Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON BUSINESS AFFAIRS AND LABOR

Date:03/18/2009
ATTENDANCE
Time:10:47 PM to 07:58 PM
Balmer
X
Bradford
X
Place:HCR 0112
Gagliardi
X
Liston
X
This Meeting was called to order by
Priola
X
Representative Rice
Ryden
X
Scanlan
X
This Report was prepared by
Soper
X
Christie Lee
Stephens
X
Casso
X
Rice
X
X = Present, E = Excused, A = Absent, * = Present after roll call
Bills Addressed: Action Taken:
SB09-159
HB09-1273		Postponed Indefinitely
Amended, Referred to Appropriations


10:47 AM -- Senate Bill 09-159

Representatives McGihon and Benefield, prime sponsors, presented Senate Bill 09-159 concerning the mandatory offer of dependent coverage to an unmarried child. The reengrossed bill changes the age of a individual for which a health insurance carrier is required to offer dependent coverage from 25 to 30. It also prohibits insurance carriers from terminating coverage for dependents who take a medical leave of absence from an institution of higher education. The carrier may terminate the coverage one year after the leave of absence begins or the date the coverage would otherwise terminate.

In 2005, House Bill 05-1101 required all individual and group health insurance policies that offer dependent coverage to offer such coverage for unmarried children under 25 year of age even if they are not students. These adult children must have the same legal residence as the parent or be financially dependent upon the parent. Coverage may be offered by rider or supplemental policy with the additional premium paid by the parent. SB09-159 expands this provision to adult children up to age 30, and other requirements remain the same.
















10:52 AM

Representative Benefield talked about her son who was placed on her insurance while in college after the law was changed to 25. She said now he is 26 and in the same predicament as he was back then. Representative McGihon talked about an amendment that was added in the Senate at the request of the Division of Insurance that added language conforming Colorado law with federal law. The sponsors were asked to address the fiscal note. The sponsors responded to questions regarding reasons 25 to 30 year-olds do not buy individual insurance. There was a discussion about the role of CoverColorado.

11:20 AM -- Donnah Moody, representing the Colorado Association of Commerce and Industry, testified against the bill. She talked about the potential increase in cost and discussed the affordability and availability of private health insurance to persons aged 25 to 30. Ms. Moody responded to questions regarding how the bill will increase the costs and whether any data is available relating to the impact of House Bill 05-1101.

11:26 AM -- James Helgoth, President of Elward Construction, testified against the bill. He said his company insures 103 employees and talked about the impact the bill would have on the cost of health insurance for his business and employees. Mr. Helgoth said that no matter the number of dependents, everyone pays the same premium. Mr. Helgoth responded to questions from the committee about the impact the bill would have on the cost of health insurance.

11:40 AM -- Jerry McElroy, representing Kaiser Permanente, testified against the bill. He talked about Kaiser Permanente's experience since the age was raised from 21 to 25 in 2005. Mr. McElroy stated that the employers did not want the additional coverage and contemplated self-insuring to get out from under the mandates. Mr. McElroy asked to change the bill to apply to policies issued or renewed after the effective date (January 1, 2010).

11:45 AM -- Patrick Boyle, representing the Colorado Group Insurance Association, testified against the bill. He talked about community rating and the various markets that will be affected by the bill.

11:49 AM -- Jamie Scholl, an insurance broker, chair of the National Association of Health Underwriters, representing the Colorado State Association of Health Underwriters, testified against the bill. He talked about the options for 25 to 30-year-olds and said they have many affordable options. Mr. Scholl listed the cost of insurance for ages 25 to 30 in each of the markets. Mr. Scholl said employers cut back their contribution to dependent coverage following the 2005 law that raised the age to 25. Mr. Scholl responded to questions from the committee.

12:04 PM -- Tom Gosselin and Rebecca Weiss, representing Anthem Blue Cross and Blue Shield, testified against the bill. Ms. Weiss responded to the earlier question of why health insurance companies cannot raise premiums. Mr. Gosselin talked about the potential increase in cost the bill may create. The witnesses responded to questions from the committee and talked about the various health insurance options that are currently available for 25 to 30-year-olds.














12:13 PM -- Travis Berry, representing the Colorado Competitive Council, testified against the bill. He said health insurance premiums have not gone down or stabilized since the passage of the 2005 law. Mr. Berry stressed that employers are not required to offer health insurance and said the bill may result in employers dropping dependent coverage.

12:18 PM -- Danny Talley, representing himself, and HUB International, a consulting firm representing employers, testified against the bill. He talked about the effects the bill will have on the individual market and the current options available for 25 to 30-year-olds. Mr. Talley said the bill may result in healthy individuals leaving employer-provided plans and finding their own individual insurance, leaving sick individuals in the employer-provided market.

12:22 PM -- Suzanne Bragg-Gamble, representing CoverColorado, testified neutrally on the bill and gave some background information on Cover Colorado and who is covered under the program. She gave some examples of the premiums 25 to 30-year-olds are charged. Ms. Bragg-Gamble was asked to talk about the eligibility requirements for CoverColorado.

12:28 PM -- Deborah Colburn, representing the Colorado Coalition for the Medically Underserved, testified in support of the bill and distributed a handout (Attachment A).

09HouseBus0318AttachA.pdf

12:31 PM -- Dominic Sulley, representing himself, testified in support of the bill. He talked about his experience receiving a heart transplant at a young age and said he may need another one which would cost $800,000 to $1.4 million. Mr. Sulley also advised the committee that he already spends about $1,000 a month on medication.

12:33 PM -- Dawn Sulley, representing herself, Dominic's mother, testified in support of the bill and talked about her experience taking care of her son. She said she would like the option of paying for her son's health care coverage rather than having him on Cover Colorado. Ms. Sulley said under the bill, the family pays the additional costs for the dependent. She said her son has had the same doctors since he was 13 and she would like him to continue to stay with those doctors. Ms. Sulley was asked who her employer is and what would happen when her son reaches the age of 30. Ms. Sulley responded that the bill bridges the gap between college and her son getting a job and receiving coverage under an employer.

12:42 PM -- Mark Randall, representing himself, testified in support of the bill and talked about the effect the bill would have on his family and his son, who also received a heart transplant at a young age. He said his son does not have the option to be uninsured. Mr. Randall said right now his son's only option is CoverColorado.

12:45 PM -- Kelly Stahlman, representing Family Voices Colorado, testified in support of the bill and talked about individuals who have chronic conditions, including asthma. She said people without insurance get medical care through emergency rooms. Ms. Stahlman discussed pre-existing conditions. Ms. Stahlman responded to questions from the committee.











BILL:SB09-159
TIME: 01:06:04 PM
MOVED:Gagliardi
MOTION:Moved amendment L.003 (Attachment B). The motion passed without objection.
09HouseBus0318AttachB.pdf
SECONDED:Soper
VOTE
Balmer
Bradford
Gagliardi
Liston
Priola
Ryden
Scanlan
Soper
Stephens
Casso
Rice
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection



























BILL:SB09-159
TIME: 01:06:28 PM
MOVED:Gagliardi
MOTION:Moved amendment L.004 (Attachment C). The motion passed 7-4.

09HouseBus0318AttachC.pdf
SECONDED:Soper
VOTE
Balmer
No
Bradford
No
Gagliardi
Yes
Liston
Yes
Priola
No
Ryden
Yes
Scanlan
Yes
Soper
Yes
Stephens
No
Casso
Yes
Rice
Yes
Not Final YES: 7 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: PASS


01:12 PM

The sponsors asked the committee to think about adding a fifth tier to insurance on second reading. Ms. Stahlman returned to respond to an earlier question about the 208 Commission's recommendation on dependent health care coverage.





















BILL:SB09-159
TIME: 01:22:26 PM
MOVED:Gagliardi
MOTION:Moved to refer Senate Bill 09-159, as amended, to the Committee on Appropriations (see substitute motion below to postpone the bill indefinitely).
SECONDED:Soper
VOTE
Balmer
Bradford
Gagliardi
Liston
Priola
Ryden
Scanlan
Soper
Stephens
Casso
Rice
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: SEE BELOW

BILL:SB09-159
TIME: 01:36:59 PM
MOVED:Gagliardi
MOTION:Moved a substitute motion to postpone Senate Bill 09-159 indefinitely. The motion passed 10-1.
SECONDED:Balmer
VOTE
Balmer
Yes
Bradford
Yes
Gagliardi
Yes
Liston
Yes
Priola
Yes
Ryden
Yes
Scanlan
Yes
Soper
No
Stephens
Yes
Casso
Yes
Rice
Yes
Final YES: 10 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS







01:37 PM

The committee recessed.


02:11 PM -- House Bill 09-1273

The committee reconvened. Two handouts were distributed to the committee (Attachments D and E). Representative Kefalas distributed a handout, two amendments, L.001 and L.002, and an unofficial preamended version of the bill (Attachments F through I) to the committee. Representative Rice went over ground rules for witness testimony and asked that witnesses please not repeat testimony.

09HouseBus0318AttachD.pdf 09HouseBus0318AttachE.pdf

09HouseBus0318AttachF.pdf 09HouseBus0318AttachG.pdf

09HouseBus0318AttachH.pdf 09HouseBus0318AttachI.pdf

02:17 PM

Representative Kefalas, prime sponsor, presented House Bill 09-1273, concerning the creation of a health care authority to develop a health care system that shall be the administrator for health care services in Colorado. The bill creates the Colorado Health Care Authority. The authority is governed by a 23-member board of directors, and is not subject to administrative direction or control by any agency of the state. The mission of the authority is to create a health care system in Colorado that is the benefits administrator and payer for health care services. The authority is to recommend to the General Assembly and implement a single-payer health care system that provides comprehensive medical benefits to all eligible participants.

Subject to sufficient gifts, grants, and donations, the board must consider a number of factors including the following:
The board is required to annually report on its progress to the Health and Human Services Committees of the Senate and the House of Representatives and to the Governor. The bill also specifies that prior to implementation of a single-payer health care system, approval must be received from General Assembly.

Representative Kefalas stated that the bill represents an opportunity to have a conversation regarding health care reform. He also stated that the current health care system is outdated, and that the employer-based insurance system stiffles innovation and entrepreneurship.


02:26 PM

Representative Kefalas responded to questions from the committee regarding the changes the bill will make to health care. There was a discussion about the 208 Commission and its recommendations and other countries that have a single-payer system.

02:43 PM -- Barry Keene, President of KEENE Research and Development, testified in support of the bill and distributed a handout (Attachment J). He commented on the 208 Commission's recommendations. Mr. Keene talked about the need for the bill. He talked about the term "single-payer" and what it involves. Mr. Keene talked about the future costs of health care under the current system. He addressed the earlier conversation on other states.

09HouseBus0318AttachJ.pdf

03:11 PM -- Dr. Irene Aguilar, representing her patients, testified in support of the bill. She talked about the 208 Commission. Ms. Aguilar talked about the benefits and cost savings of a single payer system. She talked about what she called "the extinction of primary care" due to more and more people becoming uninsured.

03:21 PM -- Dr. Kern Low, representing the Colorado Academy of Family Physicians, testified in support of the bill. He said the goal of the bill is to find a comprehensive health care system with access for everyone.

03:28 PM -- Joan Henneberry, representing the Colorado Department of Health Care Policy and Financing and the Governor's advisor on health care, testified against the bill. She talked about current legislation that is addressing problems in the health care system. Ms. Henneberry talked about her concerns with the bill. She discussed the 208 Commission's recommendations and said Governor Ritter's Administration has been following those recommendations. Ms. Henneberry responded to questions.

03:57 PM -- Mark Simon, representing himself, testified in support of the bill and distributed a handout (Attachment K).

09HouseBus0318AttachK.pdf









04:03 PM -- John Brackney, representing the South Metro Denver Chamber of Commerce, testified against the bill.

04:16 PM -- Tony Gagliardi, representing the National Federation of Independent Businesses, testified against the bill. He said they would like to see improvements on the current system. Mr. Gagliardi said the bill wipes out the current health insurance market in Colorado. He discussed language in the bill stating that the authority shall create a single payer system.

04:24 PM -- Steve Summer, President and CEO of the Colorado Hospital Association, testified against the bill. He said government cannot be both the payer and the regulator of health care coverage. Mr. Summer said they would like to see what the federal government does this summer before this bill is passed.

04:31 PM -- James Sugden, representing the Colorado State Association of Health Underwriters, testified against the bill. He discussed the 208 Commission's recommendations regarding health care reform. He responded to questions from the committee. Representative Kefalas reminded the committee that the bill only allows the authority to look at this issue and make a recommendation.

05:00 PM -- Brenda Bell Ennis, representing herself, testified against the bill. She talked about her daughter who has a health condition and talked about complex conditions that require specialty care. Ms. Bell Ennis said the bill does not allow choice.

05:06 PM -- Tom Russell, the Vice President of Health Care for All Colorado, testified in support of the bill. He responded to some of the previous testimony.


05:28 PM

Chairman Rice announced that a few of the members had to leave at 6:00 p.m., and said he would read through the remaining witnesses signed up to testify. He asked members of the audience to either stand up and state they are for or against the bill or tell the chair they would like to speak and he will call them up later so they can testify. The following people either stood up and voiced their position on the bill, distributed written comments, or both:

05:43 PM -- Dr. Carol Blackard, a primary care physician in Aurora, testified in support of the bill and submitted her written testimony (Attachment EE).

09HouseBus0318AttachEE.pdf

05:56 PM -- Dr. David Zehring testified in support of the bill and talked about the benefits of a single payer system.

06:03 PM -- Brenda VonStar, a family nurse practitioner, testified in support of the bill, talked about her patients, and submitted her testimony (Attachment FF).

09HouseBus0318AttachFF.pdf

06:06 PM -- Reverend Sally Bowersox, a priest and nurse, testified in support of the bill. She talked about the increased number of uninsured. Ms. Bowersox gave some examples of patients that are without health insurance and the problems they face.

06:15 PM -- Adam Graber, representing himself, testified in support of the bill and distributed his testimony (Attachment GG). He talked about the number of health related bankruptcies and said that most of those people had health insurance when they initially got sick.

09HouseBus0318AttachGG.pdf

06:19 PM -- Carol Garlington, representing herself, testified in support of the bill and talked about her experience paying for her young son, who has diabetes.














06:22 PM -- Dr. Rochelle Dworet, MD, representing herself as a primary care physician, testified in support of the bill and submitted her testimony (Attachment HH). She talked about the various services that are not reimbursed under the current system.

09HouseBus0318AttachHH.pdf

06:26 PM -- Bob Carlsten, a member of Health Care for All Colorado, a Medicare recipient for the last 15 years, testified in support of the bill. He addressed prior witness testimony and said there is a lack of choice under the current system.

06:32 PM -- Alisa Ray, representing herself, testified in support of the bill. She is self-employed and talked about her son's $10,000 hospital bill from pneumonia after her insurance lapsed without her knowing it. Ms. Ray responded to questions from the committee.

06:39 PM -- Chris Schwab, representing himself, a member of Health Care for All Colorado, testified in support of the bill. He talked about his experience after losing his private health insurance and said the for-profit system does not work in health care.

06:45 PM -- Ivan Miller, Ph.D., representing Balanced Choice Health Care Inc., testified in support of the bill and distributed a handout (Attachment II).

09HouseBus0318AttachII.pdf

06:48 PM -- Lesley Manring-Borchers, representing herself, testified in support of the bill. She said she used to live in Germany and said she received and liked the German National Health Care. She said Germany offered a single payer insurance and private health insurance.

06:52 PM -- Dick Barkey, affiliated with Health Care for All Colorado, testified in support of the bill. He explained that single payer health care differs from socialized health care.

06:56 PM -- Elinor Christiansen, a physician and a medical director, testified in support of the bill and submitted her testimony (Attachment JJ). She talked about the various types of health care systems she has worked with over the years.

09HouseBus0318AttachJJ.pdf













07:02 PM -- Kelli Willis, a Progressive Democrats of Colorado member, representing herself and her family, testified in support of the bill. She talked about her daughter's experience on Medicaid.

07:05 PM -- Jeff Burns, a member of the South Metro Denver Chamber of Commerce and a small business owner, testified on the bill and talked about another bill that addresses health care that may be introduced later this session. Mr. Burns responded to questions.

07:17 PM -- Hether Ayres, representing Progressive Democrats of Colorado, testified in support of the bill. She talked about a friend who suffered in pain for a year and needed back surgery but her insurance company wouldn't pay for it. She also talked about the cost of her COBRA coverage since she was let go earlier this year.

07:20 PM -- Arthur Powers, representing Thrive, a support group for people living with HIV, testified in support of the bill with amendment L.002.

07:24 PM -- Mitzi Cagle, RN BSN, representing the National Nursing Committee, stood up earlier and testified in support of the bill and distributed her comments (Attachment DD).

07:28 PM -- Ken Sullivan, representing himself, testified in support of the bill and said he cannot get insurance because he was diagnosed with Hotchkins at a young age.

07:29 PM -- Liam Sperl, representing himself, a future medical student, testified in support of the bill and talked about the importance of primary care.
BILL:HB09-1273
TIME: 07:33:38 PM
MOVED:Gagliardi
MOTION:Moved amendment L.001 (Attachment F). The motion passed without objection.
SECONDED:Soper
VOTE
Balmer
Bradford
Gagliardi
Liston
Priola
Ryden
Scanlan
Soper
Stephens
Casso
Rice
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection









BILL:HB09-1273
TIME: 07:36:26 PM
MOVED:Gagliardi
MOTION:Moved amendment L.002 (Attachment G). The motion passed without objection.
SECONDED:Soper
VOTE
Balmer
Bradford
Gagliardi
Liston
Priola
Ryden
Scanlan
Soper
Stephens
Casso
Rice
Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


07:47 PM

Representative Kefalas gave some closing comments on the bill. Some of the members of the committee also commented on the bill.


























BILL:HB09-1273
TIME: 07:58:12 PM
MOVED:Soper
MOTION:Moved to refer House Bill 09-1273, as amended, to the Committee on Appropriations. The motion passed 5-4.
SECONDED:Gagliardi
VOTE
Balmer
No
Bradford
No
Gagliardi
Yes
Liston
Excused
Priola
No
Ryden
Yes
Scanlan
Yes
Soper
Yes
Stephens
No
Casso
Yes
Rice
Excused
Final YES: 5 NO: 4 EXC: 2 ABS: 0 FINAL ACTION: PASS


07:58 PM

Adjourned.