332 waiver could be approached. He discussed other potential areas of improvement based on research in Colorado and in other states. For example, Arkansas provides a health insurance option for Medicaid clients and Vermont pursued a single payer option. He then discussed technological issues that states have faced and the sharing of information technology resources between states. Mr. Bontrager highlighted efforts to improve sustainability by increasing revenues and enrollment for the Small Business Health Options Program (SHOP) exchange. He stated that a 1332 waiver is a means to an end, not a goal by itself, and highlighted several key things to consider when Colorado looks at waiver options. He discussed certain requirements and limitations for 1332 waivers.

150715 AttachC.pdf

09:21 AM -- Presentation by OLLS about the King v. Burwell Decision

Kristen Forrestal, Office of Legislative Legal Services, came to the table and presented an overview of the King v. Burwell decision by the U.S. Supreme Court. She highlighted key provisions of the federal Patient Protection and Affordable Care Act (PPACA) under consideration in the case and outlined the key arguments for both sides of the case. Ms. Forrestal discussed the court's statutory interpretation of the phrase "exchange established by the state" and how it affects the availability of subsidies through state health exchanges. Senator Kefalas asked about how states are considering their options in light of the decision. Senator Roberts asked for clarification about the potential for a reversal in a future case, to which Ms. Forrestal responded.

09:31 AM -- Discussion of Changes to Current System using a Section 1332 State Innovation Waiver

Jeff Bontrager, Colorado Health Institute, Richard Cauchi, National Conference of State Legislatures (NCSL), and Kevin Patterson, Connect for Health Colorado, came to the table for a panel discussion on Section 1332 waivers. Mr. Cauchi began his comments and provided a packet of material to the committee concerning 1332 waivers (Attachment D). He highlighted the material in the packet from various experts for the committee. He discussed the process for states to pursue a 1332 waiver and various considerations that states could take into account. He mentioned that there is not currently federal guidelines about the process that states must follow when pursing a waiver. He discussed the Center for Medicaid and Medicare Services' (CMS) process to review and approve state waiver plans and the role of state legislatures in the process.

150715 AttachD.pdf

09:42 AM

Mr. Patterson began his comments. He discussed how a waiver could be an option to meet certain goals and improve aspects of the exchange. He mentioned how improving the customer experience is a priority for Connect for Health Colorado as the state considers different options for the future. He discussed Connect for Health Colorado's collaborations and conversations with other states, which have touched on the topic of waivers. He stated that CMS will likely look more favorably on waiver proposals if all organizations and stakeholders are on board in the state. Mr. Bontrager referred back to his prior comments and presentation concerning 1332 waivers.

09:48 AM

Senator Roberts began the question-and-answer portion of the panel discussion and outlined the process for legislators to ask questions of the panel. Senator Kefalas asked about the idea of moving away from an employer-based insurance system to a more market-oriented approach for individuals. He talked about how this could potentially save money for businesses and promote individual responsibility. Mr. Bontrager responded that it could be done, but stated that upwards of 60 percent of Coloradoans receive insurance through their employers, which would mean that it would be a substantial shift. He outlined concerns about cost and budget neutrality for such a waiver proposal. He then discussed the tax implications for employer-provided insurance, as well as TABOR impacts in Colorado. Senator Kefalas lauded the improvements to date in expanding coverage, but highlighted some areas for improvement.

09:57 AM

Representative Sias asked what services are provided by the exchange that are not provided by brokers. Further, he asked why is there a requirement that there must only be one exchange, rather than competing exchanges. Mr. Cauchi responded that there could be multiple exchanges in a state, such as regional exchanges, as well as multi-state exchanges. He noted that these arrangements have not been pursued and explained that all state exchanges are single, state-wide exchanges. He stated that such arrangements do not require a waiver. Representative Sias then asked why the exchange must be a public entity. Mr. Cauchi stated that PPACA requires exchanges to be a state agency or entity, or a nonprofit organization contracted with the state. Mr. Bontrager elaborated on the potential for private exchanges.

