These are all of the Healthcare bills proposed in the 2018 session. Each bill has its own bill number, please use your browser search feature to find the bill you are interested in. Return to the Colorado home page to pick a different bill category.

None of the text is the opinion of Engage. Each bill's description, pros, and cons are our best effort at describing what each bill does, arguments for, and arguments against the bill. If you believe we are missing something, please contact us with your suggestion. Some of these bills have the notation that they have been sent to the chamber's "kill" committee. This means that the leadership has decided to send the bill to the State committee even though it does not belong there based on its subject matter. This committee, in both chambers, is stacked with members from "safe" districts and the idea is to kill the bill without forcing any less safe members to take a hard vote. It is possible for a bill to survive the kill committee, but it is very rare.

Each bill has been given a "magnitude" category: Major, Medium and Minor. This is a combination of the change the bill would create and the "controversy" level of the bill. Some minor bills that are extending current programs would be major changes if they were introducing something new, but the entire goal here is to allow you to better curate your time. Something uncontroversial likely to pass nearly unanimously that continues a past program may not be worth your time (and please remember, you can still read all of the minor bills!).

House

Click on the House bill title to jump to its section:

MAJOR

HB18-1009: Diabetes Drug Pricing Transparency Act 2018
HB18-1082: A Woman's Right to Accurate Health Care Information
HB18-1120: The Prohibition of Dismemberment Abortions
HB18-1121 No Funding Trafficking Aborted Human Body Parts
HB18-1179: Prohibit Price Gouging on Prescription Drugs
HB18-1205: Financial Relief Defray Individual Health Plan Costs
HB18-1223: Declare Autism Epidemic in Colorado
HB18-1225: Protect Human Life at Conception

MEDIUM

HB18-1003: Opioid Misuse Prevention
HB18-1006: Infant Newborn Screening
HB18-1007: Substance Use Disorder Payment and Coverage
HB18-1040: Immediate Treatment Incentive Plans
HB18-1091: Dementia Diseases and Related Disabilities
HB18-1097: Patient Choice of Pharmacy
HB18-1112: Pharmacist Health Care Services Coverage
HB18-1136: Substance Use Disorder Treatment
HB18-1177: Youth Suicide Prevention
HB18-1207: Hospital Financial Transparency Measures
HB18-1211: Medicaid Fraud Control Unit
HB18-1212: Freestanding Emergency Departments Licensure

MINOR

HB18-1012: Vision Care Plans Carriers Eye Care Providers PASSED HOUSE COMMITTEE
HB18-1017: Psychology Interjurisdictional Compact
HB18-1032: Access Medical Records State Emergency Medical Services Patient Care Database PASSED HOUSE
HB18-1045: Dental Hygienist Apply Silver Diamine Fluoride PASSED HOUSE
HB18-1049: DHS Department of Human Services Authority to Lease Grand Junction Regional Center
HB18-1068: Eliminate Registered in Naturopathic Doctor Title PASSED HOUSE
HB 18-1085: Health Effects Industrial Wind Turbines KILLED IN HOUSE COMMITTEE
HB18-1094: Children and Youth Mental Health Treatment Act
HB18-1114: Require License Practice Genetic Counseling
HB18-1148: Stage Four Advanced Metastatic Cancer Step Therapy
HB18-1180: Mental Health Professional Dismissed Complaint Colorado Open Records Act Access
HB18-1182: Statewide System for Advance Directives
HB18-1202: Income Tax Credit Leave of Absence Organ Donation

Senate

Click on the Senate bill title to jump to its section:

MAJOR

SB18-022: Clinical Practice for Opioid Prescribing PASSED SENATE COMMITTEE
SB18-023: Promote Off-label Use Pharmaceutical Products
SB18-040: Substance Use Disorder Harm Reduction
SB18-080: Wholesale Canadian Drug Importation Program KILLED IN SENATE COMMITTEE
SB18-132: 1332 State Waiver Catastrophic Health Plans
SB18-146: Freestanding Emergency Departments Required Consumer Notices
SB18-152: Prohibit Price Gouging on Prescription Drugs

MEDIUM

SB18-024: Expand Access Behavioral Health Care Providers
SB18-115: Apply Stark Laws to Medical Referrals Outside Medicaid
SB18-130: Repeal Carrier Reporting Requirements to Division of Insurance
SB18-136: Health Insurance Producer Fees and Fee Disclosure PASSED SENATE COMMITTEE
SB18-153: Behavioral Health Care Related to Suicide Ideation
SB18-155: Hospital Community Benefits Reporting Requirements

MINOR

SB18-020: Registered Psychotherapists Auricular Acudetox PASSED SENATE
SB18-027: Enhanced Nurse Licensure Compact SIGNED INTO LAW
SB18-054: Cap Fee Increases Assisted Living Residences PASSED SENATE AND HOUSE COMMITTEE
SB18-065: Add Health Maintenance Organizations Life and Health Insurance Protection Association KILLED IN SENATE COMMITTEE
SB18-081: Emergency Medical Service Providers Licensing KILLED IN SENATE COMMITTEE
SB18-082: Physician Noncompete Exemption for Rare Disorder PASSED SENATE
SB18-113: Circle Substance Use Disorder Treatment Program KILLED IN SENATE COMMITTEE
SB18-148: Medical Benefits After State Employee Work-Related Death PASSED SENATE

HB18-1003: Opioid Misuse Prevention

Creates an opioid and other substance use disorder study committee consisting of five senators and five representatives from the general assembly to study data and stats on substance abuse problems in Colorado, the current resources and support available, what other states are doing to combat the problem, identify additional steps Colorado could take, and create legislative options to bring these steps to life. The bill also expands school-based health center grant programs to include education, intervention and prevention of substance abuse, directs the department of health care policy to award grants to substance abuse screening, intervention, and referral programs, and directs the center of research into substance abuse to develop and implement medical education activities around prescribing pain killers, in particular opioids.

Pros

Life expectancy in the United States has fallen in each of the past few years, largely, experts believe, due to opioids. Colorado must meet this crisis with everything it has, and we must understand what we are doing now and what we could be doing better. This bill is designed to not only get the legislature going on finding out best practices, but also sets up multiple grant opportunities to attack the problem head-on. We all want to jump in and solve everything right away, but sometimes it takes a little bit more effort to find the right solutions.

Cons

The key word here is crisis, and a multi-year committee seems too slow (granted the committee can put out bills without regard to usual legislative rules about timing). This bill may cause legislators not on this committee to stop working at helping stem this crisis, thinking they need to wait for their colleagues. The worry is not that this bill is not well-intentioned or that the crisis isn’t real, it’s that it’s not enough and the legislature will think that it is.

How Should Your Representatives Vote on HB18-1003

HB18-1006: Infant Newborn Screening

Updates Colorado’s newborn screening laws to provide more resources for follow-up testing to rule out false positives and strengthen the hearing screening, from an intent of 95% (current law) to all newborns with provisions for follow-up services with infants at risk of hearing loss. The bill creates a newborn hearing cash fund, funded by fees implemented by the executive director of the department of public health.

