Colorado is poised to embark on what could be one of the most ambitious re-orderings of the health care system in decades.
Lawmakers are set this coming session to do battle over a plan to offer a “public option” for health insurance that allows state officials to dictate hospital prices. A plan to import prescription drugs could soon be expanded. Employers are banding together to negotiate better health care deals.
But how state residents feel about this remains a bit of a mystery. And two new polls out from two advocacy groups offer a clue to that uncertainty.
First, a poll this month from the pro-reform group Healthier Colorado shows voters in the state have an appetite for change.
The poll, of 500 Colorado active voters from across the state, taken through live interviews over the phone, found that 45% of Coloradans think their health care is unaffordable and more than 80% think prescription drugs cost too much.
“One thing that really stood out for us is people feel there needs to be a change, that our current health care system is just too expensive.” said Kyle Piccola, a senior director at Healthier Colorado.
And, when Healthier Colorado asked voters how they thought the system should change, they favored big initiatives. Nearly two-thirds of voters said they support either a Medicare-for-All-style universal-coverage plan or a public option plan that would give people under the age of 65 the option of buying coverage through Medicare. Only 34% said they wanted to keep the existing system, built largely on health insurance provided by employers.
The views expressed in the poll echo what Denver-based health care consultant Billy Wynne said during the Colorado Health Institute’s annual conference this month: “I think the time is overdue for disruptive change.”
But, significantly, the Healthier Colorado poll didn’t dive into the fine details of these plans. It asked voters whether they support the idea, not a specific proposal. And another poll out this month provides evidence that health reform proposals become less popular when given details that make them more real.
The second poll, from the group Colorado’s Health Care Future, asked 800 registered voters in online surveys how they feel about the proposal for a public option put forth by the Polis administration.
The Polis plan would not be a Medicare buy-in — the kind of idea Healthier Colorado polled on. Instead, it would empower state regulators to set the prices hospitals can charge people who have coverage through the public option. It would at first be offered only to those who buy coverage on their own, without help from their job, but it would likely be expanded to small employers after a couple years. Insurance companies would administer the plan, so there would be no direct financial risk to the state budget. Both insurance companies and hospitals would be required to participate.
In other words, it has enough detail to it for groups to be specific in their opposition — which is just what has happened, with both the insurance and the hospital industries in Colorado coming out against the plan. Colorado’s Health Care Future is the local offshoot of The Partnership for America’s Health Care Future, whose membership draws heavily from the insurance, hospital and pharmaceutical industries.
And, so, the Colorado’s Health Care Future poll found some skepticism about the Polis plan. Only 45% said they support it — compared to 25% who said they oppose it and 24% who said they were uncertain. Nearly three-quarters of respondents said they were satisfied with their current coverage and wanted the state to work on improving the existing system rather than create a new system with heavy government controls. Lastly, 39% said they don’t trust the state government to design an effective health insurance plan, compared to 34% who said they do.
“Voters’ top concern is lowering health care costs,” said Phillip Morris, a partner of the Washington, D.C.-based Locust Street Group, which conducted the poll for Colorado’s Health Care Future, “and 79% are unwilling to pay any more than they currently do for health care to fund the state government option.”
This seesaw between loving the big picture but not necessarily the details is pretty common nationally, too.
Polls by the nonpartisan Kaiser Family Foundation have shown that most voters don’t understand the details of the Medicare for All plans, but they tend to support the idea less once they hear about some of the potential consequences.
This dynamic is a big reason why Democratic presidential candidates have been backing away from supporting Medicare for All and are now shifting their support toward more gradual implementations of the idea or toward a Medicare buy-in — which voters are more likely to support.
It also means that supporters of big changes to the health care system, both nationally and in Colorado, have plenty of work to do to persuade the public they’re the right changes to make.
“As always,” Larry Levitt, the executive vice president of the Kaiser Family Foundation, wrote on Twitter recently, “the political challenge for those opposing the health care industry is developing a coalition with clout and money to counter it.”