Recent Work in this Area
Stopping surprise/out-of-network medical bills
Too many Coloradans have been victims of surprise medical bills (also known as surprise out-of-network bills or balance bills). These bills can hit Coloradans with hundreds or thousands of dollars in unexpected and inflated charges, and often times, Coloradans were paying for or being sent to collections for bills they should not have been responsible to pay. We crafted and passed HB19-1174 to protect Colorado consumers from these surprise bills and ensure out-of-network providers cannot inflate their charges and drive up costs. Those protections go into effect as of January 1, 2020, and will apply to any Coloradan with an insurance plan regulated in our state. As of January 1, 2022, the Federal No Surprises Act will ensure that Coloradans with insurance plans regulated federally are also protected. We are working to align the state and federal protections to ensure consumers have the greatest protections possible. For more information on how these bills can occur visit our explainer page on surprise medical bills or checkout this spotlight factsheet on the new protections. Need help with a surprise bill? Contact our CAP team
Setting standards so insurance networks have enough providers (a.k.a. network adequacy)
Insurance companies have a history of restricting the network of providers consumers can access through a plan as a way to keep costs to the insurer down. Despite establishing network adequacy standards in 2016, we continue to hear from consumers running into challenges accessing providers. As part of the Colorado Option (a.k.a. Public Option) under HB21-1232, Colorado is adding additional requirements for Colorado Option plan networks to be culturally competent, provide language access when seeking care, and ensure provider networks are responsive to the populations they serve. If you encounter situations where you think an insurer has an inadequate insurance network or you’re unable to access the care you need in a timely manner, please contact us.
Ensuring hospitals comply with state and federal financial assistance laws
There are state and federal standards for hospital financial assistance (assistance provided to consumers that are uninsured/underinsured to help them cover the costs of their treatment). CCHI helped create the first state level standards with legislation in 2012 and 2014, however, through our Consumer Assistance Program, we heard from many consumers that were not appropriately screened for assistance or were incorrectly denied it. Working again with our partners at the Colorado Center on Law and Policy, HB21-1198 was passed to ensure hospitals comply with consumer financial assistance standards, screen patients consistently, and set consumer protections around payment plans and debt collection practices. For more information on hospital financial assistance, visit our explainer page.
Preventing Discriminatory Use of Big Data in Insurance
Big data can be used responsibly, but there are an increasing number of examples where it is being used, whether intentionally or not, by insurance companies in ways that exacerbate economic and racial injustices, including in health management. This is true across various types of insurance, not just health insurance. Under SB21-169, the first law of its kind nationally, insurance companies will be required to evaluate their data systems for discriminatory biases and injustice, and keep consumers whole while unraveling deep-rooted systems of discrimination, oppression, or racism.
Protecting Consumer from Non-Compliant Insurance Plans
Unfortunately, some consumers are left without consumer protections with insurance plans and health benefit products that do not have to meet the standards of the Affordable Care Act, such as coverage for pre-existing conditions, essential health benefits, and no annual/lifetime limits on coverage. While we have addressed some of these products in Colorado, like short-term benefit plans, which are now required to meet most of the same consumer protections, some products continue to leave consumers at great financial and health risk. CCHI is working to address health care cost sharing arrangements, which are organizations that sell options for health benefits that can appear to be insurance, but do not offer the comprehensive coverage and accountability of traditional health insurance plans. Furthermore, these arrangements put consumers at the center of payment negotiations and often leave them on the hook for large medical bills. CCHI supports policies that increase the transparency and accountability of these companies and products so that consumers can make informed choices about their health coverage and have more robust protection from unexpected medical costs.
Our Work
Access & Affordability
All Coloradans should have access to the health care they need, when they need it, and be able to afford it. While the Affordable Care Act has helped many Coloradans obtain health insurance, we know there are many that still struggle to access and afford the care they need because they cannot find a doctor or because the out-of-pocket costs are too high.
Social Determinants of Health
Structural barriers based on race, ethnicity, income, LGBTQ status, and age among others, prevent individuals from getting the health care they need and deserve. We work toward health equity by addressing systems of oppression and barriers that lead to disparate health outcomes.
Reimagining Health Care
Structural barriers based on race, ethnicity, income, LGBTQ status, and age among others, prevent individuals from getting the health care they need and deserve. We work toward health equity by addressing systems of oppression and barriers that lead to disparate health outcomes.
Prescription Drug Affordability
Every year health care costs continue to rise, becoming an even bigger percentage of our economy and an increasingly unsustainable portion of family budgets. We are working to control costs and hold the health care industry accountable to patients.
At the Capitol
Every year, CCHI fights for policies and bills that improve health care for Coloradans during the legislative session and year round within Colorado’s agencies that oversee health care. CCHI ensures consumers interests are advanced and protected in private insurance, Medicaid, hospitals and physicians’ offices, and access to prescription drugs. We empower Coloradans to use their own health care experiences to make positive change.
Colorado Consumer Health Initiative
303 E 17th Ave, Suite 400
Denver, CO 80203
303.839.1261
General: inform@cohealthinitiative.org
Assistance: help@cohealthinitiative.org
Media: ptelang@cohealthinitiative.org
REACH OUT!