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.

Recent Work in this Area

Stopping out-of-network surprise medical bills in many cases and bolstering consumer protections

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 (we are advocating for Congressional action to extend these protections to Coloradans who have insurance plans that are regulated federally). 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.

Creating a public option for health coverage

Many Coloradans struggle to afford health insurance coverage and out-of-pocket health care costs. CCHI helped pass HB19-1004 to start creating a public option for health coverage in Colorado to ensure Coloradans have access to more affordable health coverage options. We are working to ensure a public option and any follow up legislation that is needed moves forward and meets the needs of consumers. If you want to be involved in these efforts, visit our Take Action page.

Advocating for a reinsurance program to lower insurance premiums

CCHI worked with legislators and the Governor to create a reinsurance program through HB19-1168. Reinsurance has lead to average 20% reductions in 2020 private health insurance premiums. Reinsurance works by creating a mechansim to help cover particularly high cost medical claims that otherwise drive premiums up. Further action will be needed to maintain this reinsurance program and ensure Coloradans continue to see lower premiums because the current program is only funded for 2 years.

Supporting new mental health standards in coverage

Access to mental and behavioral health services continues to be a big challenge for many Coloradans. Working with our partners, we helped pass HB19-1269, which requires Medicaid to ensure access mental health services is held to the same standard as access to physical health services (a.k.a. mental health parity). The bill also requires commercial insurers to provide documentation proving they are meeting mental health parity standards that already exist in Colorado law. This will help ensure that regardless of a person’s source of health coverage, they have access to the mental health services they need and have improved protections as a consumer if that access is not provided. There is an unfortunate reality that there are not enough mental and behavioral health providers in many areas of Colorado, but these new requirements will encourage more investment in recruiting providers from both Medicaid and commercial insurance companies, and sets clearer standards they must work to meet.

Setting standards to guide new community-level negotiated health insurance plans

Some communities in Colorado are taking action to control health care costs at a local level to improve affordability of health insurance coverage. One form that is currently taking off in Colorado is a community-driven/co-operative negotiated insurance plan. Communities are bringing local businesses, town/county administration, and individual consumers under the same umbrella to negotiate directly with hospitals and providers in their community to bring down insurance costs. The first of these plans will launch in 2020 with the Peak Health Alliance based in Summit County, which is offering insurance plans with premiums that cost 39% – 47% less. Several other areas of Colorado are looking to replicate this model and Peak Health Alliance is looking at expanding its plans to other nearby areas. This is a new approach to insurance and CCHI supported SB19-004 that helps establish this insurance model in Colorado law and ensures the coverage provided under these plans meets the same standards as other insurance plans under the Affordable Care Act.

Capping monthly costs for insulin

It’s no secret that prescription drug costs are too high and Coloradans want to see more done to lower their drug costs. Many Coloradans with diabetes were paying hundreds, sometimes thousands, of dollars a month for their insulin with their insurance until they met their deductible or out-of-pocket maximum.Working with our members and individual advocates, we passed HB19-1216. This bill caps the copay for a 30 day supply of insulin to $100/month even before someone reaches their insurance deductible. Unfortunately, insurance plans that are regulated federally or are self-funded are not subject to this legislation. We will continue to fight to bring down prescription drug costs that Coloradans are struggling to afford.

Granting the ability for pharmacists to dispense medications in an emergency without a prescription

It is not too much to ask that Coloradans have access to life-saving and life-maintaining medication in an emergency. HB19-1077 allows pharmacists to dispense life-maintaining medications without a prescription in an emergency if their care provider cannot be reached to write a prescription renewal. This can save consumers’ lives with better access to the medication they need when they otherwise would have had to wait to get their prescription renewed.

Our Work

Protecting Consumers

Coloradans should not face financial hardship because they need access to health care or because they have received health care services. CCHI works to protect consumers from health care industry practices that jeopardize the health and financial security of Colorado families.

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Health Equity

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.

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Health Care Costs

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.

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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.

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Colorado Consumer Health Initiative
1420 N Ogden Street, Suite 1A
Denver, CO 80218

303.839.1261

General: [email protected]
Assistance: [email protected]
Media: [email protected]

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