2017 Health and Wellness Bills

We focus on health and wellness as one of our pillars for a strong economy because a healthy workforce is happy, present and productive—and creates a competitive advantage for our region.

Have a question about a position we’ve taken? Call us at 303-620-8088 or email us at publicpolicy@denverchamber.org.

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Bill # Title Summary Position Justification Materials Pillars Status
HB17-1094 Telehealth Coverage Under Health Benefit Plans

This bill clarifies that insurance companies cannot restrict or deny coverage of telehealth services based on the communication technology or application used to deliver the telehealth services, thereby improving low-cost access to health care for people in rural parts of the state.

The Chamber supports the necessary clarifications to the telehealth law in this bill because it will continue to improve rural patient’s access to quality health care through the use of technology and results in lower cost of care.

HB17-1247 Patient Choice Health Care Provider

This bill prohibits a health plan from managing the size of their network by removing their ability to choose which providers can be on the network.

This bill is a mandate that interferes with private contracts and restricts carriers’ ability to create their own network as a strategy that can help businesses and their employees contain costs of health care.

HB17-1286 State Employee Health Carrier Requirements

This bill requires that any insurance carrier that provides services to the state must also participate in the individual market, in Medicaid or the children’s basic health plan and offer individual market plans in at least two Colorado counties with the highest average premiums.

This legislation sets a dangerous precedent by putting into statute a mandate for how and where a business must operate as a condition of doing business with the state.

HB17-1307 Family And Medical Leave Insurance Program Wage Replacements

This bill creates the family and medical leave insurance (FAMLI) program in the newly created Division of Family and Medical Leave Insurance in the Department of Labor and Employment. The division would provide partial wage replacement benefits to eligible individuals who take leave from work to care for a new child or a family member with a serious health condition or who are unable to work due to their own serious health condition. The bill expands employer coverage to employers with one or more employee as compared to the 50-employee threshold under the FMLA.

This bill would be costly and burdensome for employers as they would be required to implement an additional employee payroll deduction. It would also impose significant administrative and operational costs.

HB18-1009 Diabetes Drug Pricing Transparency Act 2018

This bill requires drug manufacturers and pharmacy benefit managers to report information regarding diabetes drug prices and related profits. The information from the report is to be posted on the Colorado Department of Public Health and Environment’s website.

The Chamber is working with more than 30 organizations to identify industry-wide strategies that address Colorado’s rising health care costs. While this bill highlights an existing challenge within our healthcare system, we are concerned that this proposal exceeds the state’s legal jurisdiction. There is uncertainty regarding the state’s ability to require federally regulated companies to submit data; additionally, there is considerable inconsistency in the types of pharmaceutical organizations this regulation would impact.

HB18-1097 Patient Choice of Pharmacy

This bill prohibits a health plan from controlling costs by choosing which pharmacies to include in its networks.

Chamber members have consistently identified rising cost as the biggest concern with regard to health care. This bill undermines the ability of health plans to negotiate with pharmacies to provide patients with lower-cost options thereby making it more costly for businesses to afford these benefits.

HB19-1001 Hospital Transparency Measures To Analyze Efficacy

This bill requires the Colorado Department of Health Care Policy and Financing and the Colorado Health Care Affordability and Sustainability Enterprise Board to develop and prepare an annual report detailing uncompensated hospital costs and expenses, using publicly available data whenever possible. Psychiatric hospitals, long-term care facilities and certain critical access hospitals are exempted.

Over the past year the Chamber has worked with more than 30 health care organizations to identify industry-wide strategies to address Colorado’s rising health care costs. The group developed robust transparency and disclosure recommendations, understanding that they are key to analysis and consumer education. This bill will provide more transparency in health care, which can help consumers better navigate their care as well as other components of the industry better understand the factors contributing to health care costs.

HB19-1010 Freestanding Emergency Departments Licensure

This bill creates a new license, referred to as a “freestanding emergency department license,” for a health facility that offers emergency care and is located more than 250 yards from a hospital, whether or not it’s affiliated with the hospital. Community clinics are exempted.

This bill ensures that free-standing emergency departments align with other specialties in that they have their own specific license. It allows better tracking of data related to free standing emergency departments, which is helpful for consumers and other components of the healthcare industry.

HB19-1058 Income Tax Benefits For Family Leave

This bill creates various income tax credits for employers and employees in an effort to incent businesses to offer family and medical leave benefits to their workers. An employer and employee receive a state income tax deduction for any amount up to $5,000 they contribute to an employee’s leave savings account. An employer also receives an income tax credit if they pay an employee for leave that is between six and 12 weeks for a family or medical leave. For employers with fewer than 50 employees the credit is equal to 50 percent of the amount paid, and for employers with 50 or more employees the credit is equal to 25 percent of the amount paid.

This bill encourages businesses to create and invest in a family and medical leave insurance program for their employees and incentivizes employees to contribute to their own accounts. It also rewards companies that are already providing such programs to their employees. The Chamber supports the flexibility this legislation gives to businesses while also encouraging them to provide a program of this kind to their employees.

HB19-1154 Patient Choice Of Pharmacy

This bill prohibits a health plan from controlling costs by choosing which pharmacies to include in its networks.