10:03 AM

Representative Ryden asked about a system where employers contribute on a tax deductible basis, but where the employee have control over selecting and purchasing health insurance. Mr. Cauchi replied that prior to PPACA, employers were allowed to voluntarily contribute to or provide health insurance. He stated that the elimination of the employer mandate would return the United States to a pre-PPACA landscape. Representative Ryden then asked about the single entry system for purchasing insurance and problems with Medicaid eligibility determination. Mr. Patterson responded by discussing the shared eligibility system and the alignment of eligibility criteria. Representative Ryden highlighted the need for brokers in helping people navigate the system and find the right health coverage.

10:08 AM

Senator Lundberg stated that he is not interested in pursing waivers because the system is not functional. He stated that he is interested in listening to the committees comments, but that he wants to seek solutions that will work. He then discussed alternatives to the PPACA model. He discussed private exchanges and the lack of efficiency of Connect for Health Colorado.

10:11 AM

Senator Aguilar discussed her involvement in a ballot initiative to implement a single payer health system. She stated that some people are unable to afford health insurance and that many people are underinsured or do not think they need coverage. She discussed rising health care costs and the administrative costs under PPACA. She stated that all Coloradans should have options for robust health care coverage. She asked if a citizen-initiated constitutional amendment would count as a legislative action for the purposes of pursing a 1332 waiver. She then outlined the provisions of the "Colorado Care" proposal. Mr. Cauchi stated that he could not comment on the specific legality of such an arrangement, but mentioned the need for a certain level of detail in a waiver proposal.

10:16 AM

Senator Roberts asked about the logistics and timing of pursuing a 1332 waiver. She stated that there may be difficulties meeting certain deadlines by 2017. Mr. Cauchi responded by citing the Arkansas example and stated that there is not a deadline for states to request waivers. States can pursue waivers any time after 2017. Senator Roberts asked whether pursing a 1332 waiver at the current time is advisable when there are so many issues facing the exchange. Mr. Patterson stated that his primary focus is improving custom service and aligning eligibility. He expressed concern about pursuing changes while the current system is still working on improvements. Senator Roberts then asked about difficulties with Colorado Benefits Management System (CBMS) and whether that was an impediment to improvement. Mr. Patterson discussed the difficulty of making large system changes and stated that they have a clear idea of what needs to be done.

10:22 AM

Representative McCann asked if the members of the panel had recommendations about pursuing a 1332 waiver. Mr. Bontrager pointed out that the state needs to know what the problem is that a waiver is trying to solve. He stated that many changes can be pursued without a waiver. He discussed some ideas for waivers that are currently being discussed by states and the main challenges facing Colorado's exchange and insurance market. Mr. Cauchi did not have any specific recommendations and discussed the role of NCSL in providing information to states. He highlighted the cost neutrality requirement for waivers and stated that it is a key consideration. Mr. Patterson stated that his focus is on improving the customer experience heading into the next open enrollment period. He said that considering changes for 2017 is possible, but that he does not want to rush any decision to pursue changes.

10:28 AM

Senator Martinez Humenik asked if there were waiver options that could attract more young and healthy individuals to purchase insurance through the exchange. Mr. Bontrager discussed the example of Indiana moving clients into health savings accounts and high-deductible plans. He stated that a 1332 waiver could potentially be used to incentive such plans. He then discussed the issue of under-insurance and burdens of high cost sharing if pursing such an option. Mr. Cauchi discussed the current ability of young people to stay on their parents' insurance until age 26 and to purchase catastrophic coverage through age 30. He mentioned adjusting these age ranges as a potential option. Mr. Patterson discussed the difficulty in moving young people into the insurance market. Senator Martinez Humenik then asked about tax changes through a waiver. Mr. Cauchi responded that the federal Department of Treasury does review waiver proposals.

