Stakeholder Meeting May 29, 2019 Presented by: Kim Bimestefer, - - PowerPoint PPT Presentation

May 29, 2019

Presented by: Kim Bimestefer, Executive Director, Health Care Policy & Financing Mike Conway, Insurance Commissioner, Division of Insurance

Stakeholder Meeting

Division of Insurance / Dept. of Health Care Policy & Financing

State Option for Health Care Coverage

Division of Insurance / Dept. of Health Care Policy & Financing

Agenda

• Opening Remarks
• Our Quest
• Overview of HB19-1004 Proposal For Affordable Health Coverage Option
• Other State’s Actions – New Mexico & Washington
• Learnings from CO-OPs
• Facilitated Discussion

State Option for Health Care Coverage

Division of Insurance / Dept. of Health Care Policy & Financing

• Welcome and Thank You
• Our Quest
• Maximizing Our Strengths
• Beautiful Music
• Learning from our History
• Governor’s Principles are a Good Guidepost
• Value of Diversity of Thought & Collaboration

Opening Remarks

Division of Insurance / Dept. of Health Care Policy & Financing

• High Quality Health Care Access
• Sustainable Affordability to Customers @ Different Income Levels
• Serve Individuals and Small Employers
• Address Uninsured rate, which is not equally spread
• Maximize Existing Infrastructure, Don’t Disrupt What is Working
• Maximize Innovation
• Recognize Fed Challenges in Funding; Affordable to the State
• Increase Competition

Opening Remarks: Our Quest under HB 1004

• What else does the bill require us to include in the proposal?
• Feasibility and cost of implementing a state option
• Identify the most effective implementation of a state option based
• n affordability to consumers at various Income Levels
• Admin. and financial burden to the state (risk-bearing & solvency)
• Ease of Implementation
• Evaluate the likelihood of meeting the objectives above
• Proposal due November 15, 2019

Overview of HB 19-1004 Proposal For Affordable Health Coverage Option

• Implementation considerations
• Identify potential premium levels and cost sharing for a plan that at a

minimum is an EHB compliant plan

• Evaluate provider rates necessary to incentivize participation that will

encourage adequate networks and high quality health care delivery

• Consider eligibility criteria for individuals and small businesses
• Determine any impact to the state budget
• Determine impact on the stability of the individual market, the small

group market, and Connect for Health Colorado – including whether the product should be offered on or off C4

Overview of HB 19-1004 Proposal For Affordable Health Coverage Option

• Implementation considerations, cont’d
• Determine impact on individuals receiving subsidies
• Determine the structure of the plan including who should offer it
• Identify expected impacts, if any, to HCPF programs
• Investigate funding options including state funds and federal waivers
• Evaluate the feasibility, legality, and scope of any necessary federal

waivers

• Review information related to Senate Bill 19-004
• Create a statewide definition of affordability for consumers

Overview of HB 19-1004 Proposal For Affordable Health Coverage Option

Stakeholder’s Role in Recommendations

• Purpose – to advise DOI and HCPF in Recommendations to the

legislature

• Constraints – the recommendations are accompanied by needed

legislative changes and any funding requests

• Stakeholder’s responsibilities – be thought partners, identify

additional needed input, share with community and bring back feedback

• Timeline – Recommendations finalized by middle of October to be

received by legislature on November 15.

• Stakeholder feedback will be used to inform recommendations

Criteria

• Stability of the market
• Competition without harm
• Affordability to consumers at different income levels
• Ease of implementation
• Likelihood of success
• High quality
• Others?

New Mexico Analysis

Source: Manatt Analysis, page 6, January 2019

Washington State – Cascade Care

• Signed into law May 2019
• Coverage starts in 2021
• Offered on Exchange
• Hybrid public-private system
• State contracts with private health insurers to administer plans,

but will define benefits and negotiate costs

• Goal to offer public option plans in all 39 counties
• New plan includes capping provider reimbursement rates at 160% of

Medicare

• Only 4 of 23 ACA CO-OPs still exist today
• Two issues that we need to be mindful of as we move

forward

• CO-OPs were dependent on federal funding – the loss
• f that funding was key to their failures
• Failure of CO-OPs disrupted care for hundreds of

thousands of people throughout the country and billions of dollars were lost.

Lessons from ACA CO-OPs

State Option for Health Care Coverage

For more information and updates visit: colorado.gov/hcpf/proposal-affordable- health-coverage-option

• What should be Colorado’s approach to creating a state
• ption
• Who do you need to hear from?
• Data needed?
• What should be the frequency of meetings to get to

recommendations by October 15

• Needed workgroups?

Discussion