Pros

Hearing loss occurs in infants more often than any other condition for which screening is required. Early detection, intervention, and treatment are effective in facilitating healthy child development. Children who do not receive early help frequently require extra educational services, which are largely publicly funded. So this bill will in the end, save the state money. But really, that’s incidental to making sure that every child has access to the health care they need.

Cons

This bill sets up a nebulous fee structure with no constraints. The executive director will have the power to set this fee, however they’d like, and it’s likely to end up being passed on to consumers, through either insurance or direct payments.

How Should Your Representatives Vote on HB18-1006

HB18-1007: Substance Use Disorder Payment And Coverage

Requires all individual and group health benefit plans to provide coverage without prior authorization for a five day supply of buprenorphine (opioid used to treat opioid addiction) for a first request within a 12 month period. It also prohibits carriers from taking adverse action against a provider based on a patient’s satisfaction with pain treatment, mandates that benefit plans do not discriminate monetarily against those with chronic pain or substance use disorder diagnosis, and prohibits carriers from requiring step therapy that includes opioids before covering non-opioid options. For pharmacists, the bill allows them to administer injectable medication-assisted treatment for substance abuse (only if they are in a collaborative agreement with one or more physicians).

Pros

There are many fronts in the battle against opioids. This bill attacks the payment side, by making sure that insurers provide the treatment substance abusers need without overly punitive costs to make sure that they can get the treatment they need to get better. It also prevents physicians who either refuse to prescribe opioids or don’t submit to the medication seeking behavior of their patients from being punished for doing the right thing.

Cons

Chronic pain and substance abuse users utilize far more services than many other individuals and it is a burden to insurance companies to not be able to charge them appropriately. This burden will get shifted onto the rest of the population.

How Should Your Representatives Vote on HB18-1007

HB18-1009: Diabetes Drug Pricing Transparency Act 2018

Drug manufacturers and pharmacy benefit managers must submit annual reports to the state board regarding drugs used to treat diabetes that are subject to price increases at or above a certain percentage point. The state will publish a report of their findings and may impose penalties on those who do not comply. Nonprofits that advocate for patients with diabetes or fund diabetes medical research that receive contributions from drug companies on a list kept by the state board.

Pros

Nearly 300,000 Colorado adults are diagnosed diabetics and it is estimated that another 110,000 are undiagnosed but live with the disease. The annual medical cost related to diabetes in Colorado is $4 billion, 18% of which is prescription drugs. Insulin prices rose by 45% between 2014 and 2017. So we need to get to the bottom of what these drug companies are doing, because it is becoming an increasingly expensive load on the backs of Coloradans. It is also important that the public is aware of how much any nonprofit relies on a drug company or companies for its funding.

Cons

This bill puts onerous regulations on drug companies to come up with all sorts of paperwork (any costs of which will likely get passed to consumers) and then does do not do anything other than issue a report. Drug companies have to spend enormous sums on medical research, much of which doesn’t end up going anywhere, and thus need to be able to set the price of their medications where they see fit.

How Should Your Representatives Vote on HB18-1009

HB18-1012: Vision Care Plans Carriers Eye Care Providers

Prohibits insurance carriers from requiring eye care providers to discriminate against covered individuals when it comes to non-covered services, require covered individuals to participate in any other carrier plans, or set or require fees from the eye care provider to covered individuals.

PASSED HOUSE COMMITTEE

Pros

Those with eye care insurance should be treated the same as those without, this prevents insurance companies from leveraging their position to demand higher fees from those with their coverage or participation in other plans as a prerequisite for getting into an eye care plan. It’s basic fairness and lets the provider determine how much they want to charge, with the full knowledge of what the insurance carrier is willing to reimburse for.

Cons

Insurance carriers need the flexibility to charge providers what the insurance company needs. This bill inhibits that flexibility and may cause carriers to drop eye plans if they cannot get the money out of them they need.

How Should Your Representatives Vote on HB18-1012

HB18-1017: Psychology Interjurisdictional Compact

Joins Colorado to the Psychology Interjurisdictional Compact, which allows psychologists to practice in all states within the compact . This is a relatively new pact, and has three other members (AZ, NV, UT), with three pending (IL, MO, NE) and five states endorsed by psychology licensing board (NM, OH, RI, TX, WI).

Pros

Joining the pact would allow psychologists greater mobility, attract people from other states, and makes it easier to practice telehealth. Although this pact is fairly new, it probably will grow substantially and staying out of it would put Colorado at a disadvantage. Any individual moving to the state still has to obtain a Colorado license.

Cons

Being in an interstate compact yields some control for the state over the licensing process. While it is true that the bill specifies that the licensing standards of the state receiving telehealth are the ones that apply (so in the case of a Colorado resident being treated by someone from another state, Colorado's standards apply), the individual has still not been certified by the state of Colorado specifically and the assurance that they are qualified to have a license has not been granted by Colorado. Any potential remedies, which the bill does contain, would occur after at least some treatment has already occurred.

How Should Your Representatives Vote on HB18-1017

HB18-1032: Access Medical Records State Emergency Medical Services Patient Care Database

Requires the department of public health to provide individualized patient information from the department’s EMS agency patient care database to health information networks for any use allowed by HIPAA.

PASSED HOUSE

Pros

Health information networks are not getting the information out of this network that they need (to track patient behavior across the state to look for drug-seeking behavior, and to better coordinate patient care across multiple providers). In essence, the theory behind this database has not been implemented.

Cons

This bill provides no help to the department to implement this mandate, which is a goal that many believe in but has proven more complicated to create. For those that don’t believe in this concept, that patient information should not be accessible across providers, obviously this is a step in the wrong direction.

How Should Your Representatives Vote on HB18-1032

HB18-1040: Immediate Treatment Incentive Plans

Requires department of corrections to institute an incentive plan to contract for more mental health professionals in difficult to serve geographic areas if the number of inmates who need a treatment or service in the area exceeds the number of available spaces by 20%.

Pros

A large number of inmates are not receiving the treatment or services that were identified in their recommended rehabilitation reports. The department of corrections says this is because there are no enough mental health professionals who are interested in providing the treatment in difficult to serve areas. Inmates are therefore either being released without their treatment or denied parole and forced to remain in prison only because they can’t get this treatment. This is either dangerous or massively unfair. This bill helps the department by providing incentives including potentially increased fees, bonuses and travel reimbursements.

Cons

The bill doesn’t allocate the funds for these incentives, so the department is going to have to find the money somewhere, which is going to take it away from somewhere else.

How Should Your Representatives Vote on HB18-1040

HB18-1045: Dental Hygienist Apply Silver Diamine Fluoride

Allows a dental hygienist to apply silver diamine fluoride under the direct supervision of the dentist if they hygienist holds a license in good standing, completes a course on the use of silver diamine fluoride, is covered by professional liability insurance, and the dentist has a complete protocol setup.

