Date: 03/13/2012
Final
Presentation on CoverColorado
HOUSE COMMITTEE ON HEALTH AND ENVIRONMENT
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10:35 AM -- Presentation on CoverColorado
Suzanne Bragg-Gamble, Executive Director, CoverColorado, introduced herself and distributed a handout regarding the CoverColorado program to the committee (Attachment C). Ms. Bragg-Gamble explained that under current law, the individual health insurance market is permitted to deny coverage to individuals with preexisting health care issues, and CoverColorado provides insurance to those individuals who are denied coverage. She stated that state law requires insurers to notify individuals about CoverColorado when denying individual coverage. She explained that CoverColorado premiums are, by law, higher than those in the standard insurance marketplace. Ms. Bragg-Gamble stated that CoverColorado provides comprehensive coverage, and that individuals insured under CoverColorado have a $1 million cap on claims. She described the plans that are offered through CoverColorado.
10:38 AM
Ms. Bragg-Gamble described the funding mechanism for CoverColorado, which is as follows: member premiums (50%), an assessment charged to insurance carriers (25%), and funding from the Unclaimed Property Trust Fund (25%). She noted that member claims in 2012 are projected at $140 million. She discussed the future of CoverColorado in light of the federal health care legislation and the creation of a state health insurance exchange. She stated that the carriers in the exchange will be required to issue individual health plans in the exchange in 2014, and if insurers must take all applicants, there will be no need for CoverColorado. She stated that if the federal law is repealed or is extensively changed, and insurers are still permitted to deny coverage, there could still be a need for CoverColorado, at which time the funding mechanism for CoverColorado would have to be revised. She stated that in 2013, representatives of CoverColorado will likely approach the legislature with legislation to either wind down the affairs of CoverColorado or to revise the funding mechanism for the program so that it can be sustainable in the future.
10:42 AM
Ms. Bragg-Gamble responded to questions from Representative Kefalas regarding a task force that was created in 2008 to make recommendations regarding the funding of CoverColorado. Ms. Bragg-Gamble explained that the task force recommended that the program enact measures to reduce the costs of care, namely by reducing provider payment rates. Ms. Bragg-Gamble discussed the implementation of legislation that reduced provider payment rates. She further responded to questions from Representative Summers regarding the premiums paid by CoverColorado participants, stating that the rates are required to be 100 to 150 percent of commercial rates, and from Representative Young regarding coverage for autism treatment through CoverColorado.
10:50 AM
Ms. Bragg-Gamble reviewed the differences between CoverColorado and Getting Us Covered, which is Colorado's high-risk insurance pool that was created by the passage of the federal health care legislation. She explained that to be eligible for coverage through Getting Us Covered, individuals must have been uninsured for at least six months. She discussed the differences between the clientele served in CoverColorado and Getting Us Covered. She noted that there are about 1,200 people enrolled in Getting Us Covered, and in 2014, those individuals will be served through the state health insurance exchange. She responded to questions from Representative Summers regarding how the premiums in Getting Us Covered are determined, and she noted that the premiums in the program must be the same as in the commercial market. Ms. Bragg-Gamble noted that individuals in the Getting Us Covered program have generally not had health insurance coverage for some time and thus have many unmet health needs. Ms. Bragg-Gamble responded to questions from Representative McCann regarding how an eligible person would choose between enrolling in CoverColorado and Getting Us Covered, and from Representative Summers regarding federal moneys available to fund the Getting Us Covered program.
11:01 AM
In response to a question from Representative Schafer, Ms. Bragg-Gamble described the administration of the CoverColorado and Getting Us Covered programs. Representative Summers gave concluding remarks.
11:04 AM
The committee recessed.