10:32 AM

Representative Primavera asked about the sustainability of the health exchange and how some states have converted to the federal exchange or sold their information technology model. Mr. Bontrager discussed federally supported state-based exchanges, which are a relatively new model that some states are using. He discussed the challenges and benefits of such an option. Representative Primavera then asked about the different changes pursued by other states and whether a waiver could include multiple options. Mr. Cauchi stated that some states have pursued multiple pilots in their states. Representative Primavera then commented about cost sharing and cost transparency in the insurance market.

10:39 AM

Senator Roberts then opened the discussion up to follow-up questions. Senator Kefalas directed his question about moving away from employer-based insurance to Mr. Cauchi. Mr. Cauchi responded that other states are pursuing different ideas and noted complexity for employers who operate in multiple states. He stated that this could be a central issue that states look at when considering waiver options. Senator Kefalas asked about revenue neutrality if fines on employers who fail to provide insurance are eliminated. Representative Sias then commented on the large number of products on the exchange and asked if navigators are able to properly advise people about products and whether a waiver could somehow address this issue. Mr. Patterson responded and discussed the factors that navigators and brokers look at when directing clients to health insurance products. Mr. Bontrager stated that states have wide discretion in setting up navigator programs and that it may not be an area where a waiver is needed. Representative Ryden then asked about difference between state and federal exchanges. Mr. Cauchi discussed the experiences of various states in setting up their own exchanges and switching to the federal exchange. Mr. Patterson highlights some of the successes of Colorado setting up its exchange. Representative Ryden commented on the rising costs of insurance and health care and asked if other states have had success in controlling costs. Mr. Cauchi discussed state rate review procedures before and after PPACA.

10:53 AM

Senator Aguilar commented on high-cost populations and the incentives for other people not to purchase health insurance. She stated that Colorado needs to look at these issues and look at where the system should be going. She commented on funding for the Colorado Commission on Affordable Health Care and how it can play an important role in this discussion. She then encouraged the committee to look at prior legislation from 2009 that created a tiered system of health care payments. Senator Roberts commented on the "young invincible" populations and the potential for a medical catastrophe. She asked if there was a product that could appeal to this population and if they are needed in the health insurance risk pool. Mr. Bontrager stated that he would like to look into the current situation for catastrophic coverage in more detail. He stated that a 1332 waiver could be used to eliminate certain coverage requirements, which could potentially decrease the cost of insurance and make it more appealing to younger populations. Mr. Patterson commented that the population served by the health exchange included younger people. Mr. Bontrager mentioned a Kaiser Family Foundation study that concluded that persons aged 18 to 34 should make up about 40 percent of the risk pool, in line with their percent of the overall population. Discussion then ensued concerning the Colorado Commission on Affordable Health Care. Mr. Bontrager discussed how Minnesota implemented a basic health care plan for people with incomes up to 250 percent of the poverty level. Representative Primavera commented about the shift under PPACA from health care being "sick care" to being more health- and wellness-focused care. She then discussed essential health care benefits and coverage options, and asked about waiver options in this area. Representative Primavera then asked about health care costs and the experiences of other states.

11:14 AM

Senator Kefalas asked about administrative costs in the health care and insurance area and ways to reduce these costs. Mr. Bontrager mentioned the Clean Claims Task Force and Mr. Cauchi mentioned some research by NCSL in this area. Representative Sias asked about the 2016 rate determinations, which may result in significant premium increases. He also asked if there was a way to address price increases using a waiver. Mr. Patterson responded that rates will be approved by the Division of Insurance. He then discussed different types of products that could potential be sold on the exchange. Mr. Bontrager discussed the rating areas used by the Division of Insurance. Representative Ryden asked about employers with fewer than 25 employees and whether a waiver could address this population. Mr. Cauchi stated that there are subsidies under PPACA for newly insured employees in business with fewer than 25 employees. He stated that a 1332 waiver could be relevant if the employee threshold were to be changed for this subsidy. Mr. Patterson discussed how businesses access the subsidy and how smaller employers with less than 10 employees may not have incentive to take advantage of the subsidy. Senator Aguilar asked whether the committee would want to consider asking the Colorado Commission on Affordable Health Care to examine waiver options. Senator Roberts stated that motions and legislation can be addressed at a future meeting. She then asked about the process for determining cost neutrality of waiver proposals. She also asked about governance structures for the exchange. Mr. Bontrager stated that states are waiting on guidance from the federal government around cost estimates. The panel did not know of any limitations on governance concerning 1332 waivers.

