‘Amycare?’ ‘Bettycare?’ Colorado’s health exchange headed for final passage

By Katie Kerwin McCrimmon

Colorado’s health insurance exchange bill is sailing toward final approval with backers hailing the measure as the only successful bipartisan exchange legislation in the country.

The measure garnered initial approval in Colorado’s Republican-controlled House on Tuesday evening.  It will need final approval in both the House and Senate, but backers are confident that they will win final passage on what they’re calling “landmark legislation.”  Democratic Gov. John Hickenlooper’s aides quietly have muscled lawmakers into supporting the bill behind the scenes and the governor is expected to sign the measure.

An unprecedented bipartisan coalition of business advocates, health industry leaders and consumer representatives showed up in droves at the Capitol on Tuesday to support SB 11-200. Many insisted that Colorado needs a Colorado solution and warned that if the legislature does not create its own health exchange, the federal government will impose an exchange on Colorado, as required by 2014 under the Affordable Care Act.

Proponent’s steamrolled Tea Party activists and some traditional conservatives who believe establishing a health exchange means Colorado is capitulating to the federal government and moving forward with full enactment of the Affordable Care Act.

One Tea Party member hollered “treason” before leaving a Capitol hearing room. Other opponents of the exchange bill threatened to stage a noisy protest when they suspected that the Republican health committee chairman intended to allow two hours of testimony from supporters while requiring that opponents give quick summaries of their opposition in what would amount to a “lightning round.”

In the end, everyone who stayed for the marathon hearing got to speak, and lawmakers approved the measure in the health committee by a 9-to-4 vote. Later in the full House the measure was approved on a voice vote.

House Majority Leader Amy Stephens, who represents a conservative district north of Colorado Springs, sponsored the legislation in the House, which holds a razor-thin 33-to-32 majority over Democrats. Democrats control Colorado’s Senate and the governor’s mansion.

Stephens has withstood a barrage of hate mail from Tea Party activists and has been threatened with a primary from the right next year. At one point this spring, she appeared to be killing her own bill when she wrote a letter saying she would insist on an amendment that would require Colorado to opt out of the Affordable Care Act.

In the end, Stephens dropped the “opt-out” amendment and attached language Tuesday that asserts states’ rights, but creates no roadblocks for Democratic support. She conceded that the journey to final approval has been difficult.

“I don’t want what’s happening here to denigrate into a Tea Party discussion,” Stephens said during a mid-day press conference Tuesday.

“I was sent here to govern. Governing is not for the faint of heart.

“People of good conscience can disagree,’’ Stephens said. “This is not easy. I think this is landmark for Colorado and maybe that’s why it evokes so much emotion.”

Some exchange opponents had derided the measure as “Amycare,” but Stephens said she’d embrace the nickname. She said an editorial in the conservative Colorado Springs Gazette said, “We’ll take ‘Amycare’ over ‘Obamacare.’ ’’

“Some may want to use it derogatorily,” Stephens said. “I will wear it. I care about small business and the market. Amy cares.”

The Democratic Senate sponsor, Betty Boyd of Lakewood, later joked that she should get credit, too.

“Who says it isn’t Bettycare? I’d be proud to have it called that,” Boyd said.

Boyd said the new amendment amounts to “tweaking” and won’t raise any objections from Democratic supporters.

“This will be great for Colorado. We will have a Colorado solution,” she said. “It’s the only bipartisan exchange bill in the country.”

Dan Anglin, a lobbyist for the Colorado Association of Commerce and Industry, said that across the country, all other bipartisan exchange bills have either died or the legislative session has ended without passage of a bill similar to Colorado’s. (Click here to see a summary of health exchange legislation across the country from the Denver-based National Conference of State Legislatures. Click here to see a map showing legislative action on health exchanges across the country.)

Several lawmakers said they hoped Colorado’s measure now can become a model for other states.

Unlike other exchange legislation, Colorado’s bill has drawn endorsements from the National Federation of Independent Business and the U.S. Chamber of Commerce, both of which have been fighting the Affordable Care Act in lawsuits that are winding their way through the federal courts. The business groups did not endorse California’s exchange because the state is taking a much more aggressive approach of becoming a “purchaser” of insurance. Colorado’s bill prohibits the state from taking on this role. Instead the Colorado exchange will set up a market for health insurance.

“It will not set rates or buy or sell products. This is clearly defined in the bill,’’ said Bill Lindsay, board chair of the Denver Metro Chamber of Commerce and former chair of Colorado’s bipartisan 208 health reform commission, which supported the concept of health exchanges prior to passage of the Affordable Care Act.

Tony Gagliardi, director of the NFIB in Colorado and Wyoming said most of the 7,500 small businesses in Colorado have fewer than 20 employees.

“We all agree that the status quo is unacceptable. Since 1986, our small businesses have told us that health care costs are their No. 1 concern,” he said.

He said that nationally, the NFIB continues to try to overturn the Affordable Care Act, but he said it’s risky to do nothing while waiting for the U.S. Supreme Court to do nothing.

Opponents of the Colorado exchange found that argument to be ridiculous.

Kanda Calef said she’s a conservative, but not a Tea Party member. She lives in Stephens’ House district in northern Colorado Springs said that preemptively creating an exchange to avoid a federal exchange is like lighting your house on fire to dodge a wildfire.

“I believe that for too long, Coloradans have been beholden to the whims of the federal government,” said Calef. “Why would you want to bring Obamacare to this state?”

After the hearing, Calef said that Stephens is in deep trouble in her district.

“I believe she’s not representing us. She’s abusing her power because she knows she can. I predict it will cost her her job. She’s going to be meeting with fierce opposition,’’ Calef said.

But other residents of Colorado Springs testified in support of the bill and said they needed help buying health insurance.

Kara Parker of Buffalo Supply Inc., a medical supply company in Lafayette, said her company had to cut salaries this year in order to afford the ever-increasing insurance premiums. She said time matters and that Colorado should not delay in establishing its own health exchange. Parker said she needs better tools to find and buy affordable health care for her employees.

“We need another tool in our belt when we’re going shopping every year,” said Parker.

Jim Noon of Centennial Container in Denver also has 12 employees.

“This is something that small businesses have been looking at for years. We want to be able to band together,” he said. “If the federal legislation is overturned, then we need SB 200 to fix the problems that were there before the federal legislation. If the federal legislation is not overturned, then we absolutely need SB 200 to have a Colorado voice for our destiny.”

The lawmakers seemed most persuaded by health experts who noted that Colorado has unique issues. Most of our small businesses are small and the state has markedly different regions.

Steve ErkenBrack is a former member of the 208 Commission and president and CEO of Rocky Mountain Health Plans, a non rofit health insurance company based in Grand Junction that sells plans throughout Colorado. He said it’s critical for Colorado to build its own exchange and solve its own health policy challenges.

“There are different delivery issues in Cortez, Colorado than in Colorado Springs, Colorado and they’re both different than Julesburg. And they’re all different from Grand Junction,” said ErkenBrack.

“If this is something that Colorado takes a pass on, then Washington, D.C., will build it and with all due respect to Washington, D.C., they don’t even know where Paonia, Colorado is, much less how something will play in Paonia.”