ENGLEWOOD, Colo.—A commission appointed by Gov. Bill Ritter said Thursday it would cost $26 billion a year to provide health insurance to everyone in Colorado, including an estimated 791,000 who have no coverage.
Supporters of the proposal—called a single-payer plan—said it would save $4 billion a year overall through lower administrative costs, bulk purchases and cost-shifting.
Skeptics said the numbers don’t add up.
The Blue Ribbon Commission for Health Care Reform will submit five possible reform plans to Ritter and the Legislature this fall. The commission does not plan to recommend any single plan.
Ritter has promised to make sure all Coloradans have access to health insurance by 2010.
Besides the single-payer plan, the commission is considering proposals that would:
— Provide a basic benefit package through a large insurance pool with a $50,000 cap on benefits. It would have no mandates.
— Require all Coloradans to have health insurance.
— Place mandates on individuals and employers to provide coverage or pay an assessment.
A fifth plan, which is still being developed, would expand coverage of essential health care services for all Coloradans, with an emphasis on the uninsured and underinsured.
A commission subcommittee developing the fifth proposal has also suggested providing subsidies to individuals and families to buy health insurance.
John Shiels, an analyst for The Lewin Group, which analyzed all of the proposals, said Colorado’s current health-care costs total $30 billion, with about $4.2 billion provided by the state.
The single-payer program would be administered like a public utility, with premiums charged through income taxes and payroll deductions.
Funding would come from several sources, including the federal government, federal income taxes and payroll taxes. It also would also require that the state income tax be nearly tripled from the current 4.6 percent.
Shiels said a single-payer plan would reduce costs by $2,408 per employee per year for companies that currently provide health insurance. Companies that do not currently provide insurance would see their costs increase by $2,002 a worker.
Shiels said people with good health plans could see their coverage decline, while others without health insurance would finally get coverage, which in theory would reduce the costs currently passed on to others.
“There are winners and losers,” he said.
George Swan, a retired hospital administrator from Denver, said 30 percent of the cost of health care is administrative, and that could be greatly reduced with a single-payer system.
Rep. Bernie Buescher, D-Grand Junction, has said Ritter’s promise of universally available health insurance can be kept as long as people “don’t do the math.”
He said the plan relies on shifting costs by getting the uninsured to stop using emergency rooms for their primary health care and having the state promote wellness program to prevent illness, instead of trying to treat it after it occurs.
The commissioners said all four plans they reviewed so far have drawbacks, including the possibility the state would be overwhelmed with uninsured people moving to Colorado from other states.
Commissioners also said the proposals provide coverage without guaranteeing that health care will even be available, and they rely on increased use of technology without spelling out how to pay for it.
Previous estimates had put the number of uninsured Coloradans at 770,000. The new, higher estimate was based on more extensive research by The Lewin Group.
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