11:34 AM

The committee recessed for a 15-minute break.

11:48 AM -- Discussion of Marketplace for Next Open Enrollment Period

Mr. Patterson, Adele Work, Chief Information Officer at Connect for Health Colorado, Marcia Benshoof, Chief Strategy and Sales Officer at Connect for Health Colorado, and Adela Flores-Brennan, member of the Connect for Health Colorado Board of Directors, came to the table. Mr. Patterson distributed a document to the committee that addressed prior questions brought up at prior committee meetings (Attachment E) and a presentation on the next open enrollment period (Attachment F).

150715 AttachE.pdf

150715 AttachF.pdf

Ms. Work discussed some of the planned and unplanned challenges that arose during the last open enrollment. She discussed some of the technology challenges, including difficulties processing life change events and other policy changes. She mentioned call center issues that are being addressed for the next open enrollment. She then described the process for renewals and automatic renewals, as well as issues that arose concerning eligibility determination, tax documents, and the small business marketplace.

Ms. Work discussed the goals and objectives for the exchange. Ms. Work addressed data security and personnel. She then discussed the core technology components used by Connect for Health Colorado, including the website, online marketplace, and the shared eligibility system., as well as external systems such as CBMS and insurance carrier systems. Ms. Work provided more detail on the shared eligibility system and improvements that are planned for this system. Representative McCann asked about the data warehousing system and how carriers are paid. Ms. Work explained how an individual's information from the data warehouse is shared with the Internal Revenue Service and subsidy payments are sent from the federal government to the insurance carrier.

Senator Roberts asked about retention rates for Connect for Health Colorado compared with exchanges in other states. Ms. Benshoof stated that this year's goal was a 70-percent retention rate and that they achieved 66 percent. She discussed the industry standard in Colorado and the lack of baseline data after only one year of operations. Next year's goal is 68 percent retention for the individual market and 80 percent for the small group market. She discussed differences in how states measure retention, which can explain some differences with other states. Representative Sias asked about real-time eligibility determination and what the predicted number for next year will be . Ms. Work explained how the CBMS system evaluates applications. Mr. Patterson elaborated on the issue of real-time eligibility determination. Ms. Work further discussed problematic cases that did not result in an immediate eligibility determination or could not be used by the exchange system for various reasons. Ms. Flores-Brennan added that the board allocated funding for customer service staff that can address these cases.

12:28 PM

Representative Ryden asked about the small group SHOP marketplace and vendor oversight. Ms. Benshoof explained that the current vendors used for the SHOP system are focused on the technology side and that they are moving toward a vendor selection that has more small group expertise.

Representative Primavera asked about computer-generated messages sent to consumers and whether they are understandable to members of the public. Ms. Work stated that they are trying to work on improving the letters, but that there are certain legal requirements for letters sent concerning Medicaid eligibility sent by the Department of Health Care Policy and Financing (HCPF). Ms. Work said that the exchanges mailing are simpler.

Senator Kefalas asked how they define "real-time eligibility" and Ms. Work explained the definition that they use. Ms. Work explained which customers go through the PEAK application and which only use the Connect for Health marketplace system. Ms. Work then discussed key changes to the shared eligibility system and stated that these costs are being shared with HCPF.

