Kefalas vows to bring back single-payer health bill

DENVER – In the end, it all came down to the math.

After finding support in two House committees and heading for a third reading on the House floor, House Bill 1273 was laid to rest on April 14 – scheduled for a “lay over” non-vote on July 5 far after the close of the 2009 legislative session.

“Basically, we had 32 votes in the House and we needed 33,´ said the bill’s main sponsor, Rep. John Kefalas, D-Fort Collins. “We had six Democrats who we could not get to change their vote, including the Speaker (Terrance Carroll).”

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Then there was also the announced opposition by Gov. Bill Ritter, who had gone on record saying he did not favor the bill and hinted he would not sign it if it made it through the Legislature controlled by his own Democratic party.

“We were up against some pretty big odds, and I decided if I couldn’t get it out of the House I would lay it over and bring it to a more dignified close,” Kefalas said, choosing July 5 because it is his granddaughter’s birthday. “I just feel we did achieve a lot of good things and I think getting it as far as we did was pretty incredible.”

HB 1273, also known as the Colorado Guaranteed Health Care Act, would have created a health care authority to recommend a public health system for the state that could cover an estimated 800,000 uninsured residents. The bill would have required supporters to obtain private grants and donations for the study and for all federal impediments to such a bill to be worked out.

But in the end there was not enough support in otherwise sympathetic circles, where many said the creation of such a single-payer system was best left to the federal government.

Rulon Stacey, CEO of Poudre Valley Health System in Fort Collins, said in an interview with Colorado Managed Care that a single-payer system would be “best done on a federal level” and going to such an approach “would isolate Colorado” among its neighbor states.

“It’s unrealistic on a statewide scale,” Stacey said.

Strong support – and opposition

But the bill did have some respectable backing. Both the Larimer County Medical Society and the Health District of Northern Larimer County endorsed HB 1273, along with the grassroots group Health Care for All Colorado, which helped write the bill.

Eliza Carney, chair of the group’s Northern Colorado Chapter, said she had hoped for a less anticlimactic end for the proposal.

“A good many of us would have preferred to have had a vote (on the House floor) – even if we were going to lose – and get people on the record,” she said. “But it was John’s decision.”

Janet Seeley, M.D., a local doctor and member of the group, said she was saddened by the bill’s demise, especially given the fact that it would only have looked at the possibility of a single-payer system in Colorado.

“It didn’t cost Colorado anything,” she said. “It was a study to really look at it in detail to see if the roadblocks were insurmountable.”

But there were significant roadblocks thrown up by the health-care industry and business. The Colorado Hospital Association strongly opposed the bill and its director, Steven Summer, testified against it. Summer, a member of the 208 Commission that looked at possible changes in the state’s health care system in 2007, said that committee wisely rejected a single-payer model even though an analysis said it could save the most money.

“We came to the conclusion that the single-payer model was not viable at the state level,” Summer said, noting that implementing such a system would be impossible to mesh with current state and federal employment programs.

Instead, Summer advocates improving a “clearly broken” health-care system by making the existing private insurance-based system more inclusive. “We believe the successful model is one that maintains a pluralistic payment system with the private market system.”

The bill was also opposed by the Colorado chapter of the National Federation of Independent Business. Tony Gagliardi, NFIB director, said his membership was solidly against HB 1273.

“We really saw (Kefalas’) bill as having a board that would not be accountable to anyone,” he said. “I know the ultimate goal was to get the employer out of the equation. Probably about 40 percent of our members said we wish we didn’t have to (provide insurance coverage), but a larger percentage said we don’t trust government to do it.”

Few regrets

For his part, Kefalas said he has few regrets about the failure of HB 1273. The two-term legislator laments that he didn’t have enough time to build the kind of support he needed to land at least one more vote in the House and – with that momentum – possibly push it through the Senate.

“We wanted to get it through the Legislature and put it on the governor’s desk and see if he would sign it,” he said. “But I have a record of a solid 32 votes and I was very happy with that.”

Barring a national single-payer law being approved by the U.S. Congress later this year, Kefalas said he will “absolutely” bring a similar bill back to the next session in 2010.

“One of the things I learned out of this is how much agreement there is on the health-care system being unhealthy,” he said.

Kefalas said he doesn’t want to stand still on working to get a better health-care system. “One of the excuses we kept hearing was this was premature and the federal government might solve it,” he said. “But I’m not going to hold my breath. It’s a very critical economic issue for business. We have to get away from the idea of employers being the providers of insurance.”_