Chamber members have consistently identified rising cost as the biggest concern regarding health care. This bill undermines the ability of health plans to negotiate with pharmacies to provide patients with lower-cost options thereby making it more costly for businesses to afford these benefits. Although access is a critical component in any health care conversation, the benefits of increasing access in this case do not outweigh the significant impact to cost and quality this legislation stands to generate.

HB19-1174 Out-of-network Health Care Services

This bill requires certain disclosures to patients regarding out-of-network services provided at in-network and out-of-network facilities. It sets the reimbursement amounts for emergency services at out-of-network emergency facilities. In these cases, carriers must reimburse the out-of-network facility the greater of:
• 105 percent of the carrier’s median in-network rate provided in a similar facility or in the same geographic area, or
• The median in-network rate provided in a similar facility or in the same geographic area, as determined by payments reported to the All-Payer Claims Database.
It also sets the reimbursement amounts for other services provided by out-of-network providers working in in-network facilities. In these cases, carriers must reimburse the out-of-network facility the greater of:
• 110 percent of the carrier’s median in-network rate provided in a similar facility or in the same geographic area, or
• The sixtieth percentile of the median in-network rate provided in a similar facility or in the same geographic area, as determined by payments reported to the All-Payer Claims Database.

Over the past year the Chamber has worked with more than 30 health care organizations and dozens of non-industry members to identify strategies to address Colorado’s rising health care costs. During that process, addressing out-of-network charges at in-network facilities was discussed and prioritized by the Chamber’s members. This bill will help reduce surprise billing and ultimately help lower overall costs of health care.

HB19-1296 Prescription Drug Cost Reduction Measures

This bill creates the Colorado Prescription Drug Cost Reduction Act of 2019, requiring health insurers, prescription drug manufacturers, pharmacy benefit management firms and nonprofit organizations to report specified information about the costs of prescription drugs to the commissioner of insurance, including:
• Rebates received by carriers from manufacturers and their effects on premium prices
• Price increases by manufacturers that meet a certain threshold 30 days in advance
• Income and donations from manufacturers, PBMs or carriers by nonprofits
The bill then directs the commissioner to analyze the information and submit a report regarding the effects of prescription drug costs on health insurance premiums. It also requires carriers to pass rebates received from pharmaceutical companies or pharmacy benefit management firms on to consumers.

This bill risks exposing proprietary and trade secret information in a way that could ultimately result in increased health care costs.

HB20-1160 Drug Price Transparency Insurance Premium Reductions

This bill enacts the Colorado Prescription Drug Price Transparency Act of 2020 that requires insurers, drug manufacturers and pharmacy benefit managers to submit relevant information to the Colorado Insurance Commissioner that will be posted to the Division of Insurance’s website.

While we support efforts to increase transparency, this bill risks exposing proprietary information that has no direct tie to consumer benefit. The bill also provides no oversight on the Commissioner’s role as arbiter to decide what drug information to release.

HB20-1349 HB20-1349 Colorado Affordable Health Care Option

This bill directs the Division of Insurance (DOI) to develop and implement an insurance plan for the state in the individual and small group market, known as the “Colorado Option,” led by the Commissioner of Insurance. The Colorado Option plans would require that private health insurers administer the plans and hospitals participate, while the Commissioner of Insurance sets reimbursement rates and terms. The bill gives the Commissioner of Insurance the power to expand the Colorado Option plan to the small group market, establish a hospital reimbursement rate formula, and force carriers to offer the Colorado Option plan in specific counties. A hospital that does not participate in the Colorado Option could be fined up to $40,000 per day and have their license suspended or revoked.

This proposal is a one-size-fits-all approach that gives sweeping authority to an appointed individual, shifts costs to the employer-based coverage market, adds inefficiencies and puts us at risk for unintended consequences that harm Coloradans on subsidies and increases rates in parts of the state. Although language in the bill intends to prevent cost shifting, there is no assurance that premiums will not have to be adjusted in the fully insured market to make up for the decreased reimbursement rates from the Colorado Option. While the Chamber supports a market-based effort that increases access to health care, drives down costs for all, and is flexible for the wide range of communities, workers and businesses that make up our state, that simply isn’t what is being proposed.

HB21-1191 Prohibit Discrimination COVID-19 Vaccine Status

This bill prohibits a business from implementing disciplinary actions based on an employee’s immunization status and creates a private right of action against businesses that choose to utilize vaccine requirements with their workforce.

This bill will hinder a business’ ability to create a safe and healthy work environment and potentially cause non-compliance when certain standards direct employers to require vaccinations for their employees. Additionally, it opens the door for unnecessary and costly litigation.

HB21-1198 Health-care Billing Requirements For Indigent Patients

This bill requires health care facilities to screen uninsured patients for eligibility for public health insurance programs, the Colorado Indigent Care Program (CICP) and other discounted care. If a facility determines that a patient is ineligible for discounted care, the facility must notify the patient and provide an opportunity for the patient to appeal. Facilities and licensed professionals who provide eligible patients with emergency and other non-CICP services must limit their charges to no more than 80% of the Medicare rate, collect payments in monthly installments that equal no more than 5% of a patient’s household income, and consider the patient’s bill paid in full after 36 months of payments. Providers also must meet certain requirements before assigning or selling patient debt to a medical creditor or pursuing collections. HCPF will be required to collect reports on compliance and patient demographic data from facilities and fine facilities that the department determines to be knowingly or willfully not complying with the law.

