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Colorado must ensure competition when it rolls out public health care option, agencies recommend

There are 22 counties in Colorado with only a single insurer available to residents

DENVER, CO - OCTOBER 03: Denver Post reporter Jessica Seaman. (Photo By Patrick Traylor/The Denver Post)

Colorado’s insurance commissioner should be given the authority to require at least two companies offer the state’s new public health insurance option in counties where there’s only a single insurer, two state agencies recommend in a final report outlining the plan.

As with the draft released last month, the final proposal recommends the state require certain insurers to offer the public option on the individual market — where Coloradans buy their own health insurance — when it goes live in 2022. The report was made public Friday and submitted to the legislature.

The report said there are 22 counties in the state with only one insurer, though it did not identify them. By having at least two insurance companies carry the plan in each county, the state would increase competition among insurers and push down costs, the report states.

“We do think we should have the authority that we create competition,” said Michael Conway, the state’s insurance commissioner. “My hope is that we never actually have to implement the authority that we have.”

The report was released by the state Division of Insurance and the state Department of Health Care Policy and Financing. State legislators tasked the two agencies with crafting the proposal earlier this year.

The two agencies have recommended private health insurance companies administer the public option instead of the state using a government platform, such as Medicaid.

Coloradans who buy coverage under the public option could see monthly premiums that are 9% to 18% cheaper than projected rates for other commercial plans on the individual market in 2022.

“This final proposal for the public option plan creates an innovative opportunity for Colorado to bring more affordable health coverage to our state and start addressing underlying health care costs,” said Adam Fox, director of strategic engagement for the Colorado Consumer Health Initiative in a statement.

Under the proposal, insurance companies would bear the costs of care for patients with the plan. The state would not cover any costs of care unless state lawmakers chose to expand the benefits offered.

If implemented, the state would pay about $750,000 to launch the public insurance program during a two-year period. It would cost less than $1 million a year for agencies to oversee and manage the program, according to the report.

Under the plan, the state will set rates for how much hospitals can get in return for treating patients with public health insurance — an aspect of the proposal that has drawn criticism from the Colorado Hospital Association.

“By establishing government price controls and forcing insurers and hospitals to participate, the proposal as submitted has the potential to undermine other affordability efforts underway, especially community-based solutions and value-based care,” said spokeswoman Julie Lonborg in a statement.

Denver Post staff writer Alex Burness contributed to this report.

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