SB23-195

SB23-195 ensures any payments made by or on behalf of a covered person are counted in the calculation of the covered person’s contributions toward cost-sharing requirements. This bill reinforces the benefits of copay assistance programs and ensures access to life-saving, high-cost medicines that do not have generic alternatives, or for which generic alternatives remain prohibitively expensive. SB23-195 aligns with federal IRS guidance for high deductible plans with health savings accounts and similar legislation has passed in 16 other states with minimal to no fiscal notes or premium impact.

HB23-1183

HB23-1183 will align Medicaid’s existing step therapy protocols with commercial plans to reduce administrative burden for health care professionals, save money on unnecessary care, and improve health outcomes for Medicaid recipients living with complex medical conditions. Coloradans on Medicaid will have the same common sense criteria for step therapy exceptions that are in place for commercial plans. It will bring clarity and consistency for pharmacists and medical providers while allowing HCPF to retain the authority to approve or deny an exception request and use step therapy as a cost cutting tool in the vast majority of situations.

HB22-1370

HB22-1370 will provide immediate cost relief for Coloradans by making health care coverage more
affordable and dependable by reducing out-of-pocket costs of prescription drugs at the pharmacy counter and enacting fair, common-sense reforms. This bill also ensures that consumers get the treatment recommended by their doctor – not their insurance company. HB22-1370 helps Colorado consumers know exactly what they’ll be expected to pay for services when they sign up for health insurance by requiring 25% of plans to have set dollar amount co-pays, rather than unpredictable percentage-based payments. This will allow Coloradans to plan ahead rather than be surprised by unexpected costs. This bill ensures medications cannot be dropped from coverage and that out-of-pocket costs for medicine cannot increase for consumers in the middle of their one-year contract for health insurance. HB22-1370 will pass rebates currently pocketed by insurance carriers or unregulated parts of the pharmaceutical supply chain directly to consumers to provide an immediate reduction in out-of-pocket costs. This bill will reform step therapy protocols by providing a clear path for exemptions for providers and patients to help Coloradans get the medicine they need at the right time without having to first try and fail on a treatment that is not medically recommended.

HB21-1232 Standardized Health Benefit Plan Colorado Option

For at least three years, there has been a vigorous debate at the state Capitol about the creation of a “public option” insurance plan. At the most basic level, legislative proponents and consumer advocates have asserted the need for a more affordable health insurance plan available throughout the State of Colorado. While the fundamental goal has been consistent, the method of reaching that goal has evolved considerably. The moniker “public option” is much more descriptive of the legislation dating back to 2019. As adopted, HB21-1232 creates a standardized insurance plan to be offered by all carriers with required participation
from health care providers. The plan must be available in all the different geographic parts of the state and must represent a 15 percent decrease in price relative to existing plans. 

SB21-175 Prescription Drug Affordability Review Board

SB21-175 creates the Colorado Prescription Drug Affordability Review Board as an independent unit of state government. The board will collect and evaluate information on the cost of prescription drugs sold to Colorado consumers and perform affordability reviews. It will then establish prescription drug upper payment limits on a maximum of 12 drugs in each of the first three years. The board will also make policy recommendations to the General Assembly to improve drug affordability and report annually to the Governor and General Assembly on drug prices, board activity, and impacts to health care providers and pharmacies. Beginning January 1, 2022, it is unlawful to purchase a prescription drug at a cost that exceeds the cap established by the board. 

HB20-1008: Health Care Cost-Sharing Consumer Protections
HB20-1232: Equity in Access to Clinical Trials in Medicaid
HB20-1349: Colorado Affordable Health Care Option
SB20-030: Consumer Protections for Utility Customers
SB20-215: Health Insurance Affordability Enterprise