The insurance companies told the state that costs were higher in Pueblo because of a larger population of seniors and uninsured. That's because costs incurred from treating those who don't have insurance eventually get passed on to those who do. (Under federal law, for example, hospitals are required to treat anyone who shows up at an emergency room. If they can't afford to pay and aren't covered by Medicaid, the hospital often has to absorb the costs. By adding this expense to their bottom line, hospitals in effect transfer the cost to their insured patients, a practice known as "cost shifting.")
Thiebaut says the impact of the price jump on families of state employees would have been devastating. "The average state worker makes $2,500 to $3,500 per month in Pueblo, and many of them would have had to pay $1,000 [per month] for health insurance."
Doug Boehm
James Bludworth
Marilyn Lang has worked to get health-insurance issues heard at the Capitol.
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In October, angry state employees from Pueblo descended on the capitol, carrying signs that read: "Will Work 4 Health Insurance: state employee, five children" and "My family can't afford $800 health insurance." One speaker described Pueblo employees as "the canary in the coal mine" for a failing insurance system. During last fall's special session, Thiebaut convinced the legislature to appropriate $1.8 million to bring the Pueblo employees' costs in line with those of other state employees.
The experience convinced the senator that the state has to take a larger role in regulating health insurers. In other states, such as Maine, there have been serious discussions in the state legislature about creating a statewide single-payer system, but no one expects that the largely conservative Colorado legislature would consider such a proposal.
Later in this legislative session, Thiebaut hopes to persuade his colleagues to at least create a consumer advocate's office for insurance. The state already has a highly effective consumer advocate for utilities, and he thinks a similar advocate could examine health-insurance policies and make recommendations to the state from the consumer's perspective. Thiebaut also wants to require that insurers win state approval before they can hike rates, similar to what the Colorado Public Utilities Commission (PUC) does with telephone and power rates.
"We have a state where insurance companies can file rate increases and they're automatic," says the senator. "There should be a hearing process similar to the PUC process on utility rates. There should also be a consumer advocate who can stand up for consumers. I want somebody independent and ready to say what needs to be said."
(Thiebaut's ideas may get a hostile reception from the governor, who usually opposes new government regulations. A spokesman for Owens says he won't comment on Thiebaut's proposal before legislation is introduced.)
The state of Georgia created a consumers' insurance advocate office in 1999.
"Basically, we're an independent watchdog on insurance issues," says Lane Goldberg, spokeswoman for the office. "We provide feedback to the insurance commissioner on proposed rate hikes. We look at ways to make insurance more accessible to people."
Colorado already has an insurance commissioner who is charged with helping consumers. But Thiebaut says that, historically, the state's commissioners have come from the insurance industry, whether they're appointed by a Democratic or Republican governor.
"We need to have somebody who is accountable to the public," he says. Commissioner Kirven is the former legal counsel for PacifiCare health insurance. Despite his background with the industry, he insists that his office is trying its best to represent consumers.
"We devote most of our resources to dealing with consumer complaints," he says. "We have very knowledgeable people here who are strong advocates."
The leap in health-care costs doesn't just affect health insurance. Automobile insurance rates have also been increasing rapidly in Colorado.
"Auto premiums are going up, primarily because of medical expenses," notes Kirven. "The personal-injury-protection premium at State Farm went up 50 percent."
This year the legislature will debate the future of the state's no-fault auto insurance law. Under that law, most medical expenses in accidents are paid by each driver's insurer, regardless of fault. However, Colorado allows people with more than $2,500 in medical bills to file claims against the other driver for bodily injury, which may include "pain and suffering." There is expected to be a push this year to raise that threshold, something the state's trial lawyers will fiercely resist.
All of this skirmishing over auto insurance and mandated health care won't do much to help small businesses struggling to cover employees or the thousands of Coloradans who live without health insurance. Many people believe the crisis will only worsen, while the legislature keeps trying to find easy solutions that have little impact.
"What we see happening at the legislature is a hodgepodge of temporary fixes rather than trying to get a permanent fix," says Ellen Golombek, president of the Colorado AFL-CIO.
In the meantime, thousands of Coloradans are either frantically trying to get the money together to pay high deductibles or taking their chances without insurance.
"It's frustrating to watch this," says Pollock. "A lot of people are really struggling. Mothers go to bed at night saying 'I hope my kids don't get sick because we don't have insurance.'"
