2021 Leg Session, Health Care, Jesse Mallory

Mallory: ‘Public option’ can’t deliver on its many promises

Colorado State Rep. Dylan Roberts claims his “public option” bill would lower health insurance costs and increase access to care. In fact, it would do the opposite.

Roberts’ plan would force Colorado’s health care system — still reeling from the coronavirus pandemic — to lower premiums by 20% in just two years. If the system can’t meet this arbitrary mandate, the state would create a government health insurance plan available to any Coloradan, not just those without insurance.

We don’t doubt Rep. Roberts’ sincerity when he promises, “those who like their current coverage can stay on it.” But it does sound suspiciously like this promise during another health care debate: “If you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan.” That one didn’t exactly pan out; neither will this one. Here’s why.

It is estimated that within 10 years under a public option, a third of Coloradans who now have private health insurance would move to public option plans. Since fewer doctors see patients on public plans, Coloradans would have less access to the doctors they want.

As for cost, we should heed the warning out of Washington state, which adopted a public option plan last year. Bloomberg Law reports that despite politicians promising lower costs, Washington’s public option plans “cost as much as 29% more than traditional plans.”

In previous versions of Colorado public option bills, the state would have paid doctors and hospitals between 155% and 218% of what Medicare pays. Private insurers in Colorado currently pay more than 250%. How would hospitals make up that difference? By charging private plans more, thus harming the majority of Coloradans who get employer-provided health insurance.

In fact, one study found that due to cost shifting under a public option, “individuals who get health insurance through their job would see their premiums go up in at least 37 of Colorado’s 64 counties.”

Does a public option with its higher costs on businesses make any sense at a time when businesses large and small are struggling to survive?

Rep. Roberts claims his plan will “bolster small hospitals.” In fact, small hospitals would be hit hard under a public option. Even before the pandemic, 18 rural hospitals in Colorado were losing money with 12 at high risk of closing. By cutting payments to hospitals, a public option would force many of them to close for good, costing thousands of good jobs in the process. This would particularly hurt those living in rural areas.

Lastly, Rep. Roberts claims his plan “addresses disparities that are tied to race, income, disability or location.” But a study by the independent FTI Consulting found that more than 40% of the hospitals at higher risk of closing under a public option are those that serve racial and ethnic minority communities.

No doubt Colorado has health care challenges. At the same time, according to Wallethub, Colorado has the seventh-best health care system in America, with the second-best health care outcomes. Why would we risk all that on a government health care scheme we know will not work?

Instead of creating from scratch a new state health care program that jeopardizes hospitals and private insurance plans, state leaders should work to improve our existing health care system, for example by ending technology restrictions on telehealth, fully authorizing nurse practitioners to prescribe medication and eliminating barriers on telepharmacy.

Make no mistake, a public option would put Colorado on the road to government-controlled health care, an idea Coloradans soundly rejected in 2017, with 80% voting against it. Rep. Roberts’ plan is just another backdoor attempt to sneak a government takeover of health care past the people of Colorado who already said they do not want it.

Jesse Mallory is state director of Americans for Prosperity-Colorado.


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