PASSED HOUSE

Pros

This newer FDA approved treatment allows for noninvasive methods to stop tooth decay, particularly with young children. This leads to lower costs, fewer pediatric dental visits, and improved oral care. The treatment is safe, with the only negative a black staining in the tooth structure which should polish off. It is well within the abilities of a qualified dental hygienist to use.

Cons

The staining issue could be a problem if the treatment is misapplied, anything with this sort of negative downside should require the dentist, not a hygienist.

How Should Your Representatives Vote on HB18-1045

HB18-1049: DHS Department of Human Services Authority to Lease Grand Junction Regional Center

Authorizes the department of human services to continue leasing portions of the Grand Junction regional center campus to third-party behavioral health providers until 2020.

Pros

This is a beneficial arrangement for all, the department gaining funds and behavioral health providers continuing to have a physical location to use.

Cons

The state may be missing out on additional funds by not making these spaces available for lease to higher bidders.

How Should Your Representatives Vote on HB18-1049

HB18-1068: Eliminate Registered in Naturopathic Doctor Title

The law currently allows a naturopathic doctor to use the term “registered” in the doctor’s title. This law removes that ability.

PASSED HOUSE

Pros

This eliminates confusion for the public, who might reasonably believe that “registered” means that the doctor is registered in a similar manner to other doctors, when that is not the case.

Cons

This is part of a bias against holistic medicine. Naturopathic doctors get training, just like other doctors, and gain licensure from a governing body. This bill is an unnecessary swipe at the profession.

How Should Your Representatives Vote on HB18-1068

HB18-1082: A Woman's Right to Accurate Health Care Information

Requires that prior to having an abortion, a woman is given information about abortion alternatives and the option to see an ultrasound of the fetus. The woman must sign off that she was given this material. Makes it a crime for any abortion provider to not do it.

Pros

Ultrasounds are already done routinely by abortion providers, not doing one puts the woman’s health at potential risk. If more mothers knew the full picture about their choices and what their unborn baby looks like and will experience, more of them would choose to forgo the abortion and take another option and more babies would live. This is about giving full information, the decision still rests with the mother in the end.

Cons

This bill is yet another attempt to browbeat women while they make perhaps the most difficult decision of their lives. The assumption that they haven’t thought it through is insulting. This just makes the entire experience worse and puts more barriers between women and their right to choose what they do with their own bodies.

How Should Your Representatives Vote on HB18-1082

HB 18-1085: Health Effects Industrial Wind Turbines

Requires the department of public health to research and compile reports on the health effects of noise and stray voltage from industrial wind turbines on people and animals.

KILLED IN HOUSE COMMITTEE

Pros

Amid some reports of health problems, the state owes its residents a complete investigation to makes sure that this rapidly growing industry does not have any adverse health effects.

Cons

This is more of a culling of publicly available information and thus not something we need to spend a lot of time and energy having a state department do. Finding out if there are published health risks is something the legislature can do on its own, or give the department funds to conduct its own research.

How Should Your Representatives Vote on HB18-1085

HB18-1091: Dementia Diseases and Related Disabilities

Updates language relating to Alzheimer’s to better reflect that there are other dementia diseases. Missing people with a dementia disease is added to the missing person alert program.

Pros

This update reflects reality. Alzheimer's is a terrible disease and deserves our focus, but so do other dementia diseases. Recasting it this way broadens the view. The missing alert part of this is obvious, people with dementia frequently cannot locate where they are and require help.

Cons

Changing the law in this way may lessen focus on Alzheimer's itself, which remains the leading dementia illness, accounting for over half of all cases.

How Should Your Representatives Vote on HB18-1091

HB18-1094: Children and Youth Mental Health Treatment Act

Permanently extends the child mental health treatment act, renaming it the children and youth mental health treatment act. Also changes the act in a few ways. Evaluating mental health agencies must use a standardized risk stratification tool, the definition of mental health agencies is widened to capture larger set of behavioral health agencies, reports are required from these agencies on their activities, the department of human services is requiring to maintain a list of providers on its website, and the advisory board is modified.

Pros

This act ran out of funding last year, so the permanent extension is welcome and should help prevent such occurrences in the future. Standardized assessment tools are a common requirement in this industry, they just haven’t been made a part of this act before. Adopting them will help ensure everyone is using the same tools to make these evaluations and won’t be a “new” thing for these agencies. Reporting helps measure how we are doing with the state’s money and is information these agencies should have ready anyway as part of being an operating business.

Cons

This renewal adds a lot of paperwork burden to these agencies. In addition to yet another standardized assessment, which may or may not be different from what they have to use for other funders, the agencies have to provide quite a bit of aggregated information to the state and it may require extra work to prepare.

How Should Your Representatives Vote on HB18-1094

HB18-1097: Patient Choice of Pharmacy

Prohibits health insurance carriers that offer prescription drug coverage from restricting the ability of the covered individual to use the pharmacy or pharmacist of their choice, impose any fees or cost-sharing requirements for selecting a particular pharmacy, imposing any other conditions on this, or denying a pharmacy or pharmacist the right to participate in any network contracts if the they agree to the network conditions. All of these requirements do not apply to pharmacies that are owned by the health insurance carrier or those in managed care programs and do require the pharmacy or pharmacist to have agreed to the contract terms of the carrier.

Pros

People should have the right to choose the pharmacy of their choice and not be boxed by any side deals or other inducements insurance carriers have with pharmacies. The bill makes the reasonable exemption for plans where the entire point is that everything is done in concert under one system (managed care) or where the carrier and pharmacy are owned by the same entity.

Cons

This is an unreasonable restriction on the ability for insurance carriers and pharmacies to work together to provide the best benefits to consumers. It makes it impossible for carriers to prioritize pharmacies that provide better service or lower costs to the consumer.

How Should Your Representatives Vote on HB18-1097

HB18-1112: Pharmacist Health Care Services Coverage

Requires a health benefit plan to provide coverage for health services provided by a pharmacist if the services are within a health professional shortage area and if the plan covers the same services provided by licensed physician or advanced practice nurse.

Pros

Many areas of rural Colorado have serious shortages of physicians and nurses and it becomes difficult to get some of the run-of-the-mill treatment that pharmacists are allowed to provide by law (laws covering what pharmacists can and cannot do are not affected by this bill). This bill forces insurance companies to give coverage for these services within these shortage areas.

Cons

This forces insurance companies to allow behavior they may not agree with, while the law may permit services by a pharmacist the insurance company may have a good reason to believe these services are best performed by a doctor or advanced practice nurse.

How Should Your Representatives Vote on HB18-1112

HB18-1114: Require License Practice Genetic Counseling

Creates a licensure requirement and structure for genetic counseling requiring an appropriate genetic counseling degree and national certification, with a few small exceptions. Also requires counselors to carry insurance and abide by mandatory disclosures of past activity required by the Michael Skolnik Medical Transparency Act.

