Gov. Bill Ritter will sign an executive order today that health care advocates say is key to turning the federal government’s vague framework for reform into reality in Colorado, The Denver Post reports.

The governor’s order will create a board of health-policy advisers to guide the transition to a new health system — everything from setting up a state insurance exchange to making sure the insurance commissioner has authority to guard against companies rejecting someone for being sick.

Ritter plans to sign the order, along with four new state laws intended to improve health care in Colorado, during a ceremony at the Wellington E. Webb Center For Primary Care in Denver, 301 W. Sixth Ave.

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A proposed state law that allows health insurance discounts for improvements such as losing weight or cutting cholesterol could lead to a system where co-workers with the same coverage pay different premiums based on their health, The Denver Post writes. “People respond to incentives,” said Rep. Joe Rice, a Littleton Democrat sponsoring the bill up for debate at the Capitol. Critics of the proposal are skeptical. “It sounds wonderful and I believe in wellness, but once again I’m cynical enough to assume it’s going to be in the best interest of insurance companies, ultimately,” said Sen. Joyce Foster, a Denver Democrat who was one of two senators who voted against the bill when it passed out of committee last week.

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Women with breast or cervical cancer who qualify for a certain Medicaid program can sign up the day of their diagnosis for the federal insurance that pays for their treatment — but only if they go to the right clinic, The Denver Post reports.

If, by chance, they happen to get diagnosed at a site not designated for Women’s Wellness Connection, they are not eligible. And they are blocked from ever enrolling during their cancer treatment.

“A woman’s treatment shouldn’t depend on what door she walked into to get diagnosed,” said state Rep. Dianne Primavera, a Broomfield Democrat and breast cancer survivor. Primavera and other advocates for cancer patients are pushing Colorado to change its rules

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Gil Romero

The Las Animas County commissioners have hired a former state representative to lobby on behalf of the Trinidad State Nursing Home, The Pueblo Chieftain reports. Gil Romero was chosen Monday to represent Las Animas County and the staff and residents at the nursing home by lobbying to keep it a state-run facility. Romero served in the House of Representatives from 1984 to 1998 and he served on the Joint Budget Committee.

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By Peter Marcus, DENVER DAILY NEWS
A Republican state lawmaker is frustrated with Democrats for rejecting her proposal to encourage Congress to allow a federal tax deduction for purchasing health insurance.
House Joint Resolution 1014, sponsored by Rep. Cindy Acree, R-Aurora, would have called on Congress to allow consumers to write off health insurance premiums from their income taxes. Acree says if Congress adopts such a proposal it would help consumers manage their annual cash flow when they are responsible for paying for their insurance premiums that employers don’t pay.
“It’s about fairness and encouraging individuals to be responsible for their own health care,” Acree said in a statement. “It would encourage Colorado to move in the right direction for true health care reform and work toward more affordable health care and a more equalized tax treatment system.”
The resolution was killed Tuesday in the State, Veterans, & Military Affairs Committee on a 6-4 Democratic party-line vote.
Democrats say it is not the duty of state lawmakers to approve resolutions that deal with federal policies.
“We cannot dictate to the federal government what to do,” said Rep. Jeanne Labuda, D-Denver, vice-chairwoman of the House State, Veterans, & Military Affairs Committee.
Labuda said that while she would likely support the proposal on a federal level, she was not supportive of sending directives to Congress, especially given the recent passage of health care reform signed by the president just this week.
“I didn’t know if there was anything in there about this in the health care bill — I figured this might have been taken care of in the health care bill,” she said.
“It’s just something that is on the federal level, not the state level, and I would not be in favor of it on the state level because we’re so short of funds already,” continued Labuda.
But Acree says state lawmakers needed to send a message to Congress. She points out that the allowable federal medical tax deduction requires a consumer to spend more than 7 percent of their income on health care costs in order to qualify for the break.
Families without serious medical conditions should still be allowed the deduction, said Acree.
“How do we encourage healthy people to invest in their own health care when some people get tax advantages to do so and others do not?” asked Acree.
Because of rising premiums, many employers are also seeing their rates increase and are therefore cutting back on coverage for employees, she said. If individuals were able to take deductions for the cost of their health insurance, small businesses might be able to offer employees a cash benefit to help them pay for their insurance, Acree said.
“Employers sometimes are not able to provide health insurance to employees, which creates a wedge between the individual and provider of the health care, she said. “This resolution is good for the consumers and businesses across the state.”