While we support efforts to make health care more affordable for all Coloradans and educating consumers on how they can access programs designed to help with costs, this bill would limit what health care providers can charge to patients when they must access non-discounted services, such as emergency care, to only 80% of Medicare rates, which would force providers who treat all patients regardless of ability to pay, to shift costs to the private sector. It would also limit the means that debt collectors have to recoup debt that could have implications beyond the health care industry.

HB21-1232 Standardized Health Benefit Plan Colorado Option

The bill authorizes the Commissioner of Insurance to design a standardized health benefit plan to be offered by health insurance carriers. It also sets target individual market premium reductions for insurance carriers of 20% over a two-year period and establishes that if they fail to meet those premium reductions, a public health insurance option would be authorized in Colorado. The public option would be designed by an elected board.

With health care premiums in the individual market falling in Colorado and our economy still in recovery, now is not the time to introduce sweeping and risky legislation that would increase costs for most Coloradans, reduce competition and consumer choice, and transfer power to an appointed member of the executive branch without appropriate legislative oversight. The timelines and arbitrary thresholds in the bill almost guarantee that the private sector won’t have the time or opportunity to meet the goals of lowering premiums, turning a public option into a foregone conclusion. The Chamber is also opposed to any form of price-setting, and this legislation directs carriers to provide a specific government product and dictates the cost of that product, ensuring that we lose all the value associated with a competitive marketplace. We believe in a market-based, stepwise approach that reduces health care costs for all Coloradans.

HB21-1237 Competitive Pharmacy Benefits Manager Marketplace*

This bill requires the department of personnel to contract with a pharmacy benefit manager (PBM) and acquire the technology to support PBM reverse auction for group benefit plans. The newly acquired technology would be required to audit PBM prescription drug claims to monitor the effectiveness of the PBM and to perform market checks of prescription drug pricing competitiveness.

Rather than the impacted department eliminating a contract per the agreement, the legislature is attempting to impact an existing state contract less than one year after the state entered it. While we applaud the goal of this bill to reduce health care expenses, we are concerned that this bill sets a bad precedent far beyond this industry and makes it less attractive for the private sector to do business with the state.

HB21-1302 Continue COVID-19 Small Business Grant Program

This bill will create a grant program for small businesses that have experienced economic hardship because of the COVID-19 pandemic. Funding originally came from the federal Coronavirus Aid, Relief and Economic Security (CARES) Act, but not all businesses were able to secure funding by the deadline of Dec. 30, 2020. This bill allocates $15 million from the state general fund to continue the program and modifies grant criteria.

The Chamber supported the initial legislation in 2020 that created this grant program, and we support the additional allocation this legislation provides. Businesses in Colorado have been hit hard by the COVID-19 pandemic and are struggling to stay afloat and keep workers on payroll. The federal CARES Act was necessary to help provide critical resources to businesses, but many were not able to access these loans and many of those that did are now running out of funds. This bill will continue to support our smallest businesses and aid in the state’s recovery.

HB21-1307 Prescription Insulin Pricing And Access

This bill establishes a price cap of $100 for an individual's 30-day supply of prescription insulin and a cap of $35 for an emergency prescription supply. It also creates the insulin affordability program in the division of insurance through which an eligible individual may obtain prescription insulin at a price cap of $50 for a 30-day supply.

While the Chamber supports efforts to reduce the cost of health care, we do not support artificial price-setting for any industry. This legislation does not consider existing programs like rebates, coupons and other current practices that help offset higher drug costs. It instead dictates to manufacturers how to price their product and in some cases requiring it be provided for free.

HB22-1100 Prohibit Discrimination COVID-19 Vaccine Status

This bill prohibits an employer from taking adverse action against an employee or an applicant based on the employee’s or applicant’s COVID-19 immunization status. It allows an aggrieved employee or applicant to file a civil action lawsuit if the employer acted with malice or has repeatedly violated the law. The bill also specifies that the state cannot require any individual to obtain a COVID-19 vaccine, and a person cannot be discriminated against for their vaccination status.

Businesses have the right to decide the best way to protect their employees and private property. This bill unduly exposes businesses in the state to lawsuits by allowing employees to sue their employers for using vaccines as a tool to ensure the safety of their workplace. We should be supporting businesses as they recover from the impacts of the pandemic, not punishing them with needless litigation for their good faith efforts to move forward.

HB22-1112 Workers' Compensation Injury Notices

This bill extends the current law requiring injured employees to notify their employer within four days after occurrence to 14 days and repeals the current tolling and compensation reduction provisions. The bill amends the notice of requiring an employer to post in the workplace to requiring the notice to state the name and contact information of the insurer.

The Chamber supports legislators and stakeholders negotiating legislation that best serves Colorado employers and employees. This bill reflects a compromise between members of the business community and other stakeholders.

HB22-1144 Naturally Acquired Immunity COVID-19

This bill requires an employer or a state agency that imposes a COVID-19 vaccine or testing requirement to allow a person subject to the requirement to instead provide documentation demonstrating that the person has naturally acquired immunity to the disease.

This bill creates a logistical headache for businesses striving to make their workplace safe and profitable. The legislature is creating an additional mandate on the business community by requiring businesses to navigate different privileges and protections for their various employees. This bill makes doing business in Colorado more cumbersome and expensive.

