Colorado Blue Ribbon Commission for Health Care Reform Sarah Schulte Technical Advisor to the Commission State Officials Workshop August 2, 2007

Overview Colorado profile 5 Miracles of the Commission

Colorado Profile: Demographics

Colorado Profile: Politics In 2004, Democrats took control of both houses of the legislature for the first time in 44 years In 2005, passage of ballot measure to suspend TABOR, the nation’s strictest tax and spending cap In 2006, Democratic governor replaced two- term Republican governor

Colorado profile: Health insurance and Medicaid/SCHIP In 2002, Colorado received HIFA waiver to cover pregnant women up to 200% FPL In 2004, tobacco tax increase was approved by voters; part of funds used to increase parent Medicaid eligibility to 60% FPL In 2007, law passed to require modified community rating in the small group market

“Colorado is the Perfect Purple State”

Colorado Heath Reform In 2006, law was passed to create the Colorado Blue Ribbon Commission for Health Care Reform Commission is charged with studying health care reform plans and making recommendations to the Colorado legislature 27 Commission members

Five Miracles of the Commission

First Miracle of the Commission: Guiding Principles Goal: Increase coverage and reduce cost Protect and improve the health status of all Coloradans. Expand coverage of essential health care services for all Coloradans, with an emphasis on the uninsured and underinsured. Align incentives to provide high-quality, cost-effective, and coordinated care. Support a system that is financially viable, sustainable, and fair. Provide opportunities for meaningful choice and encourage personal responsibility. Emphasize wellness, prevention, health education, and consumer empowerment.

Second Miracle of the Commission: Proposals Received Released RFP that required proposers to answer 28 questions about their health care reform plan Other states received between 5-9 proposals Colorado received: 31 proposals

Third Miracle of the Commission: Proposal Content 11 proposals included increased subsidies for low-income to purchase insurance coverage 10 proposed significant insurance market reform 10 proposals included an individual mandate “Massachusetts Effect”

Fourth Miracle of the Commission: Data on Four Reform Approaches The Lewin Group is currently finalizing its evaluation of the four proposals that were chosen by the Commission for evaluation Results allow Commissioners to compare coverage and cost of different approaches to health care reform based on Colorado data

Fifth Miracle of the Commission: Strategies in “5 th Proposal” Commission has tentatively agreed to following elements: Individual Mandate Minimum benefit package Government subsidies for those who cannot afford coverage No employer mandate to cover employees