Final
Access to Health Insurance
HEALTH INSURANCE
Votes:
Action Taken:
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10:23 AM -- Presentation by the National Conference of State Legislatures
Laura Tobler, National Conference of State Legislatures, discussed state options for providing health insurance to the uninsured and distributed an overview of her presentation to the committee (Attachment A). Between 15 and 18.9 percent of Coloradans do not have health insurance. State initiatives for covering the uninsured fall into three categories: private market initiatives; public/private sector initiatives; and public sector initiatives. She described private market initiatives including: offering "bare bones" health insurance policies, or policies without mandates; creating group purchasing arrangements; extending the state continuation period; expanding the definition of dependent; instituting individual market reforms; creating employer mandates; and offering tax incentives. She stated that states that have made significant progress in insuring more individuals have made a number of significant policy changes, not just one. She discussed other private market initiatives including requiring college students to be insured, required provision of health insurance as a condition of state contracts, and the use of medical savings accounts and health savings accounts.
10:45 AM
Ms. Tobler described public/private initiatives to increase access to health insurance. She listed some public/private initiatives including expanding state employee health plans to include groups other than state employees and premium assistance programs that use Medicaid or Children's Basic Health Plan (CHP+) dollars or other funds to assist individuals to purchase private insurance. She further described employer-assistance initiatives in other states, and stated that other states have reported cost savings from implementing such programs. She discussed a waiver program implemented in New Mexico which provides low-cost basic health insurance through an employer-based benefit program in conjunction with the state. She responded to questions from Senator Hagedorn regarding whether the Centers for Medicare and Medicaid will continue to approve waivers which utilize unspent CHP+ dollars to subsided health insurance programs. She discussed state-funded reinsurance programs, and stated that the Healthy New York reinsurance program has made progress in reducing premiums and the number of uninsured in the state. She responded to questions from the committee regarding the reduction in uninsured in New York after the implementation of the Healthy New York program. She reiterated that states often must implement a number of different programs and initiatives in order to decrease the number of uninsured.
11:17 AM
Ms. Tobler described a number of public initiatives that may improve coverage including: expanding Medicaid and CHP+ through 1115 Health Insurance Flexibility and Accountability (HIFA) waivers; imposing cost sharing for new populations; and redirecting unused Disproportionate Share Hospital Funding, CHP+, and tobacco dollars. She discussed the Utah Primary Care Network which was implemented through an 1115 waiver and described a program recently instituted in Iowa that expands Medicaid to approximately 30,000 new eligibles per year and uses incentives in order to encourage individuals to make healthier lifestyle choices. She discussed recent legislation that mandates the collection and reporting of employment data on Medicaid beneficiaries.
11:24 AM
Ms. Tobler responded to questions from Senator Mitchell regarding medical and health savings accounts. She further responded to questions from Senator McElhany regarding the number of uninsured in the country. Senator McElhany expressed concern that a percentage of the population goes without care because of choice. Representative Green asked for more information on disease management and shared information systems. Representative Riesberg asked Ms. Tobler for information about tax incentives and disincentives for charity care.