HB22-1199 Visitation Requirements Health-care Facilities

This bill requires that health care facilities such as hospitals, nursing care facilities and assisted living residences permit patients and residents in the facility to receive visitors to the fullest extent permitted under applicable state laws or local ordinances. If circumstances require the complete closure of a facility to visitors, the facility is required to use its best efforts to develop alternate visitation protocols that would allow visitation to the greatest extent and as safely as possible.

This bill as written undermines businesses’ right to manage risk within their facilities and removes authority from health care experts to make decisions about the safety of their patients and staff.

HB22-1201 Standards for Immunization Requirements

This bill allows individuals who are required to receive an immunization to claim an exemption from the requirement if the immunization has not been approved by the federal Food and Drug Administration (FDA), has only received emergency use authorization, the manufacturer is not liable for injury or death caused by the immunization, or pivotal clinical trial the FDA relied on for approval did not evaluate the immunization’s safety for at least one year after it was first administered. The bill also requires the Department of Public Health and Environment to post on its website the criteria for immunization exemption and any diseases, risks or injuries caused by the immunization.

Businesses are working hard to recover from this pandemic, get Coloradans back to work and restore the economy. This bill creates a workaround for employees when businesses are trying to enforce safety policies. We trust that each individual business takes the responsibility to keep their employees and patrons safe seriously, and this bill undermines their efforts to do just that.

HB22-1285 Prohibit Collection Hospital Not Disclosing Prices

This bill prohibits hospitals from collecting debts accrued by patients during periods when the hospital was not in compliance with federal hospital price transparency laws. The bill does not prevent hospitals from billing a patient or health insurer for services rendered or requires hospitals to refund payments to patients. Any hospital that pursues debt collection against a patient is subject to be penalized up to the amount of the debt plus attorney fees and costs. The bill also makes debt collection against patients during times of non-compliance an unfair practice under the Colorado Fair Debt Collections Act and allows the department of public health and environment to consider this during license renewal.

While we recognize the need for and importance of price transparency, we also trust that our hospitals operate in compliance with federal standards. The Chamber believes that legislating additional regulatory and compliance framework at the state level further complicates our health care system and hospital licensure requirements.

HB22-1325 Primary Care Alternative Payment Models

The bill requires the Division of Insurance in the Department of Regulatory Agencies to create, implement, and evaluate standards around the use of valued-based payments in the health insurance system.

This bill is an example of the government intervening in the private sector and pushing for unnecessary additional bureaucratic oversight. We have serious concerns toward ongoing government overreach in telling private companies how to navigate the health care sector.

HB22-1401 Nurse Staffing Ratios

This bill requires every hospital to establish a nurse staffing committee by September 1, 2022. The committee is required to implement a nurse staffing plan and to track feedback and complaints from nurses and other staff. The bill requires hospitals to submit their plan to the department of public health and environment yearly, post the plan on their website and evaluate the plan quarterly. The bill prevents hospitals from staffing a unit unless the providers are properly trained in that assignment. Each hospital must report the baseline number of beds able to be staffed and its current bed capacity. If the staffed-bed capacity falls below 80%, the hospital is required to notify CDPHE and submit a plan to meet the requirement. The bill levies fines on hospitals who do not fulfill the requirements of staff-bed capacity, have a lack of vaccine availability onsite, and fail to include necessary testing capabilities at their sites.

This bill worsens the already significant shortage of nurses by enforcing an unrealistic nurse staffing ratio at hospitals. We believe that private businesses know how to manage and staff their facilities—balancing the needs of their patients with the nurses they have available. This bill encroaches on hospitals’ ability to be adaptable and account for a variety of circumstances that might impact how they do business.

HB23-1153 Pathways To Behavioral Health Care

This bill requires the state department of human services to conduct a feasibility study to determine if creating a system to support people with serious mental illness through a collaboration between Colorado’s behavioral health and judicial systems is feasible. The bill also requires the state to create an application process for selecting the independent third party, and to submit a report detailing the findings and recommendations by Dec. 31, 2023.

As a state, we know that behavioral health challenges are a contributing factor to homelessness. It is essential that we understand the need for behavioral health services, the capacity of state and local programs to address that need, the sector’s workforce pipeline, and the cost-benefit of existing and proposed solutions in order for our state to have a coordinated and sophisticated strategy to tackle behavioral health, and by extension homelessness and downtown revitalization.

HB23-1189 Employer Assistance for Home Purchase Tax Credit

This bill creates an employer tax credit for employers who make a monetary contribution to their employees for assistance in purchasing a home. The amount of the credit is 5% of an employer’s contribution to an employee, but the credit is capped at $5,000 per employee. The employee must use the fund for a down payment, closing costs or fees. An employee may authorize the employer to withhold earnings as a contribution to the fund. If an employee terminates their employment, they forfeit any unexpended amount of the employer contribution, and the credit is subject to recapture. In this case, the employee is entitled to the employee contribution plus any interest earned.

During a time when workforce is facing massive financial barriers to buying a home in Metro Denver, this bill creates a mechanism for businesses to attract and retain talent and establishes another way for employers to incentivize and provide more benefits to employees. This legislation is a great example of commonsense ways to help solve our affordability crisis with the business community and workforce in mind.

HB23-1201 Prescription Drug Benefits Contract Term Requirements

This bill requires the amount of a prescription charged by the Pharmacy Benefit Manager (PBM) or carrier be equal to or less than the amount paid by the PBM or carrier to the contracted pharmacy. This bill also creates transparency requirements for PBMs and carriers regarding prescription drug benefits and grants the Department of Healthcare Policy and Financing the authority to audit.

