Health plans would benefit state's uninsured

Bill Scanlon, Rocky Mountain News

Published April 6, 2007 at midnight

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Almost all the low-income uninsured in Colorado would get basic or comprehensive health coverage under two plans presented Thursday to the state's Blue Ribbon Commission on Health Care Reform.

Whether those proposals become reality depends greatly on whether the state can afford the costs, whether the feds deem the plans legal and whether employers and insurers back the plans or fight them.

About one in six Coloradans - some 770,000 people - don't have health insurance, and that number seems to be growing.

Kaiser-Permanente, one of the largest health insurers in metro Denver, proposes a gradual phase-in of coverage, starting with children and moving toward covering most uninsured adults.

Highlights of the K-P plan:

• The federal government grants a waiver to allow Colorado to use Medicaid dollars to cover more children from low- and modest-income families.

• Everyone has their own personal physician so that care is coordinated and proactive, focusing on keeping people healthy and cancer-free.

• The state provides incentives for doctors to switch to electronic records, rather than the manila folders stacked up in most doctors' offices.

Donna Lynne, CEO of Kaiser- Permanente Colorado, said the bold plan can be affordable because it will get people out of emergency rooms and get them to take responsibility for their own health - particularly with preventable syndromes such as obesity and heart disease.

"When you look at what gets people sick today, it's diseases they have a lot of control over," Lynne said. "One percent of our population consumes 30 percent of our health-care dollars - mostly on heart conditions and complications related to lifestyle."

Lynne is hoping that enough of the usual interest groups - small-business owners, doctors and insurers - have been so convinced of the need for some kind of reform that they set aside their own interests for the good of all.

The Service Employees International Union, which is affiliated with the Nurse Alliance of Colorado, proposes a plan that also would ask the feds for a waiver to use Medicaid dollars more creatively:

• Use some of the Medicaid money as a subsidy to allow low-income people, especially those who work at small businesses who don't offer coverage, to buy low-cost coverage.

• Establish a low-income safety-net pool from tax dollars now used to reimburse uncompensated care at hospitals and other facilities.

• Provide subsidized coverage for parents with modest incomes and for single adults with very modest incomes.

• Get seniors into the right long-term-care settings, with emphasis on keeping them "happy, healthy and in their homes," rather than in institutionalized settings, said spokeswoman Shannon Perez.

Most of the uninsured could get at least basic coverage almost immediately, drastically lowering the expenses wrought by inefficiencies, Perez said.

The proposals are due at the end of today.

Senate Bill 208, which established the blue-ribbon commission, requires that the commission only consider proposals that "ensure access to affordable coverage for Colorado residents."

The commission's final report is due to the legislature before Dec. 1. It must include "an unbiased economic analysis, feasibility, and technical assessment" of the reform proposals.

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