Senator Roberts thanked the panel for address the concerns raised by the committee and recognizing the challenges facing the exchange. Senator Roberts asked about people who owed taxes to the IRS through no fault of their own after using the exchange to receive an advanced premium tax credit and what Connect for Health Colorado's obligation to them. Ms. Benshoof stated that the exchange wants to educate consumers and has taken steps to let customers know that they have to update income and household information so as to avoid tax penalties from subsidies being too high. She explained that consumers can adjust their tax subsidy themselves online without a life change if they are concerned that the subsidy is too high due to increased income or other changes. Representative McCann asked about reimbursement from Medicaid for changes to the shared eligibility system. Mr. Patterson stated that they were able to leverage a 50/50 match for prior work serving Medicaid clients. Going forward, Mr. Patterson stated that they are in discussions about the match rate and other issues. Senator Martinez Humenik asked about whether consumer know they can call to make changes to income and if they are confused by the website. Ms. Work stated that they have tried to incorporate feedback from consumers and have made changes to simplify parts of the application process. Senator Martinez Humenik asked about non-English speakers and whether they have problems with the exchange website.

12:59 PM -- Review of Policy and Procedures for Board and Staff and Discussion of Fiduciary Duties of the Board

Alan Schmitz, general counsel for Connect for Health Colorado, joined Mr. Patterson and Ms. Flores-Brennan at the table. Mr. Patterson updated the committee on recent board appointments. Mr. Patterson then explained the organization's policies concerning conflicts of interest. Mr. Schmitz reviewed the statutory obligations of the board and its fiduciary duties. Senator Roberts asked about governance, the ex officio members of the board, and whether the current structure has served the board well. Mr. Patterson stated that the intent was that the right people were all at the table during implementation who understand the regulations, law, and political realities of the exchange. He stated that board members regularly recuse themselves from voting on issues on which they may have a conflict of interest. Ms. Flores-Brennan further elaborated that conflicts of interest are linked with voting decisions. She provided further background on the ex officio members. Senator Roberts stated that conflicts of interest could extend beyond voting to influencing others, being present during discussions, and other areas.

Senator Roberts asked about the issue of the "revolving door," where people get experience at the exchange and then go work at other companies. Mr. Schmitz stated that Connect for Health Colorado is a tough place to work. He expounded upon the public policy of the state and relevant case law concerning people changing places of employment. He stated that non-compete agreements are generally discouraged in the law. Mr. Schmitz stated that certain other tools such as confidentiality agreements, among others, are available. Ms. Flores-Brennen discussed concerns and perceptions about employee turnover.

01:17 PM

Mr. Patterson discussed board members' perspective about policies and disclosures of conflicts of interest. Mr. Schmitz discussed his role of in reminding board members about their fiduciary duties. Senator Roberts asked the panelists to consider how the board structure could be improved.

01:24 PM

Senator Kefalas asked if Ms. Work could return to the table to address additional questions regarding technology. Ms. Work and Ms. Benshoof responded to questions about the timing of a decision regarding receiving funding for the shared eligibility system. Mr. Patterson responded to questions about whether the funding source for the shared eligibility system is state funds or federal funds. He discussed recent federal guidance that Connect for Health Colorado received on the issue of funding for the shared eligibility system. Ms. Benshoof answered questions about the memorandum of understanding with HCPF that is in the process of being updated. Ms. Benshoof answered questions about requests for proposals for technology vendors. Ms. Work answered questions about the dual enrollment of some people in both Medicaid and advance premium tax credits.

01:38 PM

Ms. Work answered questions about training on the website for health coverage guides, brokers, and others who provide enrollment assistance. Ms. Work answered questions about whether someone on Medicaid who received an advanced premium tax credit would have to pay back the credit, and outlined the options to someone who is dually enrolled in both Medicaid and health insurance sold on the exchange. Ms. Benshoof responded to questions about work group on simultaneous enrollment, and stated that Connect for Health Colorado is still waiting on guidance from CMS regarding issues related to simultaneous enrollment.

