Bill Summary for Bill Number HB09-1143

Date: 02/04/2009

Final
BILL SUMMARY for HB09-1143

HOUSE COMMITTEE ON BUSINESS AFFAIRS AND LABOR

Votes: View-->	Action Taken:
Moved amendment L.001 (Attachment H). The motion Moved to refer House Bill 09-1143, as amended, to	PASS PASS

01:33 PM -- House Bill 09-1143

Representative Swalm, prime sponsor, presented House Bill 09-1143 concerning the authority of a health maintenance organization to offer basic health services through a limited benefit plan. He distributed a handout entitled Transforming Colorado's Behavioral Health System. This bill allows health maintenance organizations (HMO) the option to offer basic health care services to enrollees through limited benefit plans. Basic health care services are services an HMO policyholder might require to maintain good health such as doctor and hospital visits, laboratory, and x-ray services. Limited benefit plans are not defined, but generally such plans are offered at low cost and limit the amount of payments on particular services and total coverage per person.

HB09-1143 is effective August 4, 2009, if adjournment is on May 6, 2009, unless a referendum petition is filed.

Representative Swalm said the opposition is concerned with limited benefit plans and wants comprehensive coverage. He feels that is like saying, if you cannot afford a Cadillac you must walk, and he feels there is room for a Chevy plan.

01:46 PM -- Ed Kahn, representing the Colorado Center on Law and Policy, testified against the bill. He said the bill is another version of a bill that was attempted in previous years. Mr. Kahn talked about Senate Bill 08-217 that passed last year that created a study to see if people were interested in limited benefit plans and offer recommendations. Mr. Kahn said this bill should wait until the study is finished. There was a discussion about the cost of HMOs.

01:59 PM -- George Del Grosso, representing Colorado Behavioral Council, testified against the bill. He talked about HMOs and the elderly and the limited mental health benefits that are provided by a HMOs. Mr. Del Grosso said they are concerned that there is no mental health benefit. Representative Bradford asked whether the witness knew that the plans would have no mental health benefits. Mr. Del Grosso responded that he has not heard that none of them will have mental health benefits, but assumes they will not. Mr. Del Grosso responded to additional questions from the committee.

02:14 PM -- A.W. Schnellbacher, representing the AARP, testified against the bill. The AARP feels the intentions of the bill are good, but the bill may have opposite effects than what are intended. He said premiums may go up as a result of this bill. Representative Balmer commented on the statistics Mr. Schnellbacher discussed. Mr. Schnellbacher stated that since these plans are so limited, people will not buy them. He listed services that are not covered in limited benefit plans. There was a discussion about AARP plans. Representative Priola asked Mr. Schnellbacher the number of people who are uninsured. Mr. Schnellbacher stated there are 2.1 million Coloradoans uninsured or underinsured. Representative Priola stated that he feels that the plans would be good for young people who are just entering the market.

02:38 PM -- Steven Kopanes, representing Health America of Colorado, testified against the bill. Mr. Kopanes said limited benefit plans are unlikely to save money. He talked about cost shifting that would result if the bill passes.

02:42 PM -- Dede de Percin, representing the Colorado Consumer Health Initiative, testified against the bill. She talked about the discussion of a little coverage versus no coverage at all. She said it depends on whether you can get what you need with a little coverage. Ms. de Percin mentioned that the report from the Senate Bill 09-217 study is due March 1. Representative Stephens stated that limited benefit plans already exist in Colorado and said that this bill is just allowing HMOs to sell them as well. Representative Ryden asked whether it is the employer or the employees that make the decision of purchasing an HMO. Ms. De Percin said the employer is the one who decides in the smaller market. Representative Bradford listed a number of illnesses plans may not cover, including colonoscopies and hip replacements and stated that young adults do not want to purchase coverage for all of those illnesses.

02:53 PM -- Lawrence Krausz, representing himself, testified against the bill and stated that no matter how you look at it, we are playing Russian roulette. He talked about his experience of having schizophrenia at the age of 19 and that coverage for schizophrenia is not available. Mr. Krausz discussed the number of persons with mental illness in the prison system. He said without mental health coverage, you end up in prison most of the time.

02:58 PM -- Vanesa Haneman, representing the Colorado Association of Health Plans, testified in support of the bill and distributed a handout (Attachment F). Representative Swalm asked Ms. Haneman to talk about current limited benefit plans. She said PPOs can offer limited benefit plans as allowed in statute.

03:04 PM -- Cindy Sovine Miller, representing the Colorado State Association of Health Underwriters, testified in support of the bill and said they have been working with the sponsor for over a year on this bill. Ms. Sovine Miller stated that the limited benefit plans do not fit for everyone. Representative Stephens asked about current limited benefit plans and whether they currently exist. Ms. Sovine Miller said they do exist and this bill would allow HMOs to offer them as well. Representative Liston asked for the average cost of a premium for a limited benefit plan. Representative Soper stated that it is unclear how these plans will look if the bill passes. Ms. Sovine Miller agreed and said the bill only allows HMOs to provide these plans, it does not lay out the plans themselves.

03:14 PM -- Jerry McElroy, representing Kaiser Permanente, an HMO, testified in support of the bill. He said the bill would be another option for employers. Mr. McElroy talked about his Kaiser Permanente plan and the use of his health insurance. Representative Liston asked if this bill would be different than the one passed in Tennessee. Mr. McElroy said yes.

03:21 PM -- Cindy Palmer, San Louis Valley HMO, testified in support of the bill and distributed a handout (Attachment G). She talked about a McDonald's in her area that wanted to offer limited benefit plans and she said she couldn't help them because she has an HMO license. Ms. Palmer stated that United and other insurance companies that hold an insurance license and an HMO license can already offer limited benefit plans, but those that do not have both, and only have an HMO license, including Kaiser Permanente and San Louis Valley HMO, cannot. Ms. Palmer stated that if the bill passed and they could offer limited benefit plans, they would still need to meet all the minimum coverages under statute, but it allows them to offer minimum coverage in a limited benefit way. Ms. Palmer responded to the question about the difference between underinsured and a limited benefit plan.

03:41 PM

She talked about her support of the amendment that would be presented. Ms. Palmer responded to questions from the committee. She said the HMOs would be more constrained then those who currently offer these plans under an insurance license.

04:04 PM -- Travis Berry, representing the Colorado Competitive Council, testified in support of the bill and stated that the debate has been productive. Mr. Berry stated that employers are not required to offer health insurance, it is a mutually beneficial relationship. This bill creates an additional opportunity for access to health insurance.


BILL:	HB09-1143
TIME:	04:08:13 PM
MOVED:	Liston
MOTION:	Moved amendment L.001 (Attachment H). The motion passed 10-1.
SECONDED:	Balmer
		VOTE
	Balmer	Yes
	Bradford	Yes
	Gagliardi	No
	Liston	Yes
	Priola	Yes
	Ryden	Yes
	Scanlan	Yes
	Soper	Yes
	Stephens	Yes
	Casso	Yes
	Rice	Yes

Not Final YES: 10 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS

04:10 PM


BILL:	HB09-1143
TIME:	04:11:59 PM
MOVED:	Balmer
MOTION:	Moved to refer House Bill 09-1143, as amended, to the Committee of the Whole. The motion passed 6-5.
SECONDED:	Priola
		VOTE
	Balmer	Yes
	Bradford	Yes
	Gagliardi	No
	Liston	Yes
	Priola	Yes
	Ryden	No
	Scanlan	Yes
	Soper	No
	Stephens	Yes
	Casso	No
	Rice	No

Final YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS