Committee backs statewide study of universal-health payment options; funding to come from donations

The House Health and Human Services Committee voted to send Senate Bill 45 — a study of statewide, publicly financed health care payment systems — to the Committee on Finance with a favorable recommendation, 9–4.

Senate Bill 45 would commission the Colorado School of Public Health to expand earlier modeling and produce a more detailed microsimulation analysis of options to achieve universal coverage through a range of payment systems. The bill directs the school to evaluate potential cost, provider reimbursement, impacts on hospitals and private insurers, out-of-pocket costs for patients and other stakeholder effects.

Representative McCormick, a bill co-sponsor, framed the measure as a “homework assignment” to gather more data than prior work did; McCormick said the new study will model provider reimbursement and other variables to inform the legislature. “This study is not that [Amendment 69],” McCormick told the committee, noting the 2016 ballot measure addressed by voters. Co-prime sponsor Representative Basenacker said the bill builds on House Bill 19‑1176, the earlier comparative analysis conducted by the Colorado School of Public Health.

Witnesses who supported the bill included Dr. Jack Berry, a retired rural family physician and former Colorado Medical Society president; William Semple of the Colorado Foundation for Universal Healthcare; George Marlin, chair of Counties and Commissioners Acting Together (CCAT); Greg Tong (associate professor, Colorado School of Public Health) who said the school would build a microsimulation to estimate impacts for hospitals, doctors and individuals; and multiple clinicians and advocates who said administrative burdens and rising costs justify more analysis. Dr. Tong said the school’s role would be to bring “the best data, scientific evidence and analysis to help to inform decision making.”

Opponents included representatives of the Denver Metro Chamber of Commerce, the Colorado Association of Health Plans, and America’s Health Insurance Plans (AHIP). Opponents argued the study is biased toward single‑payer ideas and could increase uncertainty for health-care markets; they also pointed to voter rejection of Amendment 69 in 2016 and warned about fiscal consequences of major system changes.

Sponsors said the bill will not use state general fund money. Representative Basenacker and McCormick said a coalition of nonprofits and donors has organized a fundraising plan; the sponsors said the school will not begin work until gifts, grants and donations are in place. McCormick said the decision to fund the study from private sources mirrors previous legislative studies funded similarly.

The committee heard technical testimony about methods: Greg Tong described extending the 2021 microsimulation used in HB19‑1176 to produce stakeholder‑level estimates (for example, how an employer‑sponsored enrollee’s out‑of‑pocket costs would change under multiple payment options). Supporters stressed transparency — making data sources, assumptions and replicateable appendices available so others can audit results.

The committee voted to send the bill to the Committee on Finance. The roll call recorded 9 yes and 4 no votes. Supporters said the study will provide data the legislature and the public can use in future policy decisions; opponents urged focusing on existing reforms such as the Colorado Option and warned of unintended economic consequences.