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December 28, 2018 04:23 PM UTC

Dems Push Quick Health Care Relief For Mountain Towns

  • 34 Comments
  • by: Colorado Pols
Rep. Dylan Roberts (D).

The Denver Post reports on an ambitious agenda item proposed by Democrats representing mountain communities beset with some of the highest health coverage costs in the state, bringing long-sought and potentially speedy relief to consumers paying insurance premiums that can rival and even exceed mortgage payments:

State Rep. Dylan Roberts and Sen. Kerry Donovan, who represent mountain communities along Interstate 70, plan to introduce a pair of bills on the first day of the 2019 legislative session that would direct the state to create a public health insurance option.

Roberts’ bill would instruct state agencies to create the infrastructure needed to establish a state insurance program and request federal approval. His goal is to provide the new option by 2020.

Donovan’s companion bill would instruct the state to immediately create a pilot program to offer a public option to counties that have limited insurance choices and face extraordinarily high premiums. If the bill wins approval, the smaller program would begin in 2019.

Although the generous subsidies in the Affordable Care Act have offset some of the expense for health coverage on the individual market on the Western Slope and other rural areas of the state, for those with too much income to qualify for those subsidies–not to mention folks caught between enrollment periods or facing other inevitable circumstances–health coverage has become an unworkable burden. These were trends in motion long before the passage of the Affordable Care Act, but partisan gridlock has made any remediation of the problem since then impossible–at the federal level since the 2010 elections, and in Colorado since the Colorado Senate was taken by Republicans in 2014.

If Colorado Democrats succeed in tangibly reducing the burden of exorbitant health coverage costs in Colorado’s resort towns and elsewhere outside the Front Range next year, they’ll be rewarded in some of the last places in the state they don’t already own politically. From there, the long-term vision is very exciting–but we wanted to focus on this immediate move to bring relief to people who need it, well, immediately. This has been a vexing problem for years, and while solutions were not unimaginable they were not politically viable.

At the state level anyway, the blockage has been removed.

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34 thoughts on “Dems Push Quick Health Care Relief For Mountain Towns”

  1. Sounds great on paper. But I want to see the introduced bills, and more importantly, see the fiscal notes (cost & who pays), before deciding what I think of this effort.

    1. Well- we all pay now.

      Pick any large for profit heath insurance company.
      Top five will be making $25mm/yr. And they aren't even physicians! They are gate keepers.

      Are they making healthcare accessible or affordable?
      Why don't you object?

      No one would create the system we have now by choice.
      The power that resulted for big pharma, insurance and the federal gov't that feeds the for profit model is an accident of history, not a choice.

      For-profit, 'free' market models for consumer products have demonstrated amazingly productive outcomes.

      But for-profit healthcare leads to bizarre and detrimental results. Subsistence models are not productive or amazing. Sure the Great Wall of China is a thing, likewise the pyramids of Egypt and the plantations of America.
       

      1. MADCO: there is only so much time in the day for advocacy and too many issues. As for me personally, I have good and competitively priced health insurance through Kaiser P. 

        I'll note in addition that Kaiser offers preventative care. Some of the health care cost could be alleviated if people were more responsible for their own health; moderate alcohol use, no smoking, better diet and exercise.

    1. Well, not living in Nebraska is always a thing.

      Reasonable people can all agree that the ACA is dumb. It's expensive, counterproductive and foolish. (read the history of who invented it and why – I know you know)

      but not everything costs the same everywhere. I support a public option, but if the goal is to equalize the cost of living statewide – nu-uh.
      First- we would have to agree to get rid of every county with less than… 3500 residents, every school district with less than 500 students, and build a Colorado wall on the Nebraska border.

  3. I’d also like to see the state employees’ existing health plans made available to the public state-wide.  My wife is 18 months from Medicare with only 5 months of cobra coverage left.  We’re looking at $1,000 monthly premiums just for her during that gap if nothing changes soon.

    1. State health plans are still for-profit boondoggles for the industry.

      Colorado should create a plan that works just like Medicare, but allows residents to enroll at a lower age, I would support that.
      Of course, we would need a wall to keep out the rest of the country. Or we could just make the coverage only in Colorado. But still a wall for Nebraska

      1. Voters shot that down already.  Medicare buy-in will take a federal bill.  We’ll need another 60 seat senate majority and visionary Dem president in 2021 for that.  We need something sooner than that, despite flaws.

          1. While I believe the most expedient solution is simply to expand Medicaid and the state’s existing private offerings to the 100k or so Coloradans needing coverage, and setting up a new state agency to manage a Colorado-only single-payer system is not in the cards, a potential third option might be for the state to put out an RFP to healthcare groups to bid on a state funded Medicare Advantage-like option.  Kaiser has a good model, and it would cover folks that venture beyond the state borders.  Funding would need a vote to raise the money from an appropriate source (not a sales tax!)