While this bill aims to create more transparency around prescription drug prices, the consequences of it would create less choice for employers and as such, less competitive pricing and higher insurance premiums. This extra cost would be shouldered by businesses and workforce as health plans increase in price. With high costs of living, we must do all we can to keep healthcare costs low.

HB23-1209 Analyze Statewide Publicly Financed Healthcare

This bill requires the Colorado School of Public Health to study legislation creating a publicly-funded and privately-delivered universal health care model. This bill also creates the statewide health care analysis task force consisting of appointed members and the Governor, as well as executive directors of state departments, the commissioner of insurance, and the CEO of the Colorado health benefit exchange.

While we recognize that this bill does not directly establish publicly financed healthcare, we have several serious concerns with this proposal. First, Coloradans overwhelmingly voted against a single-payer, publicly owned system in 2016. Second, we do not believe the legislature can justify the expense of this study when there are other policies and programs whose funding is jeopardized by a tighter budgetary environment. Third, we believe information on the feasibility of publicly financed health care already exists and has been studied in Colorado through other mechanisms; this cost and information would be redundant. Fourth, this system of health care is incompatible with the programs we have already set up to address health care costs and access, specifically the Colorado Option and the reinsurance program.

HB23-1215 Limits On Hospital Facility Fees

This bill prohibits healthcare providers affiliated with a hospital from charging a facility fee for: outpatient services provided at an off-campus location or through telehealth or services identified by the medical services board that must be provided safely, reliably, and effectively in nonhospital settings. The bill also requires the provider to give notice of the fee to patients, prepare an annual report on facility fees, and makes it a deceptive trade practice to charge, bill or collect a facility fee when prohibited.

With the significant amendments made to this bill to allow our hospitals to continue the critical work that they do, we have moved to a neutral position. 

HB23-1224 Standardized Health Benefit Plan

This bill makes changes to the “Colorado Standardized Health Benefit Plan Act” to: require the health benefit exchange to develop a format for displaying standardized health benefit plans on its website; grant the commissioner 120 days to analyze the rate filings as opposed to the current 60 days; require a carrier to submit a plan to the commissioner on how it will meet rate requirements if it does not offer a standardized plan; and specify that the commissioner’s decisions are final agency actions subject to judicial review.

In 2021, we opposed HB21-1232 Standardized Health Benefit Plan Colorado Option because it introduced sweeping and risky legislation that would increase costs for most Coloradans, reduce competition and consumer choice, and transfer power to an appointed member of the executive branch without appropriate legislative oversight. This is still the concern for HB23-1224 with no modifications to the bill to lower consumer costs and increase consumer choice, which will have long term effects families and businesses impacted by increasing inflation.

HB23-1225 Extend And Modify Prescription Drug Affordability Board

This bill modifies certain functions of the Prescription Drug Affordability Board. Some of these changes include: specifying that only board members, and not employees, are required to recuse themselves during a vote if they have a conflict of interest; allowing the board chair to cancel a meeting if there is good cause; making certain changes to the procedure by which the board identifies prescription drugs that may be subjected to an affordability review; removing the prohibition of the board to set an upper limit on prescription drug prices; and establishing that it is an “adverse determination” if a patient is denied a prescription drug benefit because the manufacturer has withdrawn that drug from sale in the state.

This bill removes two key elements the Chamber fought to have in the passing of SB21-175 Prescription Drug Affordability Review Board (PDAB). These two elements include the agreed upon sunset date and putting a cap of up to 12 drugs that could be brought to the board for review. Further, we oppose the expansion of a program that has never been utilized and has not been proven to lower drug costs or evaluate pricing. The board has not completed an affordability review or set an upper payment limit for a prescription drug since the initial bill was passed. By expanding the number of drugs that could be subject to affordability review, removing the limit on the number of drugs for which the PDAB can set an upper price limit, and extending the sunset date for the law, this bill rolls back important protections that were put in place in an attempt to limit unintended consequences.

SB17-003 Repeal Colorado Health Benefit Exchange

This bill repeals the Colorado Health Benefit Exchange Act, effective Jan. 1, 2018, and allows the exchange to continue for one year for the purpose of winding up its affairs.

The Chamber, along with more than 100 diverse stakeholders as part of the Colorado Health Policy Coalition, has identified a set of principles that we urge Congress to consider when examining a replacement plan for the Affordable Care Act (ACA). We oppose a repeal of the ACA without a clear replacement because of the uncertainty and potential cost increases a repeal without replacement would create for businesses.

SB17-057 Colorado Health Care Affordability and Sustainability Enterprise

This bill repeals the Hospital Provider Fee and enacts the Colorado health care affordability and sustainability enterprise as a state business outside of the revenues used for evaluating TABOR (Taxpayer’s Bill of Rights) and Referendum C cap levels. The enterprise would charge and collect a new Hospital Provider Fee and would implement and administer the state Hospital Provider Fee program.

Last year, the governor imposed a $100 million reduction in Hospital Provider Fee (HPF) collection to help balance the budget for Colorado, which resulted in the loss of an additional $100 million in matched funds for Colorado by the federal government. This year that number increased to $195 million, and it will continue to rise exponentially unless reclassification of the HPF is addressed.

