Public-option hearings may move insurance, health providers to lower costs
(Colorado News Connection) Rocky Mountain Health Plans and Anthem Blue Cross Blue Shield, health insurance companies who offer lower-cost public option plans, have failed to meet their premium reduction targets and will face public hearings next week.
At the Colorado Consumer Health Initiative, Deputy Director Adam Fox said transparency on pricing - a big part of a new state law aiming to bring down overall health costs - seems to be working.
"The process is creating an incentive," said Fox, "for the insurance carriers and hospitals to reduce costs."
Hearings on June 20 and 22 can be accessed through the Colorado Division of Insurance website, doi.colorado.gov.
The DOI recently called out pricing at 20 hospitals, costs ultimately passed along to consumers through higher insurance premiums.
The Colorado Hospital Association criticized the move as an over-reach of authority, and points to other sources of higher costs - including the rising price of prescription drugs.
Cigna Healthcare and Kaiser Permanente, the other two Colorado Option carriers in the state, didn't face public hearings because they reached settlements with providers.
Fox noted that the DOI has broad regulatory powers to implement the Colorado Option law passed in 2021, and is supposed to try to ensure the carriers meet the premium reductions.
"And the insurers who didn't file a complaint didn't fully participate in the process," said Fox. "And DOI stepped in because they didn't, and that is part of their regulatory authority."
The statute calls on insurance carriers to reduce premiums by 15% for the 2025 plan year, and the DOI can force hospitals to bring prices down closer to Medicare reimbursement rates.
Fox said he'll be watching to see how the settlements affect next year's insurance rates, expected to be announced in August.
"Colorado's going to be a great test case," said Fox, "as to how far this type of model can go to reduce costs and make health coverage more affordable, and ensure that the hospitals and providers are held accountable in that process."
