It’s a testament to how hot the insurance issue has become that a forum on health care reform can draw as big a crowd as a Denver Broncos rally.
Well, maybe not quite that big. Nonetheless, the Buechner Breakfast First Friday on “The Revolution in Health Care: How Reform is Working in Colorado” attracted an overflow crowd to the Terrace Room in Lawrence Street Center on Jan. 10.
Amy Latham, of the Colorado Health Foundation, sponsor of Friday’s breakfast, called the event “incredibly important” as it brought together local experts on the Affordable Care Act, also known as Obamacare, to discuss the law’s implications.
“As we all know there are many who are looking to make quick judgments about whether this law is a success or a failure,” Latham said. “Unfortunately, it’s not very likely that the politics of this issue will subside anytime soon.”
Indeed, the law has survived a U.S. Supreme Court challenge and dozens of Congressional votes for reversal just to get to this point.
The panel featured Sue Birch, executive director of the Colorado Department of Health Care Policy and Financing; Steve ErkenBrack, president of Rocky Mountain Health Plans and board member for Connect for Health Colorado; Michele Lueck, president and CEO of the Colorado Insurance Institute; and Marguerite Salazar, commissioner of insurance, Colorado Division of Insurance. The discussion was moderated by Katie Kerwin McCrimmon, senior writer for Health News Colorado, formerly known as Solutions.
ErkenBrack, who served on Colorado’s 208 Blue Ribbon Commission for health care reform, explained that Colorado has a long history with reform, extending back to the years of former Gov. Dick Lamm, who was in the audience Friday.
With the onset of required coverage and health exchanges — Colorado opted for launching its own, Connect for Health — the insurance industry is migrating from “cost avoidance” to “care coordination,” ErkenBrack said. States with exchanges are tailoring their systems to the needs of their constituents, so systems in Colorado, California and Vermont, for instance, are all different, he said.
“We’re all going to learn from each other as we go through the next several years,” ErkenBrack said. “But the point is, it’s not a one-size-fits-all-Washington-DC-has-dictated-how-this-is (system). This is not a one- to three-month process. It’s multi-year. We’re not in a sprint; we’re in a marathon.”
Under the federal law, Colorado is among the states that opted for expanded Medicaid. The state has 86,000 new Medicaid participants as of Jan. 1, Birch said, with as many as 160,000 new signees expected soon. She said “it needs to be there for the most vulnerable” because one-in-five Coloradans are projected to be on Medicaid in the future.
“With better information technologies, values, design and other administrative simplifications, we know we can get a lot more bloat out of the system,” Birch said. “A third of the health care spending in our state and nation is suggested to be wasteful, so I think we’ve got to look at how we’re in this very long process of reforming the system over time. It starts with coverage, service delivery platform and payment.”
But Obamacare has plenty of critics. Recent polls show that as many as 43 percent of Americans think the law should be repealed entirely.
One audience member asked the panel why consumers should have to shoulder the burden of 15 to 20 percent of Americans who are uninsured. He advocated simpler solutions such as health savings accounts and portability — the sale of insurance plans across state lines — rather than ‘creating a monster bureaucracy that is going to drive up costs.”
ErkenBrack noted the reality is that some of those solutions have been attempted — health savings plans have their place, he said — but health care costs have doubled in the last 10 years.
Reasons for the jump in premiums and care include more people using emergency rooms for care, personal bankruptcies caused by devastating health care bills, and inefficiencies in the system.
“We talk a lot about insurance reform, but we really need to talk about health care reform. We get those two mixed up,” Salazar said. “Over time, I believe that all of our rates are going to go down because there will be more people in the pool, and it’s the plan we got. It’s maybe not the one everybody wanted, but it’s the one we’re trying to make work.”
Lueck noted that the public side of the reform — expanded Medicaid — has been more popular than the private side — the health care exchange. About 220,000 Coloradans were projected to sign up for coverage through the exchange, but so far only 50,000 have.
The important thing to remember, she said, is that Connect for Health Colorado is a brand new marketplace. “It’s a different way of getting health insurance and we’re educating people who are interested in getting health insurance … the chronically uninsured,” Lueck said. “I would suggest these early indications are just that — it’s not an indication of success or failure, it’s really an indication of where we need to potentially put resources and invest in this new system of getting care.”
The Buechner Breakfast series is coordinated by the Buechner Institute for Governance, which is part of the School of Public Affairs. The series continues on Feb. 7 with the topic of “Colorado’s Transportation Future.”
(Photo: Panelists discuss health care reform at Buechner Breakfast on Jan. 10 at CU Denver. Pictured from left are Sue Birch, director of Colorado Department of Health Care Policy and Financing; Steve ErkenBrack, president of Rocky Mountain Health Plans; Michele Lueck, president of Colorado Health Institute; and Marguerite Salazar, commissioner, Colorado Division of Insurance.)