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 (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.
Setting standards for consumer notification and certification for Freestanding ERs
As Freestanding Emergency Rooms (FSERs) have multiplied in Colorado, especially on the Front Range, more Coloradans have been hit by exorbitant charges at these facilities. Some consumers would visit these FSERs only to discover they were ill-equipped to address their emergency, and they had to be transfered to a hospital ER, adding potentially thousands of dollars in cost. We passed SB18-146 to require better notification to consumers about the costs they could face when visiting these facilities, HB18-1282 to ensure each FSER has to report its insurance charge/claim data independently (many were reporting data under a hospital with which they were affiliated, obscuring their individual facility’s charge and claims data), and HB19-1010 to set clear licensing standards for FSERs ensure they are better equipped similarly to hospital ERs.
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. Increasingly, we heard from consumers who could not see a provider promptly or within a reasonable distance with their plan. In 2016, we worked with the Division of Insurance to establish robust insurance network adequacy standards to protect consumers from these issues. 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 state level standards with legislation in 2012 and 2014, however, we continue to hear from Coloradans that have not been appropriately screened for assistance or were incorrectly denied it. We are continuing to work at the state level to ensure all hospitals follow the law and help Coloradans when they should. For more information on hospital financial assistance, visit our explainer page.
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.
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.
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.
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.