Pros

Genetic counseling is a medical field and we regulate medical fields for obvious reasons. This bill treats genetic counseling like any other medical field in the state.

Cons

Requiring a license for this emerging field may stifle innovation and keep some people out.

How Should Your Representatives Vote on HB18-1114

HB18-1120: The Prohibition of Dismemberment Abortions

Prohibits the use of a sopher clamp to perform abortion by dismembering the fetus in order to remove it from the mother’s body unless it is required by a medical emergency. Makes the crime a misdemeanor with a fine between $50 and $500.

*This bill has been assigned to the House's "kill" committee, state affairs*

Pros

Bad enough that an unborn child is being killed, but this procedure forces it to be mutilated as well. There are other ways, even if they are not as convenient for the mother and doctor. These types of abortions are extremely common, over 95% of second trimester abortions use them. The medical community needs to move to something else if it wants to keep doing these later-term abortions.

Cons

The use of this type of abortion in the first place is all about the health of the mother. It’s commonly done after 12 weeks so as to not damage the woman’s cervix and potentially undermine her future ability to have children, as well as being an out-patient procedure that carries less potential danger to the mother. This is a way to in effect ban abortion after 12 weeks since it cannot be done safely. A similar law in Texas was just blocked by federal courts, as were attempts in Alabama, Kansas, Louisiana, and Oklahoma. This won’t pass federal court scrutiny.

How Should Your Representatives Vote on HB18-1120

HB18-1121 No Funding Trafficking Aborted Human Body Parts

Bans any higher education institution that receives funding from the state from engaging directly or indirectly in the harvesting, trafficking, purchasing, or selling of aborted human body parts by removing funding if an institution does so.

Pros

Harvesting the bodies of dead babies for research subsidizes the abortion industry and provides an incentive to perform abortions, particularly late-term abortions which are more “valuable” for research. Recent videos and whistleblowers have shown alarming evidence that the potential for an actual industry structured around this practice exists. Research can still be done on fetal tissue from miscarriages or still births.

Cons

Fetal tissue research is critical in the development of life-saving medicine. It is different from adult tissue and represents a specific period of development where the cells have unique properties: they are more flexible, less specialized, easier to grow, and more adaptable. It is currently being used to develop and test vaccines for potential treatment of influenza, dengue fever, HIV/AIDS, and hepatitis B and C. It is vital for research in other areas as well. Ongoing research using cells derived from fetal tissue includes work on neurodegenerative diseases such as Parkinson’s, Alzheimer’s, amyotrophic lateral sclerosis, spinal cord injury, stroke, retinal disease, and age-related macular degeneration. It has been used in the United States since the 1930s. Federal law requires consent from the mother for its use and prohibit profit from selling or trafficking it in any way. Nearly all of the video and whistleblower “evidence” that these laws are being broken has been thoroughly debunked, either highly selective editing or outright lying was involved. There is no evidence that the practice of using fetal tissue from abortions has any influence on a mother’s decision to terminate her pregnancy. As for miscarriages and still births, congressional research has shown that these are often unpredictable and can pose serious health risks to the mother so that tissue collected under these circumstances is often not suitable for research purposes.

How Should Your Representatives Vote on HB18-1121

HB18-1136: Substance Use Disorder Treatment

From the Opioid and Other Substance Use Disorders Study Committee. Adds residential and in-patient substance use disorder services to the state’s medical assistance program. Contingent on the department of health receiving federal authorization required to secure federal financial participation in the program. Managed service organizations (groups that help funnel government money toward treatment) would reprioritize money from marijuana taxes to assist in these treatments for people who are not otherwise covered by public or private insurance.

Pros

Part of dealing with the opioid crisis is getting addicts the treatment they need, which frequently is in a facility, not on an out-patient basis. This bill helps the state leverage federal funds to do just that.

Cons

The marijuna fund is not a bottomless pool, the tax is already maxed out and money moved out of there is coming from somewhere else.

How Should Your Representatives Vote on HB18-1136

HB18-1148: Stage Four Advanced Metastatic Cancer Step Therapy

Prohibits insurance carriers from requiring a patient undergoing treatment for stage four advanced metastatic cancer to undergo step therapy (trying less expensive drugs first) prior to receiving a drug approved by the FDA if the drug is consistent with best practices for cancer treatment.

Pros

People with this kind of cancer don’t have the time to go through step therapy treatments, they need the medication their doctor is prescribing now, not when they’ve already tried the less expensive options and found them lacking.

Cons

This inhibits the ability of insurers to keep costs down, the entire notion behind step therapy is that there are frequently less expensive drugs that provide the same benefit and we need to try those first. Cancer treatment is already incredibly expensive and we all pay these costs in a distributed manner, that’s how insurance works. This bill will increase costs for everyone.

How Should Your Representatives Vote on HB18-1148

HB18-1177: Youth Suicide Prevention

Requires office of suicide prevention to work with appropriate entities to develop and implement a training program for people who regularly interact with potentially at-risk youth but are not in a profession that typically receives training, like camp counselors, rec center employees, youth group leaders, clergy, and parents. Office must approve at least three non-profits statewide to participate. Classes must be free to the public, the state will reimburse for any associated expenses. The office must also implement a public awareness campaign. The bill also lowers the age of consent for psychotherapy services from 15 to 12, except for a minor seeking inpatient services in which case it stays at 15.

Pros

Unfortunately we cannot always choose who a teen will or will not feel comfortable opening up to, so it is critical that the training that can save lives is spread as broadly as possible. In addition, the ability for a teen to see a school counselor without a parent’s permission could be the critical difference for a child who is unable to talk to his or her parents, for instance in a case where a gay or lesbian 12 year-old cannot come out to their parents and needs help.

Cons

Lowering the age of consent may prevent parents and caregivers from being involved in treatment, which would decrease the effectiveness of the treatment. If a school-based person or therapist is having a hard time getting consent for treatment from a parent that is a neglect issue and is probably indicative of other more significant problems in their child’s life.

How Should Your Representatives Vote on HB18-1177

HB18-1179: Prohibit Price Gouging on Prescription Drugs

Prohibits increasing the price of an essential off-patent or generic drug if the price increase is not directly attributable to additional costs for the drug. Also gives the attorney general the ability to subpoena any manufacturer they believe is price gouging and gives guidance on what essential off-patent drugs are and what remedies the courts have for forcing prices back down.

(this bill is essentially identical to SB18-152)

Pros

The entirely legal actions of Martin Shkreli, where he jacked Daraprim for $13.50 a tablet to $750 a tablet (a life saving drug that had no generic alternative in the US and cost as little as $0.10 a dose in other countries), are sadly not outliers. Consumers need protections from the laws of supply and demand when lives are at stake. People should not be forced to choose between bankruptcy and life saving medication. This bill would make actions like Shkreli’s illegal in Colorado. It is important to note that the alternative to Daraprim is not just Daraprim in different form: it’s the basic drugs compounded differently, with unknown efficacy and side effects in comparison. There is no FDA testing, as would be required for a generic version and obviously takes years. It might not be as good as Daraprim, which remains prohibitively expensive to this day.

