Source: Colorado Politics
The adage even a stopped clock is accurate twice a day seems appropriate to Gov. Jared Polis’ excitement for the nomination of Robert F. Kennedy Jr. to serve as the Secretary of Health and Human Services in the Trump administration. Even the nominee’s hometown paper, the Boston Globe, headlined its recent editorial, “RFK Jr? Seriously?”
For a man with one eye on the Democratic presidential nomination in 2028, this sure feels like a political blunder. Kennedy’s periodic desire to focus on the American diet and illness prevention over the treatment of chronic disease makes considerable sense. On nearly everything else, he is a threat to public health and American lives. Just ask American Samoans who listened to his anti-vaccine ranting only to experience a measles outbreak the following year which killed 80 Islanders, most of them children.
Before the MMR vaccine that protects against measles was developed, more than a million kids came down with the disease each school year producing thousands of deaths. The most recent annual incidences were 15 cases and zero fatalities — quite an improvement. We also no longer fear polio or smallpox. Each is so rare we rarely bother to vaccinate against them, having snuffed these scourges out across the United States. My Generation X children are among the last to sport a smallpox scar on their shoulders. Giving the governor modest credit, he may be hoping to keep the federal door open for exceptions from any changes to federal regulations governing health insurance. In his zeal to reduce the cost of health care coverage, Colorado introduced the “Colorado Option” as a bellwether, low-cost plan offered on the state’s insurance exchange.
The purpose was to demonstrate private plans are overpriced and, ultimately, to force premiums down among all carriers. The experiment has proven a failure. The governor’s attention would be better spent attempting to remedy a strategy that has perversely reduced competition, penalizing many Coloradans with fewer choices — especially in rural and mountain counties. Worse yet, the Colorado Option isn’t even the cheapest available option despite mandated premium reduction targets established in its enabling legislation. Less than 1% of residents have enrolled in what passes for a “public option” program, yet has stifled coverage. Nearly 40% of private plans have exited the Colorado market.
The Achilles heel in the Colorado Option is the notion market costs can be managed with price controls. One is reminded of King Canute’s effort to command the tides by ordering the sea to recede. It didn’t work for a king and it hasn’t worked for our governor. The desire to improve affordability by reducing premiums is belied by the necessity for increasing Colorado Option premiums 4.25% in 2025. Reality can prove a harsh mistress. With the expected rollback in Medicaid coverage, which had been extended in response to the COVID pandemic, more than a half-million Coloradans have lost their access to health care. The state was asleep at the switch despite the fact deadlines were well known. Consequently, there is an urgent need to offer genuinely affordable plans to these families.
Unfortunately, it has been counties distant from the Front Range that have experienced the greatest loss of plan choices, up to 75% now gone. Their residents now face daunting premiums for minimal access to medical assistance in health care “deserts” that require travel to the Front Range for any but the most basic care. It isn’t apparent the Colorado Option can be “fixed.” In the near term, reopening the exchange to true competition by scuttling the program would, at the very least, expand options. Ordering premium reductions as though pricing can be manipulated independently from costs is a fool’s errand that ultimately penalizes the public by placing health insurance beyond the reach of family budgets. Small wonder America’s health results trail most other advanced nations.
The Polis administration has been so focused on “saving money for Colorado taxpayers” it has become penny wise and pound foolish. During the past 50 years, the health care sector has grown its size in the economy from a single digit to 20% plus. Together with the financial industry, which has pulled a similar maneuver, nearly half the nation’s GDP is now generated between them. Costs, however, for health care are primarily driven by providers — doctor practices and hospitals, many of which have been gobbled up by hedge funds and holding companies. Expecting insurance companies to drive costs is rather like trying to lead your dog by the tail.
It’s past time for the legislature to rethink the structure of coverage for their constituents if Colorado is to extend health care access at an affordable price statewide. The sick will be treated, the injured will be healed and the more who have insurance the lower will be the average individual cost. It’s all well and good to talk about competition, but when you break a leg, you don’t go shopping on Craigslist for an orthopedist. Comparison shopping for medical care is a myth. You drive to the closest emergency room or urgent care. They expect to be compensated. There may be a national health service in our future — some version of single payer — but that’s a long way off. For now, we need to keep tinkering with the insurance structure we have and it’s abundantly apparent the Colorado Option, though well-intentioned, isn’t a solution to our problems. Rather, it’s contributing to them.
