Straight talk on health care reform: Bipartisan effort to create health exchange a good step forward

At a time when political bipartisanship is a rare event, state leaders from both parties have reached agreement on a matter of real substance.

Key Republican and Democratic legislators, in conjunction with Governor Hickenlooper's office, have achieved consensus on the governance and structure for a health benefit exchange in Colorado. The result is Senate Bill 200, sponsored by Representative Amy Stephens (Republican Leader of the House) and Senator Betty Boyd (Democratic President Pro Tempore of the Senate and Chair of the Health & Human Services Committee).

A health benefit exchange will provide consumers and small businesses with a one-stop marketplace where they can find information about health plans and health insurance policies, and where they can enroll in whichever plan they choose. The exchange will allow users to easily compare health insurance options based on price, benefits, services and quality.

The exchange simply offers one more option for purchasing health coverage. Individual consumers and small businesses are free to use the exchange or any other available method to get insurance. Still, the exchange has the potential to create a more efficient and competitive market by pooling more people together. A well functioning exchange could reduce costs, improve quality and increase transparency for consumers and businesses.

States must demonstrate by 2013 that they are sufficiently prepared to implement a health benefit exchange. If states are unwilling or unprepared to do so, a federally run exchange (which has yet to be described in any detail) would be implemented by January 1, 2014. To date, only Florida and Louisiana have elected not to implement a state run exchange.

Colorado is wise to move forward with its own exchange. Unlike the federal option, Senate Bill 200 creates a Colorado specific-solution to meet the unique needs of the citizens in our state. It will create a non-profit organization to oversee the establishment and operation of the exchange. Most importantly, it requires an open and public process for creating the exchange, with open meetings, open records, and clear conflict of interest policies and accountability.

The non-profit oversight body will be governed by a board of directors composed of 9 voting members appointed by the Governor and state legislature and 3 non-voting members representing three key state departments. A 10 member Legislative Health Benefits Exchange Implementation Review Committee will guide implementation, review operational plans and grant applications, carry legislation and make other recommendations.

This legislation only represents the first step in a much longer process. And as with most legislation, there is room for improvement. For instance, we believe the bill should include language explicitly establishing cost containment and quality improvement as major goals for the board of directors. The board of directors should also have approval authority over grant applications, rather than the legislative review committee which might be more subject to undue political pressure. We will advocate for these improvements as the bill works its way through the legislature.

Nevertheless, Senate Bill 200 represents an important step forward. The majority of Colorado's citizens want our elected representatives to work together toward a common good and avoid political deadlock. We thank the bill sponsors and the Governor's Office for their leadership, and we hope the process will continue to be bipartisan.