Bill At State Legislature Would Cut Premiums Paid To Hospitals & Doctors

DENVER (CBS4) - It may be the boldest move yet to lower our health care costs in Colorado. Some state lawmakers want to limit how much doctors and hospitals are reimbursed on the individual market.

They say it will lower premiums by 8 percent as early as next year. For Brin Goldberg, who lives on the Western Slope, it would be life changing.

"I was in the ER for about an hour. I received an IV of fluids, some pain reliever and a blood test and was charged $8,000."

Health care costs in Colorado's mountain communities are among the highest in the country. Tamara Drangstveit, a health care advocate at the Family and Intercultural Resource Center in Breckenridge, says Coloradans in Summit County spend on average 30-40 percent of their income on health care.

"When I tell you that health insurance in Summit County is a crisis, I'm not using hyperbole."

It's why Summit County Rep. Julie McCluskie and Mesa County Rep. Janice Rich have teamed up on bill that could dramatically lower the cost of health care on the Western Slope. It's a top priority for Gov. Jared Polis, who attended a press conference about the bill.

"It's really a win-win because, guess what, when prices come down, families can afford insurance." He says fewer uninsured Coloradans lowers health care costs for everyone.

The bill is aimed at around 5 percent of people with chronic conditions who make up about 50 percent of health care costs. When their claims reach a certain amount, insurance companies would pay providers and hospitals less money for their care.

The money insurers save would then be passed onto everyone in lower premiums. Katherine Mulready with the Colorado Hospital Association says some hospitals will be forced to cut services.

"We don't believe that the government should tell private insurance companies how much to pay hospitals, doctors, nurses and other medical providers."

But McCluskie says the health care system doesn't operate under free market principles now. Medicare and Medicaid reimbursement rates are set by the government. She also says bill makes exceptions for struggling hospitals, primary care and mental health providers.

"We are working aggressively to get this passed and into place so that by January of 2020 our working families will experience a reduction in health insurance premiums and we can take the pressure off what so many Coloradans are facing."

Coloradans like Brin Goldberg, who begged lawmakers to pass the bill, said, "It would mean so much for me and other community members to be able to rest assured that we don't have to continue to ask ourselves, how much is our mental and physical health worth."

The bill only applies to people who are insured on the individual market - about 30 percent of Coloradans. The Colorado Medical Society has not yet taken a position on the bill. If it passes, the state would need a waiver from the federal government before implementing it.