SB17-088 Participating Provider Network Selection Criteria

This bills requires health insurers to disclose the standards they use to construct and market their provider networks. It also requires carriers to outline a process by which providers may seek reconsideration if a carrier decides to make changes to, terminate or deny participation in its provider network.

This bill is a mandate that interferes with private contracts and restricts carriers’ ability to create their own network as a strategy that can help businesses and their employees contain costs of health care.

SB17-151 Consumer Access to Health Care

This bill imposes new mandates on how insurers should make decisions pertaining to authorizing providers, health care services and coverage, particularly removing the requirement that the insured receive a referral before seeing a specialist.

This bill is a mandate that interferes with private contracts, and with the ability to directly visit a specialist, will increase health care costs.

SB18-146 Freestanding Emergency Departments Required Consumer Notices

This bill requires freestanding emergency departments (FSEDs) to disclose information to potential patients regarding the type of facility in which they’re seeking care as well as costs and coverage associated with care.

The Chamber is working with more than 30 health care organizations to identify industry-wide strategies that address Colorado’s rising health care costs. Throughout this process, requests for transparency and continue to emerge. The disclosures required in this bill could help patients make more informed decisions about the health care services they receive.

SB19-073 Statewide System Of Advance Medical Directives

This bill requires the Department of Public Health and Environment to create and administer a statewide electronic system that allows qualified individuals to upload and access advance medical directives.

End-of-life care is one of most costly parts of the health care system. This bill streamlines this process by creating a single electronic repository, allowing health care providers to more easily locate advance medical directives for treatment. This will honor and respect a patient’s wishes and, in some cases, may help contain costs by allowing physicians to more quickly access this important information. Best practices should be considered when implementing this legislation to ensure ease of use and ability to update, should a patient change their mind on their directive.

SB19-134 Out-of-network Health Care Disclosures And Charges

This bill sets the reimbursement amounts out-of-network provides can charge in-network facilities for emergency services. In these cases, carriers must reimburse the out-of-network facility the greater of the following:
• The carrier’s average in-network rate
• 125 percent of Medicare
• The average in-network rate as determined by payments reported to the All Claims Payer Database.
It also sets the reimbursement amounts out-of-network providers can charge in-network facilities for non-emergency services. In these cases, carriers must reimburse the out-of-network facility the greater of:
• The average allowed amount for in- and out-of-network rates multiplied by 150 percent for urban providers and
• The average allowed amount for in- and out-of-network rates multiplied by 200 percent for rural providers.
The bill also authorizes arbitration for payment of claims that are in dispute if certain criteria are met.

This bill will result in increased health insurance premiums, which is the opposite of what we need in Colorado. Chamber members have consistently identified rising cost as the biggest concern regarding health care. The benchmark payments in this proposal are set at such a high rate that they will result in higher costs well beyond current rates.

SB19-188 FAMLI Family Medical Leave Insurance Program

This bill creates a mandatory Family and Medical Leave Insurance (FAMLI) program, providing partial wage replacement to eligible individuals who take leave from work to care for a new child or a family member with a serious medical condition, because of a serious medical condition of their own or due to certain needs arising from a family member’s active duty service. It requires a 60-40 split between employees and employers, respectively, to cover the cost of the premium. Premiums are based on a percentage of the employee’s yearly wages.

Bill sponsors have accepted various amendments on this bill to:
• create a task force to be appointed by the governor and General Assembly;
• have the task force study options of a third party to run a family leave program;
• require a study of the costs and financial impact of a family and medical leave program;
• require recommendations be presented to members of the General Assembly and the governor; and
• require that the General Assembly introduce a new bill next session to implement the program based on the results of the study.
Legislators took a critical step to better understand a program that will undoubtedly impact all working Colorado families. The Chamber feels confident that these changes will allow for a thorough analysis of the implications of such a program and that the results will be taken into account when reviewing the proposed program next legislative session.

SB19-217 Healthcare Provider Liens

A health care lien is a demand for repayment that may be claimed against a personal injury case for medical care related to that case. This bill creates a regulatory framework for health care lien companies and increases access to financing for personal injury claims.

This bill will legitimize a practice that essentially incentivizes the inflation of damages, driving up costs for everyone involved in a personal injury case and making it easier for health care lien companies to operate in Colorado. It also puts injured parties at risk for extensive claims if they lose their case. Additionally, it will result in similar companies moving to Colorado and increase the volume of personal injury claims.

SB19-234 Sunset Professional Review Committees

This bill implements the recommendations of the Department of Regulatory Agencies’ sunset review on the professional review committee and extends the committee, currently set to sunset in September 2019, for 11 years. Professional Review Committees review and evaluate the competence, professional conduct or the quality and appropriateness of patient care of a physician, physician assistant or advanced practice nurse and ensure that care can be analyzed at the patient and provider level.

These peer reviews help ensure patient safety and maintain a high quality of care. We join the health care industry in support of protections that allow for this peer review process to continue.

SB19-238 Improve Wages And Accountability Home Care Workers

This bill sets a minimum wage for certain home care workers by requiring that at least 77 percent of the reimbursement that a home-care agency receives from Medicare or Medicaid for certain services be passed on to their non-administrative employees that provide those services. Additionally, it directs the Department of Health Care Policy and Financing (HCPF) to seek an 8.1 percent increase from the federal government for these service categories, with the entire amount being applied to the employee compensation. Each agency is also required to make certain disclosures to HCPF, which will then be added to a publicly available website.