Cons

This is price fixing by the government, pure and simple. The government should not be able to dictate what is and what is not a reasonable price increase in private industry. In cases like Daraprim, the obvious market solution is what in fact happened: another company stepped in and created the product that people actually wanted to buy, at a cost of $99 for 100 tablets.

How Should Your Representatives Vote on HB18-1179

HB18-1180: Mental Health Professional Dismissed Complaint Colorado Open Records Act Access

Currently, when a complaint against a mental health professional is dismissed, information contained in the files of the regulatory board is exempt from disclosure under public records law. This bill allows the mental health professional who was the subject of the complaint to access this information and the professional’s client names and other recipients of service cannot be redacted.

Pros

Mental health professionals should have the right not to treat individuals who are filing false complaints against them, this bill would enable them to do that.

Cons

This bill opens up the person who filed the complaint to retaliation from the mental health provider. Particularly in the field of mental health, that is a concern too big to allow.

How Should Your Representatives Vote on HB18-1180

HB18-1182: Statewide System for Advance Directives

Directs the department of health to create an electronic system that allows medical professionals and individuals to upload and access advanced directives for medical treatment (or non-treatment). Paid for by grants, gifts, and donations.

Pros

A paper system is an obvious problem in this area, where the whole point of an advanced directive is to enable an individual to make their wishes known when their medical condition makes it impossible for them to do so in the moment.

Cons

Electronic systems are more vulnerable to hacking and literal life and death decisions shouldn’t be exposed in this manner.

How Should Your Representatives Vote on HB18-1182

HB18-1202: Income Tax Credit Leave of Absence Organ Donation

Allows an employer a state income tax credit equal to 35% of their expenses incurred for paying an employee during a leave of absence to make an organ donation, not to exceed 10 working days, and the cost of temporary help during that absence. Not valid for employees who make more than $80,000 a year.

Pros

Nearly 2,400 Coloradans are on the waiting list for organ transplants and 96% could receive a donation from a living donor. The ability to get paid time off work is a large barrier for living organ donors. This bill would make it easier for the company to support short paid leave for an organ donation and hopefully will encourage more living organ donations.

Cons

Corporations already make too much money in this country and certainly don’t need yet more tax breaks.

How Should Your Representatives Vote on HB18-1202

HB18-1205: Financial Relief Defray Individual Health Plan Costs

Creates a program to help people who live in the three costliest counties in the state for health insurance premiums and who spend more than 20% of their household income on premiums. Individual or family must be between 400 and 500% household income above the poverty line (thus not eligible for federal subsidies) and not have access to Medicaid, Medicare, or an affordable employer sponsored plan. People who qualify will receive funds to bring their total cost back down to 20% for the lowest-cost Bronze level exchange plan. The state is limited to spending $6 million a year.

Pros

Premiums in rural areas are considerably higher than in metropolitan areas and in some places there is only one carrier offering coverage. Because of these high costs, and not qualifying for federal subsidies, many people in these areas may choose to go without insurance which is not only bad for their health and financial stability, but bad for all of us, as the cost of any emergency medical treatment they cannot pay will get passed along to everyone. This bill should help some of those people get the insurance they need.

Cons

We cannot afford to bail out the state exchanges with more money. The solutions to our insurance problems are not in government money but in freedom from the requirements of the Affordable Care Act.

 

From the other side: The $6 million limit should not be here. If people need help, we need to help them all, not just the ones who were fast enough to sign up before we hit the ceiling.

How Should Your Representatives Vote on HB18-1205

HB18-1207: Hospital Financial Transparency Measures

Requires the department of health care policy and financing to prepare an annual report detailing uncompensated hospital costs and expenditures information by payer group.

Pros

Getting a handle on our health care costs involves understanding where those costs are coming from, and one of the biggest cost centers is hospitals. This will allow us to have a better idea of not only what the landscape looks like, but if any changes are having an effect as we go forward.

Cons

This is too big an ask for hospitals, opening up their books for the government to examine and publicly parade around.

How Should Your Representatives Vote on HB18-1207

HB18-1211: Medicaid Fraud Control Unit

Establishes the Medicaid fraud control unit which will be responsible for investigating and prosecuting Medicaid fraud and waste, as well as patient abuse, neglect, and exploitation. Sets up penalties based on the amount of fraud, ranging from class 1 petty offense to class 2 felony.

Pros

Medicaid fraud is currently prosecuted under an executive order signed by Governor Roy Romer in 1987. It’s time to put it into state statute instead of relying on an executive order. The money saved will likely pay for the expenses of the new unit.

Cons

We already have a fraud unit inside the attorney general’s office, as well as a Colorado Medicaid False Claims Act to prosecute offenders under. This is not a widespread problem requiring this large change, the unit recovered over $22 million between 2013 and 2015. What we have is working fine.

How Should Your Representatives Vote on HB18-1211

HB18-1212: Freestanding Emergency Departments Licensure

Creates a new license specifically for freestanding emergency departments. The license prohibits freestanding emergency departments from charging a fee if the patient needs to be transported to another facility because the freestanding ER was unable to stabilize the patient. It also limits facility fees to be reasonably related to operating expenses and requires full reports on these fees to the state.

Pros

Colorado is one of the top three states in the nation for the number of FSEDs in the state. They need their own licensure and we need protection from circumstances where they either are overcharging or end up sending patients to full emergency rooms.

Cons

This goes too far in limiting what these facilities can charge. If the market won’t support the fees these freestanding ERs are charging, then they won’t get enough traffic and go out of business. The market, not the government, should be the arbiter.

How Should Your Representatives Vote on HB18-1212

HB18-1223: Declare Autism Epidemic in Colorado

Directs the state to convene the governor’s expert emergency epidemic response committee to determine if there is an autism epidemic in Colorado, if the committee determines there is one, then reasonable steps must be taken to address it and protect public health.

Pros

The number of children with autism in the state has grown at an alarming rate, with more than 7,000 school-age children reported in 2016. This bill makes the state confront this problem and commit real resources. Only one of the 18 recommendations of the 2009 autism commission’s recommendations have been taken up. It’s long past the time to act.

Cons

Autism does not spread. It is not a disease that is communicable and it is not something caused by the environment. The science is very clear on these points and the likeliest cause of the increase in diagnosis is simply that we are more aware as a society. Using communicable disease standards is therefore highly inappropriate.

How Should Your Representatives Vote on HB18-1223

HB18-1225: Protect Human Life at Conception

Prohibits abortion except in cases of protecting the mother’s health. Makes it a class 1 felony for the doctor, no punishment for the mother.

Pros

If you are against abortion, you should not want it to be legal at all. We should not allow mothers to end pregnancies unless their own health is at risk.

