New health benefit mandates would face greater scrutiny under proposed law


In recent years, Colorado Governor Jared Polis has expressed concern that state legislation requiring health insurance companies to provide new benefits could drive up the cost of care. For example, Polis signed a 2021 law that required state-regulated insurance plans to provide alternatives to prescription opioids, but with the caveat that lawmakers should develop a “uniform, evidence-based process.” evidence” to determine the costs and benefits of future health insurance mandates.

Now lawmakers appear to have answered the governor’s call with the bipartisan Senate Bill 22-40, which passed the Colorado Senate on Tuesday. The bill would require the state’s insurance division to hire a contractor to conduct up to six actuarial reviews a year of proposed laws that would impose new health benefit mandates on insurers. These reviews would involve economic analysis predicting how the new mandates might affect Coloradans’ insurance premiums on various health plans.

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The spearheads of the SB-40 are the senses. Jim Smallwood, a Republican from Parker, and Faith Winter, a Democrat from Westminster, as well as Representatives Perry Will, a Republican from New Castle, and Susan Lontine, a Democrat from Denver.

Under SB-40, required actuarial reviews for proposed new health benefit mandates should include:

  • An estimate of the number of Colorado residents who would be directly affected by the proposed law
  • Estimated changes in utilization rates of specific health care services that could result from the proposed law
  • Estimated changes in cost sharing with consumers that would result from the proposed law
  • Estimated premium changes for covered individuals or employers enrolled in health benefit plans sold in the individual, small group and large group markets
  • Estimating Direct Cost Changes in State Employee Group Benefit Plans, Medicaid Plans, and Small, Medium, and Large Employers
  • An estimate of potential long-term cost changes associated with the new Medicare mandate
  • How the proposed law could help improve people’s health
  • Social and economic impacts of the proposed law

“This bill basically encourages us to do actuarial studies when we start working on health insurance issues, because sometimes the best intentions increase premiums,” Winter said in the Senate Monday. “We need to make these policy decisions in the best possible way, understanding the benefits and the costs, and this bill will help us do that.”

The Senate voted unanimously on Tuesday to pass SB-40, sending the bill to the House for consideration. Outside of the Capitol, the bill has support from Denver Health, the Colorado Hospital Association and the progressive advocacy group Healthier Colorado.

It is opposed by the Colorado Chapter of the American Physical Therapy Association and AARP.

The latest version of the bill would provide $100,000 to the Division of Insurance to manage the actuarial review process and authorize the division to accept additional gifts, grants and donations to help cover costs.

Despite Polis’ warning about health benefit mandates, lawmakers this session introduced at least one bill that would impose new requirements on health insurance companies. It is Internal Bill 22-1094, sponsored by Representatives Brianna Titone of Arvada and Naquetta Ricks of Aurora, as well as Senator Rhonda Fields of Aurora, all Democrats, who would impose new financial demands on the state’s Medicaid program. The bill would make a torture survivor who received rehabilitation services in Colorado eligible for state medical assistance whether or not they met federal Medicaid requirements.

Members of the House Health and Insurance Committee approved HB-1094 on February 16, sending it to the House Appropriations Committee. Tuesday, there was no hearing of the credit committee.


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