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The top prosecutors in 13 states — 12 of them Republicans — filed a lawsuit Tuesday challenging the health care bill minutes after President Barack Obama signed the landmark legislation into law, The Denver Post reports. In a suit filed in federal district court in Tallahassee, Fla., the attorneys general claimed that the new law’s requirement for all Americans to buy health insurance is unconstitutional.

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Insurance companies couldn’t charge women higher rates for health coverage than men in individual plans under a bill that received initial Senate approval Monday, The Denver Post reports. Supporters of the legislation say women often are charged as much as 40 percent more than men for individual health-insurance plans. Proponents said group plans and public health programs do not have different cost structures for men and women, but individual-market plans frequently do. The bill would affect about 140,000 women, proponents said.

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By Peter Marcus, DENVER DAILY NEWS
Republicans and Democrats are at odds over a bill that is likely soon to be on its way to the governor that would require local health insurance companies to offer maternity and contraceptive coverage.
Democrats look at House Bill 1021 as providing necessary health coverage to women during such important life moments as pregnancy.
Republicans view the legislation through a fiscal eye, arguing that the bill would make coverage more expensive for everyone.
HB 1021’s Senate sponsors — Sens. Joyce Foster, D-Denver and Betty Boyd, D-Lakewood — say they are protecting mothers and their children by ensuring proper medical care and treatment through individual and group insurance policies.
“This really changes the paradigm of health care for women in Colorado,” said Foster. “Pregnancy will not be considered a pre-existing condition any longer. This is a huge step for women, their families and Colorado.”
The House bill passed through the Democratic-controlled Senate Thursday on second reading. It must pass through the Senate one more time before being sent off to the governor for his signature.

Would measure raise rates?
Republicans say the measure would only raise rates for all Coloradans because insurance companies would be forced to pass the mandated cost along to consumers.
“Whenever we put a mandate on medical insurance, we make it more expensive,” Sen. Nancy Spence, R-Centennial, simply stated in a news release.
Critics are also concerned that the measure would result in younger, healthy individuals dropping their coverage because they don’t want to pay higher premiums. They say that leads to a downward spiral in which costs increase while fewer consumers are covered.
But Democrats point out that health insurance providers in Colorado don’t provide a maternity package, which puts families at risk. Supporters of the legislation point to several statistics, including one in five women in Colorado did not receive prenatal care during their first trimester, making them three to four times more likely to die from complications; lack of proper care during pregnancy can lead to the decreased health of the child; the percentage of low-weight births has increased to 9 percent in Colorado; and one out of every eight babies born in Colorado is premature.
“Although women are making strong advances in something as complex as politics, they are not finding parity when it comes to something as basic as health care,” said Boyd.

In other coverage:

The Colorado Senate gave initial approval Thursday to a bill requiring individual health insurance plans to cover maternity care and contraception, sparking objections from Republicans who said the mandate would make health care more costly, The Denver Post reports. And state Sen. Kevin Lundberg, R-Berthoud, called the bill “morally repugnant” for requiring coverage of IUDs and so-called morning-after pills, both of which can prevent implantation of a fertilized human egg into the uterus. Lundberg called those contraceptive methods abortion-inducing.

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By Debi Brazzale, COLORADO NEWS AGENCY

State lawmakers are poised to debate a bipartisan measure this week that supporters say will create incentives to stay healthy and opponents say will create yet another tier of winners and losers in the country’s much-debated health-care system.

House Bill 1160 expands current law to allow small-group and individual health-care markets to offer wellness incentive programs in exchange for a discount on insurance premiums that larger group markets, self-funded and government plans are already allowed to offer. Under the measure, an additional discount could also be allowed for individuals who actually participate in a wellness program.

Yet, Kelli Fritts, Colorado associate director for the American Association of Retired Persons, contended the bill is not about wellness programs but rather is another way for insurance companies to play gatekeeper. Fritts said the measure will exacerbate a market that needs more healthy people to join to stave off rising premiums.

“This bill is a way to segment the health insurance market—to cherry pick and lemon drop,” said Fritts.  “The goal that AARP is seeking is to bring everyone into the pool and this bill doesn’t bring everyone into the pool.”