01:45 PM -- Discussion with DOI about Committee Concerns Raised During June 5 Meeting

Peg Brown and Scott Lloyd, Division of Insurance, introduced themselves. Ms. Brown discussed whether spreading exchange user fees across all plans is legal. She discussed the mechanisms for funding for the exchange. She referenced the Colorado Regulation 4-2-52 and also discussed a federal regulation on user fees. She then addressed costs for carriers for consumer services and information technology upgrades. Ms. Brown explained how these costs are calculated as part of the required medical loss ration. Ms. Brown then addressed the issue of carriers discontinuing certain health plans. Ms. Brown responded to a prior question about adverse selection from specialty drug coverage. Next, Ms. Brown explained that Colorado did not have an insurable interest requirement that would prevent health care providers from paying the insurance premiums for patients to ensure that they receive payment. She stated that the federal government has issued guidance in this area to discourage the practice in most cases. Ms. Bown addressed a prior question about how the guaranty fund protects consumers in the event of carrier insolvency and how this process works in practice. Ms. Brown next addressed concerned about Colorado HealthOp, and stated that the carrier meets the minimum reserve and financial requirements. Lastly, Ms. Brown discussed the current rate review process and how the Division of Insurance compared rate requests with carrier financial status.

02:02 PM

Senator Aguilar asked if carriers are complying with the specialty drug requirements and Ms. Brown stated that they are complying. Ms. Brown and Mr. Lloyd responded to a question about the maximum amount that can be paid from the guaranty fund on behalf of a consumer. Senator Aguilar asked about reserve requirements and discussion ensued concerning the rate review process and financial assessment of carriers. Senator Lundberg reiterated his concern and question about the legality of the fees funding the exchange. Ms. Brown then cited Section 11 of the PPACA as permitting a fee to fund exchange operations and that federal law requires that it be assessed across a carrier's entire book of business, both inside and outside the exchange. Representative Ryden ask about noncompliant plans that were not renewed under PPACA and the characteristics of those plans. Representative Sias asked about the Division of Insurance's decision not to seek a waiver to allow non-compliant plans to be renewed. Ms. Brown described the Division's decision to do the transition over a one-year, rather than two-year, period. Discussion then ensued about the fees charged by the federal exchange.

02:21 PM -- Discussion with HCPF about Committee Concerns Raised During June 5 Meeting

Chris Underwood and Marivel Guadarrama, Department of Health Care Policy and Financing, came to the table. They provided a handout of responses to questions raised at the last meeting (Attachment G), which also includes examples of the mailings provided to consumers. Senator Martinez Humenik expressed concerns about the letters provided to consumers as being overly complicated. Mr. Underwood expressed the department's concern about this as well, and highlighted the cover letter that provides a brief overview of the determination made. Discussion ensued about developing a more user friendly product. Senator Aguilar asked if the HCPF is currently looking at any 1115 Medicaid waivers. Mr. Underwood noted some prior waivers but said they are not currently developing or seeking additional waivers. Senator Kefalas asked why some people are enrolled in both Medicaid and private insurance. Mr. Underwood explained several scenarios under which this would arise. Senator Roberts noted that she disagreed with the department's response to the adequacy of providers for Medicaid clients. Senator Aguilar asked about addressing churn, where client shift between Medicaid and private insurance as their incomes change, through the use of continuous eligibility. Mr. Underwood explained that continuous eligibility currently applies to children, but that an 1115 waiver would be required to extend this to adults. He noted some efforts they currently have to reduce churn. Senator Aguilar asked about developing a basic health plan or extending advanced premium tax credit to certain low income adults. Mr. Underwood stated that Colorado decided to pursue a Medicaid expansion to 133 percent of poverty, rather than such an approach, but stated that the state could examine additional options in the future. More discussion ensued about churn and tracking clients after they leave Medicaid.

150715 AttachG.pdf

02:41 PM -- Public Comment

Ryan Ross, representing himself, came to the table. He provided a handout to the committee (Attachment H) outlining his proposal to decouple health insurance from employment. He discussed the problems with the employer mandate, described his proposal, and explained how it benefits businesses and employees. Discussion ensued between Mr. Ross and members of the committee concerning his plan.

150715 AttachH.pdf

02:56 PM -- Adjourn

Senator Roberts announced that the August 14 committee meeting will be cancelled. She reminded the committee members about the Connect for Health Colorado audit follow-up at the August 31 meeting of the Legislative Audit Committee. Senator Roberts discussed the committee bill drafting process for the September 11 and October 27 meetings. The committee adjourned.