This bill will reduce access to care for individuals needing these services by increasing costs to a point that will likely be unsustainable for home-care agencies, potentially putting them out of business. It also created significant privacy concerns for workers. Most importantly, however, it jeopardizes Colorado’s balance between right-to-work and union agreements by creating a back-door option for unionizing these workers. The Chamber has consistently opposed any efforts to weaken the existing Labor Peace Act because its statutory framework has provided a balance to ensure a healthy relationship between business and labor in this state. Colorado’s Labor Peace Act is a unique legal middle ground between right-to-work and union states that has contributed to Colorado’s economic well-being.

SB20-084 Prohibit Requiring Employee Immunization

This bill prohibits discriminatory employment practices based on employee’s immunization status, including health facilities.

This bill would hinder a business’s ability to create a safe and healthy work environment and potentially cause non-compliance when certain standards, for example OSHA, direct them to require vaccinations for their employees. The Chamber’s primary interest is lowering the cost of health care, and preventive care, like immunizations, is a documented way to do that.

SB20-127 Committee Actuarial Review Health Care Plan Legislation

This bill creates a committee in the division of insurance to review introduced bills that impose new requirements or amend existing requirements of health benefit plans. Among other things, the committee must analyze the number of Colorado residents directly impacted by the bill, estimates in changes to consumer cost sharing, the financial impact on group benefit plans offered under the State Employees Group Benefits Act and the financial impact on business employers.

This bill will allow for legislators to more fully understand financial implications of legislation on health care plans, allowing them to make more informed decisions when voting on and sponsoring legislation.

SB20-205 Sick Leave for Employees

This bill requires that all employers provide paid sick leave to their employees starting Jan. 1, 2021, accruing one hour for every 30 hours worked, up to a maximum of 48 hours. Sick leave may be used for mental or physical illness, the care of a family member, domestic abuse or school closures due to a public health emergency. OPPOSE UNLESS AMENDED

While the Chamber supports providing paid sick leave to employees, we must ensure that employers who are today providing these types of benefits are recognized as meeting the requirements in this bill, even if they have different terms of use. As it is currently written, the bill would also interfere with collective bargaining agreements, which are thoroughly negotiated private contracts between businesses and union representatives. The current language in the bill would force employers and employees in collective bargaining agreements to apply different sick leave terms and conditions in Colorado and result in the need to renegotiate national agreements years in the making.

SB20-215 Health Insurance Affordability Enterprise

This bill creates an enterprise to assess a fee on health insurance carriers and hospitals in order to fund the state’s reinsurance program. In addition to paying for the reinsurance program, the funds would be used for expanded services and programs not included in the initial reinsurance program.

Rather than addressing the root cause of health insurance premium growth, this bill simply shifts costs from the individual market to the fully insured market, a market comprised of small and medium-sized businesses. Carriers will be forced to pass on the new fee to employers in the form of premium increases, which businesses cannot afford during this challenging time. Rather than just picking up the state’s share of reinsurance funding, this bill also aims to create additional revenue for a variety of other programs and expansion on the backs of the businesses. While we understand many Coloradans are challenged to pay for health insurance premiums today, increasing the affordability for one group by decreasing affordability for another is not the way to solve this challenge. Many small and medium-sized Colorado businesses were already struggling to provide health insurance benefits for their employees before the public health crisis and this bill only exacerbates those challenges for employers and their employees.

SB21-061 Claims for Economic Damages Incurred by Minors

Current law allows a parent or guardian the right to sue for damages of a minor. This bill would permit minors to also bring a claim to recover damages and it expands the statute of limitations for civil claims.

The current law sets the statute of limitations for claims at two years, which is the national norm and encourages people to bring claims in a timely manner. This law would greatly extend that statute of limitations and also jeopardize our state’s policy that parents are responsible for taking care of a minor’s medical needs and recovering damages on their behalf.

SB21-085 Actuarial Review Health Insurance Mandate Legislation

The bill requires the Colorado Division of Insurance (DOI) to retain a contractor on or before Nov. 1, 2021, to perform actuarial reviews of proposed legislation that may impose a new health benefit mandate on health benefit plans. Fiscal notes for any legislative proposal that may impose a new health benefit mandate on health benefit plans shall either note premium impact information that is produced by the contractor during their review or indicate that no information was produced by the contractor during their review.

This bill helps legislators and constituents understand upfront the costs that Coloradans may incur as the result of health benefit mandates. This is particularly important given the changes to health care policy that are under consideration in the current session that would require premium reductions. Health benefit mandates increase costs for many insured Coloradans and it’s critical that we increase awareness of their impacts, so that an accurate cost benefit analysis can occur.

SB21-175 Prescription Drug Affordability Review Board

The bill creates the Colorado prescription drug affordability review board and requires the board to perform affordability reviews of prescription drugs and establish price caps for prescription drugs that the board determines are unaffordable for Colorado consumers.

While the Chamber applauds efforts to reduce the cost of health care and increase transparency, we do not support artificial price-setting for any industry. We continue to actively lead efforts to decrease the high cost of health care and encourage all stakeholders to collaborate toward solutions that work for consumers and employers.