House Sponsors of the bill, Rep. Joe Rice, D-Littleton, and Rep. Amy Stephens, R-Monument, say the proposal simply provides an incentive that creates a win-win for both the insured and the insurance company.

“We know that participation in an exercise program will reduce risk and reduce cost–which is where the self-interest of the insurance company comes in,” said Rice. “In order to induce people to (participate),  they are willing to give the discount.”

Wellness programs can include things such as smoking-cessation classes, gym memberships or nutrition programs that are voluntary for the insured, but the financial incentive, said Rice, is key.

“When you say, ‘Here’s an incentive,’ some people will participate that don’t now.  It’s good for their own health, but it kind of becomes a part of the office culture or in your own mind when participating in these programs,” said Rice

The market that the AARP is concerned about is the 50-to-65 year-olds who are too young for Medicare but old enough to have pre-existing conditions or emerging health needs.  The bottom line, said Fritts, is that financial incentives based on health outcomes should not be tied to premiums.

“We support community ratings where everyone is paying the same rate regardless of health status and claims history.  If the industry is given the ability to underwrite–or set the criteria—based on wellness programs the losers will be older people,” said Fritts.

The bill is scheduled for debate by the full House as early as Tuesday.

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By Debi Brazzale, COLORADO NEWS AGENCY
A panel of four women and three men talked gender Thursday at the Capitol as they considered a measure that would tell health insurance companies that they can no longer charge women higher rates than men for their premiums.
The proposal passed, but only after a lively discussion on whether men or women ultimately get the short end of the stick from the insurance industry.
“The disparity in the cost of health insurance between men and women is unacceptable, and correcting this inequity should be one of our top priorities,” said Sen. Gail Schwartz, D-Snowmass Village, who introduced House Bill 1008 in the Senate alongside Sen. Morgan Carroll, D-Aurora.
Flying in from Washington D.C. to testify for the bill before the Senate Health and Human Services Committee, Lisa Codispoti from the National Women’s Law Center said the bill is needed because of the tenuous status of national health reform, a pending version of which also would ban gender-based rating for health coverage.
“Women and men of Colorado should not have to wait on Congress to remedy this harmful and discriminatory practice,” said Codispoti.
Skeptics of the legislation, however, have noted that women in key age groups simply are more expensive to insure given their health-care needs, and disparities in rates reflect that reality.
Under questioning by the committee’s Sen. Shawn Mitchell, R-Broomfield, Codispoti acknowledged that there is indeed a statistical difference between men’s and women’s health-care needs. However, she said the statistics are not fair to the individual.
“It is true that women throughout their lifetime do use more health care services than men, but what we find troubling about gender rating is that it makes an assumption that because you belong to a particular group that you will use more health care services,” Codispoti said. She also said rates charged to women varied greatly from state to state and policy to policy.
Sen. David Schultheis, R-Colorado Springs, said that dynamic also reflects market realities.
“We should allow the free market to find the price based on it’s own criteria … this is not the Soviet Union here,” said Schultheis.
Schultheis contended the bill would discriminate in reverse.
“What you’re doing is discriminating against men, and that’s not fair. Why should men have to pay a higher premium when on balance they require less health care … over their lifetime?” asked Schultheis.
Carroll contered that in a truly merit-based system, being gender-blind is more fair because it leaves it up to claims history and health status and that to add anything beyond that is a gender surcharge.
“Under this bill anyone that uses more will pay more and anyone that uses less will pay less,” said Carroll.
Erin Benett, the Colorado organizer of 9 to 5, the National Organization of Working Women, said the status quo is flat unfair.
“No one should be able to charge a person more for a product simply because of gender. Being a woman is not a pre-existing condition,” said Bennett.
Mitchell pressed Benett on her premise that gender should not be a factor in determining the price of an insurance product.
“Should auto insurance companies be allowed to charge more for boys than girls?” asked Mitchell, in reference to the much higher rates that are applied to the policies of teen-age male drivers than to teen-age female drivers.
Mitchell nevertheless was the lone Republican joining the Democrats on the committee in voting for the bill, saying that he will now consider introducing a bill that prohibits gender discrimination for auto insurance and that he anticipates their support. The other two men on the committee, both Republicans, voted against the bill.

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