5 Things Colorado: Rx affordability board, Q&A w/Vincent Atchity, Health in the budget
May 12, 2021
By: DJ Wilson
Today is the 89th legislative day in what has been a unique legislative year. Sine die is scheduled for June 12th, but the budget is already passed and on its way to the governor’s desk. So, policy makers are in this odd place where the legislature can still act, but much of the heavy lifting is done. Lots of bills are still alive, but a key opportunity for leverage and horse trading is behind us.
We’re tracking some of that activity in this edition of 5 Things We’re Watching in Colorado health care for May, 2021.
With help from Emily Boerger
1. Atchity discuss priority BH legislation
As President and CEO of Mental Health Colorado, Vincent Atchity has in-depth knowledge of Colorado’s unique mental health needs. In this Q&A, Atchity describes the factors that contribute to Colorado’s low mental health rankings, and the legislation and initiatives he is watching to help improve outcomes in the state.
Atchity says Mental Health Colorado is supporting several pieces of behavioral health legislation this year including the 988 suicide hotline implementation bill, the BH peer support services bill, and the secure transportation bill. Mental Health Colorado also supports the creation of the statewide Behavioral Health Administration (BHA), but Atchity says a persisting question is if the BHA will really serve everybody, or if it will serve the small subset of individuals “who fall between the cracks of private payers and Medicaid.” The full conversation is available here.
2. No more public option this year
Colorado’s longstanding effort to establish a state public health insurance option came to an end last month. Following two weeks of deliberation with stakeholders to address concerns raised in the bill’s first committee hearing, HB 1232‘s sponsor Rep. Dylan Roberts revealed an amendment that changes the bill significantly – completely removing its “public option” provision.
Instead of implementing a state-run plan if health plans don’t lower premiums, the amendment – approved by the House Health and Insurance Committee – requires health plans to offer a yet-to-be-established “standardized plan” created by the state through stakeholder negotiations, beginning in 2023. Insurers must annually lower plan premiums at specified rates over the next three years. HB 1232 passed the House on Monday, and now heads to the Senate.
3. Health funding in the budget
The Colorado Legislature’s recently finalized $34.1 billion state budget for FY 2021-2022 now awaits Gov. Polis’s signature. In this piece, State of Reform Reporter Eli Kirshbaum dives into the details of the budget bill, highlighting significant health-related funding.
The budget dedicates $13.2 billion to HCPF, including nearly $10 billion for medical services premiums and close to $1 billion for behavioral health community programs. Of the $2.4 billion slated for DHS, $9 million is slated for the new Behavioral Health Administration. CDPHE will receive $625 million, over half of which is funding from the federal government.
I like poring over the smaller details for a sense of legislative priorities. There is $500k in additional funding to the Suicide Prevention program at CDPHE. There is $2m more for mental health screenings conducted via school-based health centers, and $5m more to the Domestic Abuse Program at DHS. These show a clear concern for Coloradan’s mental health, I think.
4. Update on prescription drug pricing policy
With one month left before the end of session, legislators have advanced several substantial bills to Gov. Polis including the heavily debated SB 123, which paves the way for the state to import prescription drugs from countries other than Canada. Following the bill’s passage, Colorado now awaits a change in federal law to permit the state to expand on its in-progress prescription drug importation efforts.
Another policy making its way through the Legislature is SB 175, which aims to reduce prescription drug prices by establishing an affordability board to enforce upper payment limits for certain medications. The bill passed the Senate last week by narrow margins. While supporters of the bill say it will make prescription drugs significantly more affordable, opponents claim it doesn’t guarantee any cost savings and would be harmful to patients, health professionals, and health plans.
5. Uncertainty in the 2021 federal health agenda
President Biden’s health policy agenda got off to a quick start but may slow in the coming months. In his latest piece, State of Reform columnist Jim Capretta outlines the high-profile health reforms that Democrats are discussing for possible inclusion in the infrastructure or family support bills that Biden has teed up.
Among the list of reforms up for discussion are efforts to lower the Medicare eligibility age to 60, include dental and vision coverage under Medicare, give HHS the authority to negotiate pricing for Medicare-covered drugs directly with the pharmaceutical industry, and create a public option. Capretta highlights the outlook, challenges, and opposition for each of these proposals.