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Bill Detail: HB20-1349

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Title Colorado Affordable Health Care Option
Status House Committee on Appropriations Lay Over Unamended - Amendment(s) Failed (06/16/2020)
Bill Subjects
  • Health Care & Health Insurance
House Sponsors D. Roberts (D)
C. Kennedy (D)
Senate Sponsors K. Donovan (D)
House Committee Health and Insurance
Senate Committee
Date Introduced 03/05/2020
Description

Beginning January 1, 2022, the bill requires a health insurance
carrier (carrier) that offers an individual health benefit plan in this state
to offer a Colorado option plan in the Colorado counties where the carrier

offers the individual health benefit plan. The commissioner of insurance
(commissioner) is required to develop and implement a Colorado option
plan that must:
  • Be offered to Colorado residents who purchase health
insurance in the individual market;
  • Implement a standardized plan that:
  • Allows consumers to easily compare health benefit
plans; and
  • Provides first-dollar, predeductible coverage for
certain services;
  • Include the essential health benefits package;
  • Provide different, specific levels of coverage;
  • Include a hospital reimbursement rate formula;
  • Require hospital participation;
  • Require a minimum medical loss ratio of 85%; and
  • Require carriers and pharmacy benefit management firms
to pass rebate savings through to consumers and document
the savings and pass-through in a form and manner
determined by the commissioner.
The Colorado option advisory board (board) is created to advise
and make recommendations to the commissioner on all aspects of the
Colorado option plan.
The bill authorizes the commissioner to promulgate rules to
develop, implement, and operate the Colorado option plan, including:
  • Expanding the Colorado option plan to the small group
market;
  • Establishing a hospital reimbursement rate formula; and
  • Requiring carriers to offer the Colorado option plan in
specific counties.
If a hospital refuses to participate in the Colorado option plan, the
department of public health and environment may issue a warning,
impose fines, or suspend, revoke, or impose conditions on the hospital's
license.
The commissioner, in consultation with the board, is required to
evaluate the Colorado option plan beginning July 1, 2024, and each year
thereafter.

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