  4. This bill, like its predecessor Amendment 69, only creates a mandate and a study commission to create a health plan.

    It will face the same obstacles: massive propaganda and disinformation from the right wing "stink tanks", pushback from seniors who are already getting free or low cost Medicare, and Colorado's anti-abortion restrictions.

    To counter this, I would recommend

    1. including a massive public information campaign to counter the inevitable lies and distortions, using every available medium and face to face meetings.

    2. Incorporating the input of retired people and Medicare recipients in the design of communications and policy.

    3. Early work on changing Colorado's constitutional prohibition against using public funds for abortion. Although Colorado was one of the first states to allow legal abortion more than 50 years ago, it is also one of to follow the restrictions of the Federal Hyde amendment, and has done so since 1984. Since 1994, Colorado has allowed Medicaid funds to pay for abortions only in cases of rape, incest, or the endangerment of the mother's life.

    /More realistically, if we are going to provide some relief for mountain towns with high insurance premiums, legislators will have to find some workaround to allow people to privately pay for an abortion ‘rider” on their health insurance. It stinks, and it’s unfair and wrong, but it may be a temporary fix until/unless both the Federal and state Hyde restrictions on abortion are removed.

     

     

      1. I’m looking to future interim health care bills, the ones discussed in this article,and recommending that drafters of the legislation consult seniors and senior organizations. (And spend money on countering right wing narratives, and craft a workaround that allows women to have both affordable health insurance, and access to reproductive services.)

        You can stay stuck forever complaining about A69 if you like – but I’m moving on. 

            1. And where is the "gain"? The cash profits from taxpayers providing free care.  A worthy goal, perhaps, but an unlikely source of windfall profits.

              Actually, I think the best answer is medicare for allcanadian style single payer. But I don’t think any state, acting alone, can do that. We need a national solution.

            1. Wasn't "from each….to each" a classic Communist mantra? Of course, we all know how that worked out, with Lenin, Stalin, et al, living high on the hog at the expense of the workers and kulaks.

              My “ability” is to support the charities of MY choice, and not to be dictated to by activists who demand I support theirs.

              I’ll repeat my initial thought. Let’s wait to see what the fiscal notes are on these bills, after they’re introduced.

              2. Seriously, certain services, universally needed, are best provided by socialism.  Police, fire, military are obvious examples.  I suspect health insurance — at a kaiser level — would be best paid f or by universal government program as it is in virtually all other advanced countries — at considerally less cost and with better outcomes than our chaotic system.  We still need to figure out how to pay for it. 

                My solution would be a value added tax, again a source used by most other advanced countries.  We don't need socialized cars — if you can't afford a car, walk, bike or bus.  But health care should be a right, because if dying is your only alternative, the magic of the market ain't so magical.

                Of course, some health care — such as most cosmetic surgery — should remain private and optional.  

                Another possibility would be a stiff buffoon tax– and let trump pay for a national health care system.k

  5. How to pay for it?  It's very easy, provided we have the collective and legislative will to 'tweak' from other budgets in varying amounts (military is a prime example; another is from oil/gas subsidies, and others).  

    If indeed our military budget is greater than the next 5 or 10 countries combined, slowly taking it incrementally down over a few or several years by, say a total of 10% wouldn't cause the 'end of the world as we know it', and would start to get us there to at least a no-frills, basic Medicare for all, moving downward in age, again by increments, and doing the same for some of the other fed. budgets.

    The hardest part would be to reach the will to start and to try!

    1. A nickel tax on every share of stock traded would not only easily pay for Medicare for All, it would reduce wild swings in the markets due to speculative program trading of billions of shares each day that have nothing to do with fundamentals for the companies, the market or the economy.

      1. Not really, Davey.  Your premises are at war with each other.  Your nickel tax won't raise $1 trillion unless wildass trading continues.  If your tax makes the markets more stable, then you will get less revenue.  

        1. Agreed that the trading volumes would go down (a good thing).  As for settling on the tax rate, well, I admit, I invested all of 10 seconds thinking about an amount (don’t we pay trillions in taxes each year for government analysts to figure those things out? 😠). But I don’t agree that it has to raise a trillion dollars (see below — I’m one finger typing on an iPad and don’t want to reenter  the same information)

          1. CNBC had a bit of reality testing:

            There are several problems with a FTT, whether it is a broad one or a targeted one like that proposed by Clinton.