Cons

This bill is unconstitutional. The current law of the United States makes abortion legal and federal law is supreme. This bill also contains no exception for rape or incest, forcing a woman to carry her abuser’s baby to full term and delivery. Women have the right to make their own decisions about their bodies, this bill strips them of those rights.

How Should Your Representatives Vote on HB18-1225

SB18-020: Registered Psychotherapists Auricular Acudetox

Current law allows licensed mental health care professionals and level III certified addiction counselors who have documented that they have undergone auricular acudetox training (acupuncture addiction therapy) to perform auricular acudetox. This bill allows registered psychotherapists who can document that they have undergone the same training requirements to also perform the therapy.

PASSED SENATE

Pros

In the midst of the opioid epidemic, the need for addiction counseling is stronger than ever. This bills allows those in the mental health field who can prove they have been trained in this therapy to perform it, regardless of licensure.

Cons

Licensure exists for a reason, the experience required to gain a license is just as important as the training in any particular therapy. This bill would open up therapy to those who are not required to have this experience and thus are not as well equipped to deal with the wide range of experiences that occur in the real world.

How Should Your Representatives Vote on SB18-020

SB18-022: Clinical Practice for Opioid Prescribing

Restricts the number of opioid pills a health care practitioner may prescribe for an initial prescription to a 7 day supply and one refill for a 7 day supply, with a few exceptions. The bill also requires practitioners to query the prescription drug monitoring program before prescribing the first refill, with a few exceptions. Current law only allows practitioners to query the database.

PASSED SENATE COMMITTEE

Pros

The gateway into the opioid epidemic is prescription painkillers. This bill takes some necessary steps to reign in abuses in prescribing while still allowing medical professionals to give opioid painkillers to those that truly need larger amounts.

Cons

The bill gets between doctors and patients by severely limiting the amount of opioids a health care professional can prescribe. There are exceptions that the medical professional can claim, but with the drug monitoring program the state is going to have the ability to see what medical professionals are taking these exceptions and may take further action in the future. Getting medical professionals out of the habit of prescribing opioids (something many are already doing on their own) is not the job of the government.

How Should Your Representatives Vote on SB18-022

SB18-023: Promote Off-label Use Pharmaceutical Products

Allows a pharmaceutical manufacturer or its representative to promote off-label use of a prescription drug, biological product, or device approved by the FDA.

Pros

The bill contains protections for consumers by requiring any promotion to be truthful and consistent with generally accepted scientific principles. It will allow companies to not have to apply to the FDA every time they find another use for one of their products and want to advertise that use to the public. This will greatly benefit public health, as consumers become aware of effective treatment options from products that already have FDA approval, just not for this exact usage.

Cons

The reason we have the FDA is to make sure that any promoted usage of these potentially dangerous products has been thoroughly examined by a neutral party, not the pharmaceutical company itself. This bill opens up Pandora’s Box, allowing pharmaceutical companies wide latitude in deeming what its products can be used for and the history of pharmaceutical companies does not indicate they will use this latitude wisely.

How Should Your Representatives Vote on SB18-023

SB18-024: Expand Access Behavioral Health Care Providers

This bill modifies the Colorado health services corps program, a loan repayment program that targets the need for primary care services in health care professional shortage areas in the state. The program provides loan repayment to professionals who commit to practicing and providing primary care in a shortage area for at least two years. The bill adds behavioral health providers to the program, prioritizing those that work in the non-profit sector. It also establishes a scholarship program for those obtaining addiction counseling certifications. It pays for these additions with $2.5 million from the marijuana tax fund.

Pros

Behavioral health counseling is just as needed as primary care and this bill allows the state to help underserved areas, just as it already does with primary care providers. These underserved areas are particularly hard hit by the opioid crisis since they do not have the treatment facilities to deal with it. The scholarship program will help address the crisis directly.

Cons

The bill opens up the program to licensure candidates, not just those with licenses already. While it is true that the bill requires the two year commitment to occur after licensure, it opens up the state to spending money on individuals who may never obtain licensure. It is not a guarantee and the bill does not address what happens if the licensure candidate fails to obtain a license. The marijuana tax fund is also not a bottomless well, we’ve already increased the tax to the maximum allowed and the money is already being used for a variety of purposes.

How Should Your Representatives Vote on SB18-024

SB18-027: Enhanced Nurse Licensure Compact

This bill replaces the current nurse licensure compact, which allows nurses to practice in all states within the compact, with the new enhanced compact. The state joins 26 other states in the compact.

SIGNED INTO LAW

Pros

Not joining this is devastating for nursing in Colorado: mobility, attracting people from other states, telehealth. We’d be stuck with just Wisconsin, New Mexico, and Rhode Island in the old compact and they will probably jump ship to the new compact too, leaving us by ourselves. We already have a shortage of nurses in the state, do not need to add more barriers. The license standards are robust and have worked great for the state already.

Cons

Being in an interstate compact yields some control for the state over licensing standards. Instead of creating our own we have to adhere to what this group of states has decided. While it is true that nurses moving here would have to obtain a Colorado license, we would be guaranteed they were up to Colorado standards.

How Should Your Representatives Vote on SB18-027

SB18-040: Substance Use Disorder Harm Reduction

Specifies that hospitals can be used as clean syringe exchange sites, provides civil immunity for participants in the clean syringe exchange program, creates a supervised injection facility pilot program in Denver and provides civil immunity for those in the program, allows schools to obtain opioid antagonists and train employees to administer them to counteract overdoses, requires sentencing commission to study opioid related sentencing offenses.

*This legislation has been sent to the Senate “Kill” committee, State Affairs*

Pros

Clean syringe exchanges are already operating in Colorado, this merely provides the best possible place for this exchange, a hospital, to be eligible. Schools should have the ability to stop overdoses if they can, there are literally lives at stake and the antagonists are not going to contribute to anyone using drugs more. The most controversial provision is undoubtedly the injection pilot program. We need to be realistic. Opioid addicts are going to shot themselves up with heroin. Doing it out in the streets just leads to more deaths. This provides a chance to keep them alive long enough to get them clean. It’s also an opportunity: users are going to come in and tell us they are addicts, giving us a chance to convince them to go into treatment.

Cons

The state should not be encouraging drug use. Syringe exchanges and injection facilities are all ways to make it easier to abuse drugs. How are we supposed to get people clean if we’re handing them needles and safe (and legal!) places to shoot up? No one wants people to die, but we cannot stop the behavior by encouraging it.

How Should Your Representatives Vote on SB18-040

SB18-054: Cap Fee Increases Assisted Living Residences

Fixes a loophole in the law for the state board of health’s fee assessment for assisted living residences. Currently the board can raise fees higher than the inflation rate, which is not the case for most department-regulated health facilities. The bill imposes the inflation limit on fees for assisted living residences.

PASSED SENATE AND HOUSE COMMITTEE

Pros

This merely brings assisted living residences into the same system as most other department-regulated health facilities, a system that works just fine. Fees only need to keep pace with inflation in most circumstances and if something truly unique comes up that really does require a higher increase the legislature can always step in.