SB22-040 Actuarial Reviews Health Insurance Mandate Legislation

This bill requires the Colorado Division of Insurance to retain a contractor on or before Nov. 1, to perform actuarial reviews of proposed legislation that may impose a new health benefit mandate on health benefit plans. Fiscal notes for any legislative proposal that may impose a mandate shall note premium impact information that is produced by the contractor during their review or indicate that no information was produced.

This bill helps legislators and constituents understand upfront the costs that Coloradans may incur as a result of health benefit mandates. Health benefit mandates increase costs for many insured Coloradans. An accurate cost benefit analysis would increase awareness of the impacts of these mandates.

SB22-053 Health Facility Visitation During Pandemic

This bill requires hospitals and nursing care facilities to allow patients receiving inpatient care to have at least one visitor of the patient’s choosing. It also restricts health care facilities from creating policies or procedures that prohibit visitors for the sole reason of reducing the risk of pandemic disease transmission, but facilities can impose specified restrictions and limitations for visitors to reduce the risk of transmission. Health care facilities must provide written policies and procedures that list and give reasons for restrictions and limitations.

Using their data-based expertise, health care professionals are most knowledgeable for how to keep patients, visitors and staff safe in their facilities. These facilities should have the right to create their own policies and procedures without government interference.

SB22-097 Whistleblower Protection Health & Safety

This bill protects whistleblowers who raise a reasonable concern related to public health and safety, expanding existing whistleblower protections outside of declared public health emergencies. This extends temporary whistleblower protections related to public health and safety granted during a declared public health emergency to all times, regardless of whether an emergency is declared. 

This bill is duplicative of existing laws and protections.

SB22-131 Protect Health of Pollinators and People

This bill implements protective measures for both pollinators and individuals by restricting the use of pesticides on school grounds, childcare facilities and children’s camps. If pesticides are being used at any of these locations, a notice must be sent to individuals in these locations. This bill also requires the executive director of natural resources to conduct a study to best address the pollinator decline and increase pollinator health in Colorado while also creating a pilot program under the Department of Agriculture to fund research and production of noncoated insecticide on crops.

While the Chamber supports protecting the health of individuals and the environment, this bill interferes with certain safety protocols, such as fire prevention, that require the use of certain insecticides and herbicides to prevent growth from happening near energy lines. This bill allows the regulation of pesticides to happen at a municipal level and creates a bureaucratic nightmare for businesses that have an industrial need for pesticides in business operations across the state.

SB22-145 Resources To Increase Community Safety

This bill establishes three new law enforcement grant programs within the Division of Criminal Justice in the Department of Public Safety to be used for crime prevention, law enforcement recruitment and law enforcement training.

Our members, and the people they employ, have expressed concerns about the safety of the downtown area as businesses transition back to in-person workplaces. We can’t restore the vibrancy of downtown or rejuvenate the businesses that rely on in-person traffic without providing confidence to businesses that their teams are safe. This bill provides additional resources to increase community safety, which benefits both businesses and consumers. Additionally, the program’s two-year length allows the state to meet this moment and be responsive to these safety concerns without committing to a long-term program.

SB22-159 Revolving Loan Fund Invest Affordable Housing

This bill creates the transformational affordable housing revolving loan fund program, which provides flexible, low-interest, below-market rate loans to eligible recipients to encourage affordable housing development.

By ensuring eligible recipients have access to favorable lending rates, Colorado is better positioned to retain a vibrant workforce despite rising housing prices. The revolving loan mechanism is a long-term solution that will positively impact affordable housing for many years to come.

SB22-226 Programs to Support Healthcare Workers

This bill makes several appropriations from the economic recovery and relief cash fund to bolster the healthcare workforce, including: $2 million to establish the health-care resilience and retention program; $20 million to establish the practice-based health education grant program, which would increase training opportunities for health profession students; $26 million to assist community colleges and occupational boards to administer credentialling programs for rapidly expanding the short-term supply of in-demand professionals; $3 million to expand of the school nurse grant program; and $10 million to recruit and re-engage health care professionals with current or expired licenses. It also directs the Primary Care Office and the Governor’s Office of Information Technology to establish a data-sharing agreement to analyze the need and allocation of state-administered or state-financed workforce initiatives in healthcare, removes a limitation on payment for volunteer nurses, and requires the nurse-physician advisory task force to make a series of workforce recommendations.

The health care industry was uniquely burdened by the pandemic, and the industry is now experiencing significant workforce attrition in a field so highly specialized that workers are difficult to replace. Improving the workforce shortage through worker retention, higher education enrollment and developing workforce skills is a crucial way to sustain this sector, retain employees and rebuild our economy. This bill would provide recovery and relief cash to support these initiatives and our business community.

SB23-252 Medical Price Transparency

This bill requires hospitals to create a public list of all standard charges for all hospital items and services provided to patients. It also requires hospitals to make a public list of at least 300 shoppable services and report the lists to the Department of Health Care Policy and Financing. This bill also requires the department to monitor hospital compliance and issue a written notice if found in violation.

At a time when we should be supporting our hospitals as they recover from the COVID-19 pandemic and work to regain operational normalcy and profitability, these added regulations complicate this recovery. Codifying federal rules into state statute creates the potential for duplicative and conflicting state and federal rules, and changing the regulatory mechanisms and organizations adds unnecessary confusion and ambiguity and makes doing business in Colorado more difficult.