            1. It's been tried and hasn't worked as hoped. The U.S. did impose a tax on stock transactions, for 50 years, from 1914 to 1964. The Revenue Act of 1914 levied a tax of 2 cents per $100 of par value on all sales or transfers of stock (this is far less than Sanders'proposal of 50 cents per $100). The rate was doubled in 1932. A 1934 study concluded that it didn't raise a lot of money and didn't check the speculative activity it claimed it would check. It lingered on for 32 years,collecting little money, until it was killed in 1966. Many other countries do have FTTs of various types. Sweden had an FTT from 1984 to 1991, but it was repealed because so much trading moved offshore. Germany abolished its FTT in 1991 for a similar reason.
            2. It won't raise as much money as everyone thinks. In Italy, which has levied a 0.1 percent tax on bonds, stock, and derivative trades executed on a regulated exchange since 2012, the tax has raised just 159 million euros, well short of the 1 billion euros expected. Investors have apparently switched investments away from purely domestic equities and toward platforms and asset classes that had no tax or lower taxes. France introduced a FTT in 2013, and it was initially predicted it would raise 1.5 billion euros but has raised less than half that.

            1. That analysis is woefully outdated.  The high speed trades (tens of thousands of trades per second, looking for micropenny differentials in prices) causing volatility would be greatly reduced from the “friction” supplied by even a penny transaction tax.

              High-frequency traders move in and out of short-term positions at high volumes and high speeds aiming to capture sometimes a fraction of a cent in profit on every trade.[9] HFT firms do not consume significant amounts of capital, accumulate positions or hold their portfolios overnight.[15] As a result, HFT has a potential Sharpe ratio (a measure of reward to risk) tens of times higher than traditional buy-and-hold strategies.[16] High-frequency traders typically compete against other HFTs, rather than long-term investors.[15][17][18]HFT firms make up the low margins with incredibly high volumes of trades, frequently numbering in the millions.

              A substantial body of research argues that HFT and electronic trading pose new types of challenges to the financial system.[8][19]Algorithmic and high-frequency traders were both found to have contributed to volatility in the Flash Crash of May 6, 2010, when high-frequency liquidity providers rapidly withdrew from the market.[8][18][19][20][21] Several European countries have proposed curtailing or banning HFT due to concerns about volatility.[22]

      2. Is this what you're talking about, Davey? (Sanders campaign).5% stocks,  0.1 percent for bonds. A stock trade of $1,000 would thus incur a cost of $5. .005

        Or this? (Communication Workers of America) .03% per transaction .0003

        Or this (Institute for Policy Studies) – .25% per trade .0025

        Apparently, FTTs (financial transaction taxes) work well in the UK, Singapore, Hong Kong, and Switzerland, generating billions / year. Over 30 countries have FTTs, with various rates and applications, and various degrees of success

        Per Foreign Policy in Focus,    FTT myth busters, appendix 1 countries that have financial transactions taxes (FTTs)

        1. Yes, same idea.  As your link indicated, we used to have one, and it should have been retained, especially for NASDAQ which started this whole program trading nonsense.

          As I mentioned above, I would assess it on a per share basis (although V’ger’s dollar volume works fine too).  Of course, we’d still collect Medicare taxes from employers and employees, and the monthly premium of $134/month per person would still be needed (plus any advantage-like premiums for vision, dental, etc).

          The notion is to use Medicare reimbursement rates to place downward pressure on provider costs, which private insurance companies can’t or won’t do.  Voluntary Medicare buy-in seems to me to be the best approach, and not try to tuck the entire Mission to Mars program into the  total industry spend😉

          Private insurance over time would become a boutique service, not judge, jury and executioner for hire.

      3. Nyse averaged $169 billion in trades a day in 2013, according to Wikipedia.  Davey's "nickel" presumably is Sanders 1/2 percent or .005.  Given today's trading volume that's about a billion a day or $250 billion a year.  Health care in this country is a $3 trillion industry so 250 billion while significant, doesn't go very far.  That's why I urge a value added tax, mainly to offset employer costs which currently underwrite most of the cost.   As a nation, we'd almost certainly pay less.  The difficulty is changing from the current crazy quilt to a rational plan.

      1. Military budget has gone up, Voyageur.  The acknowledged, on-book budget for the DoD is about $716 billion this year.

        But yeah, $60 or $71 billion isn't much, when "CBO and JCT project that the federal subsidies, taxes, and penalties associated with health insurance coverage for people under age 65 will result in a net subsidy from the federal government of $685 billion in 2018."

        Gonna have to update the saying AGAIN, to "a trillion here, a trillion there, and pretty soon, you are talking REAL money."

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