With control of state government, Democrats who for years saw their marquee health care proposals thwarted by Republicans are now talking about sweeping reforms – just not soon.
Democratic legislative leaders and Gov.-elect Bill Ritter plan to use 2007 to work with groups wrestling with how to expand coverage and decrease costs.
Expect plenty of tweaking when lawmakers return to the Capitol on Jan. 10, Democrats say, but no wholesale changes.
The new majority wants to lower state prescription-drug costs through bulk-buying, reform Medicaid managed care and provide more coverage to children from low-income working families.
“I think a 2007 system reform is not possible, a systemwide reform. I think there are things we can do in the short order,” Ritter said.
Topping the list is reducing the price of prescription drugs.
Democrats want to require the state to buy prescription drugs in bulk from a multi-state drug purchasing pool. The resulting volume discounts could save the state $10 million annually in Medicaid drug costs, they say. To join the pool, the state must adopt a prescription drug list (PDL), which largely limits what drugs can be purchased.
Pharmaceutical industry officials have helped defeat similar proposals in each of the past three years. They argue that the preferred-drug roster hurts patients who depend on unlisted drugs – an argument Republican Gov. Bill Owens cited both times he vetoed the proposals.
Democratic House Majority Leader Alice Madden said she hopes Ritter will implement the prescription drug list and enter Colorado into the purchasing pool through executive order, avoiding a likely contentious legislative fight.
Ritter spokesman Evan Dreyer said Ritter would like to talk to Democratic leadership before making a decision.
The Pharmaceutical Research and Manufacturers of America said in a statement that the group “has serious concerns about any measure that would limit access to needed medicines.”
“After implementation of a PDL, hospital and physician visits increase, raising the states overall Medicaid costs,” said Jan Faiks of PhRMA in the statement.
Democrats plan to propose legislation that would require the state to buy generic drugs at near-wholesale prices and pass that savings on to uninsured Coloradans.
They are also trying to beef up Medicaid managed care.
Democratic Rep. Bernie Buescher of Grand Junction is drafting legislation that could bring private managed care back to Medicaid with a model that provides incentives for improved quality and preventive care.
Managed care allows the state to negotiate cost. Without it, doctors bill Medicaid at the highest rate.
“There are no disincentives to show up at the ER” under the current system, said Democratic Sen. Bob Hagedorn of Aurora.
The House and Senate health committee chairs, Rep. Anne McGihon of Denver and Hagedorn, are also discussing requiring the state to acquire or create its own managed care organization to run Medicaid.
The duo are also considering increasing privacy protections for electronic health records, streamlining mental-health funding and improving long-term care.
Buescher would also like to cover more low-income children under Colorado’s CHP+ program but said he doesn’t know if such a move has a sustainable funding source.
Lawmakers are also keeping close tabs on a health care reform commission created by lawmakers this year and charged with recommending proposals to expand coverage and decrease costs.
Last week, commission members met with Ritter officials to discuss including more voices. Ritter campaigned on the promise to include all stakeholders when discussing health care reform. He said he wants to “dovetail” his efforts with the commission’s.
“If we operated totally separate, we would be stupid,” said Bill Lindsay, the commission’s chairman. “For us to do something and ignore the chief executive of the state would be insane.”
But just because wholesale changes are off the table next year, that doesn’t mean that health care interests won’t show up.
“We’re not waiting for 2008. There’s stuff to be done,” said Denise de Percin of the Colorado Consumer Health Initiative.
The nonprofit advocacy group hopes to clean up legislation that prevented government services to illegal immigrants. For instance, it’s unclear whether lawmakers meant to prohibit prenatal care to illegal immigrants because the law also exempts children.
The Colorado hospital association, a spokeswoman said, is considering asking lawmakers to extend their deadlines to report certain hospital-acquired infections to a federal database because of its delayed start.
Staff writer Chris Frates can be reached at 303-954-1633 or cfrates@denverpost.com.