Cons

This makes it more difficult for the state board of health to accurately increase its fees to account for its costs. While it is true that the state legislature can always change the law, that is a slow process.

How Should Your Representatives Vote on SB18-054

SB18-065: Add Health Maintenance Organizations Life and Health Insurance Protection Association

Adds health maintenance organizations (HMOs) to the state’s life and health insurance protection association (a non-profit made up of member companies from life and health insurance companies to fulfill obligations of policies issued by carriers that become insolvent). To boost the association’s funds to deal with the new potential insolvency obligations, it adds a $2 fee for health benefit plans to charge the policy or contract holder, with all funds going into a special fund solely for health insurer insolvency.

KILLED IN SENATE COMMITTEE

Pros

It makes sense to add HMOs to this association and protect Coloradoans from facing the possibility of paying into insurance that suddenly no longer exists. Many residents don’t have the luxury of simply switching carriers, they have medical bills that need to be paid and most insurance plans don’t cover any expenses occurred before you signed up.

Cons

This is in effect a $2 fee hike on either Colorado residents (if they are self-insured) or Colorado businesses (if they provide insurance).

How Should Your Representatives Vote on SB18-065

SB18-080: Wholesale Canadian Drug Importation Program

Creates a program by which the department of health can import prescription pharmaceuticals from Canada. The program must ensure drug safety and cost savings for Coloradans and must be approved by the federal department of health and human services.

*This bill has been sent to the Senate “kill” committee, state affairs*

KILLED IN SENATE COMMITTEE

Pros

It is estimated that US citizens pay twice as much as Canadian citizens for patented prescription drugs and 20% more for generic drugs. Federal law allows this program to exist, so long as it ensures drug safety and cost savings. Canada has its own version of the FDA and the US and Canada have a memorandum of understanding on pharmaceutical regulation cooperation since 1973. So this can be done safely, with proper precautions against fraudsters. This is literally a matter of life and death for many people, who sometimes have to choose between medication and other basics like clothing and food. We need to provide our citizens some other way to get the life-saving medicine they need.

Cons

The FDA opposes this for safety concerns. Canada may have its own version but it is not the same as our FDA. Importation also greatly increases the risk of counterfeiting, particularly with Internet pharmacies. The state’s ability to construct some sort of monitoring system to ensure safety may either not exist or be extremely expensive. This bill makes no provisions for funding at all. Also, massive importation from Canada is just going to drive up the prices in Canada, since they aren’t sitting on massive stocks of drugs just to sell to Americans.

How Should Your Representatives Vote on SB18-080

SB18-081: Emergency Medical Service Providers Licensing

Changes emergency medical service provider regulation from “certification” to “license” and adds the group to the list of providers who must comply with the Michael Skolnik Medical Transparency Act, which requires individuals to disclose information about their work history, including disciplinary actions, malpractice settlements, and stipulations in their license (among others).

KILLED IN SENATE COMMITTEE

Pros

Emergency medical service providers are health care professionals and thus belong with other health care professionals in the transparency act.

Cons

The transparency act is designed to help consumers make better informed choices about their health care providers. But consumers generally don’t choose their emergency medical service providers, it’s a situation thrust upon them. So the transparency act will not help and will instead just cause more paperwork for emergency medical service providers.

How Should Your Representatives Vote on SB18-081

SB18-082: Physician Noncompete Exemption for Rare Disorder

Makes an exception to physician non-compete agreements (whereby a physician who leaves a group practice may be compelled to pay damages for soliciting former patients) for patients with a rare disorder, as defined by nationally recognized criteria, who would otherwise not have ready access to a physician for treatment.

*This bill has been assigned to the Senate’s “kill” committee, state affairs*

PASSED SENATE

Pros

We should not be playing with people’s lives here. Rare disorders need specialized care and in some areas of the state there may not be another option beyond one doctor. This is an instance where the need of the patient trumps the financial needs of the profession.

Cons

The bill makes no attempt to define having access to another physician for treatment so there will be no burden for anyone to look. This is a case of the government meddling in the private sector. Non-compete clauses are essential for any form of business with clients or patients as they protect the business that help build up that client or patient list from huge losses if someone jumps ship. The more holes you put in the clauses the less effective they become.

How Should Your Representatives Vote on SB18-082

SB18-113: Circle Substance Use Disorder Treatment Program

Establishes in law the circle substance program in Pueblo, a 90-day inpatient treatment program for people with co-occurring mental health and substance use disorders. This program was closed last June by the department of human services because of staffing problems in the hospital where it is located.

KILLED IN SENATE COMMITTEE

Pros

The circle program was the gold standard in the state with a four-six month waiting period and a nearly 80% program completion rate. A 2011 study estimated it had saved the state nearly $3 million in just two years through treatment rather than incarceration.

Cons

This bill puts the program in statute but does nothing to fix the underlying problems at the state facility in Pueblo that caused it to close in the first place. The state hospital was at risk of losing federal funding due to violating required staffing ratios and had to make some hard choices. Perhaps the program needs to be funded separately or moved to another provider or another location.

How Should Your Representatives Vote on SB18-113

SB18-115: Apply Stark Laws to Medical Referrals Outside Medicaid

Currently health care providers who receive reimbursement through Medicaid are prohibited from making referrals to an entity owned or controlled by the provider or family members, with some exceptions. This bill extends the prohibition to all health care providers, not just those in Medicaid.

Pros

Federal law was constructed with these “Stark” laws for a reason: to keep health care providers from profiteering off of consumers who do not have the knowledge of the medical community (who does?) to make an informed decision that the referral is just to get money out of them. Prior to Stark laws being enacted in 1992 under a Republican president (so yeah, we’ve been living with them for a long time), the government found it was being overcharged by $28 million in Medicare in 1987 alone. So it does not make sense that this law does not extend to all health care providers, period. There is no reason only Medicaid consumers should enjoy this protection and everyone else should not.

Cons

This gets between a doctor and their patient. Doctors can choose not to accept Medicaid patients if they do not want to deal with these restrictions, this would force the restrictions on everyone. No one should be punished because they happen to be related to another physician or provider. Let the market expose and deal with anyone making phony referrals.

How Should Your Representatives Vote on SB18-115

SB18-130: Repeal Carrier Reporting Requirements to Division of Insurance

Repeals requirement that health insurance carriers report average reimbursement rates for inpatient day or 25 most common inpatient procedures.

Pros

Current law is an unreasonable burden on insurance carriers to develop all of this information.

Cons

This is a step in the wrong direction. We’ve been trying to increase price transparency in health care for years, to shine some sunlight on what can be wildly varying pricing in the industry. Without an average to compare to, it can be difficult for consumers to understand how expensive the treatment being proposed actually is.

How Should Your Representatives Vote on SB18-130

SB18-132: 1332 State Waiver Catastrophic Health Plans

Requires state to ask for federal waiver to allow catastrophic health plans (less expensive insurance designed only to cover catastrophes) to be sold to any individual on the state exchanges.

