Centennial State About to Discover Public Option’s Nightmare


Colorado is about to become the first state to implement a public health insurance option through Section 1332, a provision in Obamacare that allows states to waive many of the law’s regulations.

The Biden administration approved the program, known as the Colorado Option, on June 23.

The new state-sponsored health plan is slated to be available for the 2023 plan year.

Proponents of the Colorado Option are quick to note that it will reduce the cost of coverage for patients throughout the state.

They may be right.

But, the plan does so in the most destructive way possible  by imposing strict price controls on private insurers, doctors, and hospitals.

It’s no model for the rest of the nation.

The Colorado Option would force all of the state’s insurers to offer a heavily regulated “standardized plan.” Starting next year, insurers will have to sell this plan at a rate that is 5 % less than what a comparable plan cost in 2021.

By 2025, rates would have to be 15% lower than they were in 2021.

The price controls don’t end there.

Should premiums fall short of these targets, the law empowers the state to dictate the prices Colorado Option plans pay to doctors and hospitals  ostensibly forcing providers to take massive pay-cuts.

The Colorado Option is one of many state-level public option efforts underway around the country. Washington’s is in its second year and has struggled to gain traction.

Nevada’s was signed into law last year but will not launch until 2026.

By utilizing the Obamacare waiver process, Colorado’s has the formal backing of the federal government. The Biden administration hasn’t been able to advance a public option at the national level.

But waivers might enable it to do so on the state level.

From a policy standpoint, Colorado’s plan is a step in the wrong direction.

After all, the reason patients are clamoring for more affordable coverage options in the first place is that Obamacare’s insurance market regulations have made health plans outrageously expensive across the country  including those in Colorado.

In 2013, for instance  the year before Obamacare’s insurance market restrictions took effect  the average monthly premium for an individual plan in the Rocky Mountain State was just $237, according to a Heritage Foundation analysis of federal data.

By 2019, that figure had more than doubled to $586.

In states like Alabama, Wyoming, and Missouri, average premium increases exceeded 200% during that period.

By capping what insurers could charge older people at three times what they could charge younger ones, requiring them to sell to all comers regardless of health status or history, and mandating coverage of ten “essential” benefits, Obamacare guaranteed that overall premiums would rise.

Yet instead of relaxing these premium-inflating mandates and regulations, Colorado lawmakers are imposing even more stringent requirements on insurers and the rest of the state’s healthcare system.

If the state follows through on its threat to cut payments to providers, the quality and availability of medical care will inevitably suffer.

Doctors will retire early or leave the state  and thus exacerbate Colorado’s doctor shortage. Indeed, two-thirds of the state’s counties  mostly in rural areas  are facing primary care shortages, according to reporting from Colorado Public Radio.

The fallout from Colorado’s public option may be confined within its borders. But other states and the Biden administration have made no secret that they’d like to follow the Centennial State’s lead.

In 2020, then-candidate Biden championed a public option in opposition to Sen. Bernie Sanders’s, I-Vt., proposal for Medicare for All. But a public option is just a stepping-stone approach to single-payer healthcareAs such, it’s an option Americans would do well to pass up  whether at the state or federal level.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

Scroll to Top