Pros

Some younger fitter people simply don’t need all of the bells and whistles of full insurance. They are forced to pay higher premiums (or simply don’t get insurance at all) rather than getting what they want and what the market can provide: insurance that protects them in case of some catastrophe but nothing else. People should be able to decide for themselves what kind of insurance they want in a free country.

Cons

Those under 30 can already get this insurance on the exchanges. Anyone over 30 needs real insurance. This isn’t just about protecting people from their own bad choices (we’ve sadly seen too much evidence that people don’t understand what their insurance does and does not cover until it’s too late), when someone can’t afford to pay their medical bills that cost rebounds to all of us. People who don’t have copays for routine preventative care tend not to get that preventative care at all. That’s bad for their long-term health and bad for all our pocketbooks when it results in dangerous situations not being addressed early.

How Should Your Representatives Vote on SB18-132

SB18-136: Health Insurance Producer Fees and Fee Disclosure

Allows health insurance brokers to charge a fee if they do not receive a commission related to the health plan selected and if the fee is disclosed.

PASSED SENATE COMMITTEE

Pros

Brokers are currently encouraged by the system to steer clients into products that will provide them a commission. This lets them make the best decision instead, since they will get paid either way.

Cons

This steers things in the opposite direction. With no guidance on the fee, the broker can charge more than they would receive in commission and steer clients in the opposite direction.

How Should Your Representatives Vote on SB18-136

SB18-146: Freestanding Emergency Departments Required Consumer Notices

Requires free standing emergency departments (FSED) to provide anyone who enters the facility a written declaration of their rights, including that the FSED will treat any individual regardless of ability to pay, that individuals have the right to ask questions and reject treatment, and that the facility is not an urgent care but an emergency facility. The FSED must also post a sign indicating what insurance plans it accepts and its price for the 25 most common health care services. After determining that a patient does not have an emergency, the FSED must provide in writing the information on the sign, as well as some additional information about making payments.

Pros

Emergency departments, including FSEDs are widely recognized as the most expensive setting for receiving nonemergency health care and data indicates that seven of the top ten reasons for visiting a FSED are for nonemergency situations. Furthermore, Colorado is one of the top three states in the nation for the number of FSEDs in the state. FSEDs are not urgent care replacements and too often patients are ending up at them when they have viable less expensive alternatives.

Cons

This is overly burdensome to FSEDs, who are basically directed to drive away their customers unless it is an emergency. If patients don’t realize they can get cheaper care elsewhere, that is not the responsibility of the FSED.

How Should Your Representatives Vote on SB18-146

SB18-148: Medical Benefits After State Employee Work-Related Death

Currently when any state employee dies, their family loses their benefits at the end of the month of their death. This bill changes this only if the employee dies in a work-related death. In this case the state must continue to give health and dental benefits (same coverage) for a full year after death and pay for their cost.

PASSED SENATE

Pros

It’s really the least the state can do if an employee dies while at work for the state. Cutting off the family from all of their benefits right away is cruel.

Cons

While any death is of course tragic, this puts the state on the hook for tens of thousands of dollars for any work-related death without considering any sort of fault. Some state jobs, like police officer, are inherently dangerous and unfortunately tragedies happen. That is not the state’s fault.

How Should Your Representatives Vote on SB18-148

SB18-152: Prohibit Price Gouging on Prescription Drugs

Prohibits increasing the price of an essential off-patent or generic drug if the price increase is not directly attributable to additional costs for the drug. Also gives the attorney general the ability to subpoena any manufacturer they believe is price gouging and gives guidance on what essential off-patent drugs are and what remedies the courts have for forcing prices back down.

*This bill has been assigned to the Senate “kill” committee, state affairs*

Pros

The entirely legal actions of Martin Shkreli, where he jacked Daraprim for $13.50 a tablet to $750 a tablet (a life saving drug that had no generic alternative in the US and cost as little as $0.10 a dose in other countries), are sadly not outliers. Consumers need protections from the laws of supply and demand when lives are at stake. People should not be forced to choose between bankruptcy and life saving medication. This bill would make actions like Shkreli’s illegal in Colorado. It is important to note that the alternative to Daraprim is not just Daraprim in different form: it’s the basic drugs compounded differently, with unknown efficacy and side effects in comparison. There is no FDA testing, as would be required for a generic version and obviously takes years. It might not be as good as Daraprim, which remains prohibitively expensive to this day.

Cons

This is price fixing by the government, pure and simple. The government should not be able to dictate what is and what is not a reasonable price increase in private industry. In cases like Daraprim, the obvious market solution is what in fact happened: another company stepped in and created the product that people actually wanted to buy, at a cost of $99 for 100 tablets.

How Should Your Representatives Vote on SB18-152

SB18-153: Behavioral Health Care Related to Suicide Ideation

Requires the department of public health to identify and address any data gaps that may exist in the department’s office of suicide prevention. Also must collaborate with community partners to evaluate best practices for suicide prevention. The bill requires the implementation of the new federal Medicare payments codes designed to pay for performance rather than treatment. It also requires the department to create a universal outpatient mental health form that allows individuals to consent to the release of their health care information when transitioning from different environments to better coordinate care. Finally, health care facilities must have a plan in place for increased levels of community-based care and support for individuals transitioning from inpatient to community-based care who are being treated for suicide risk.

*This bill has been assigned to the Senate “kill” committee, state affairs*

Pros

Suicides in the state have been increasing and reached their highest rate ever in 2016, the last year for which we have data. The opioid epidemic is of course a factor in this as well. This bill addresses this problem by looking to fill in the gaps that can occur when a potentially suicidal person moves between treatment facilities.

Cons

The problem is not forms and plans for increased levels of care in community-based care, these basically already happen. The problem is the timely release of information from different providers which this bill does not address. It instead just adds more layers of bureaucracy.

How Should Your Representatives Vote on SB18-153

SB18-155: Hospital Community Benefits Reporting Requirements

Requires hospitals that are exempt from state or local taxes to report the tax benefits they receive and the community benefits they provide. The state would analyze the reports and make any recommended changes to the exemption system to the general assembly.

*This bill has been assigned to the Senate “kill” committee, state affairs*

Pros

We provide enormous exemptions to hospitals because they are obviously critical elements of our communities and provide benefits sometimes without payment, as they are required to treat anyone by law. However, there have been numerous examples throughout the country of supposedly non-profit hospitals taking advantage of these exemptions without providing the community benefits. A recent government accountability office study found no difference between non-profit and for-profit hospitals in their amount of uncompensated care. UC-Health got singled out for this behavior three years ago. We need to make sure taxpayers are not being taken advantage of.

Cons

This is a wasteful exercise. Any hospital that the state believes is violating any non-profit rules or regulations around seeing patients can be investigated for those violations. This bill is just added costs to the hospitals to prepare the report and added costs to the state to analyze it. Guess who will end up paying for all of that?

How Should Your Representatives Vote on SB18-155