By Erica Breunlin, Jennifer Brown, Moe Clark, John Ingold and Jesse Paul
The Colorado Sun
From mental health to teacher pay, Colorado’s leaders are exploring innovative ideas to tackle the state’s biggest challenges.
Gov. Jared Polis and four state lawmakers pitched their ideas Tuesday at the Big Ideas Forum hosted by The Colorado Sun, CBS4 and the University of Denver.
Here’s a look at their ideas and the challenges they face that will help define the 2020 legislative session.
REPLAY: See the pitches for yourself
Big Idea: A health insurance option that guarantees lower prices
There are 22 counties in Colorado where there’s only one health insurance company selling plans to people who buy coverage on their own. And, by some measures, Colorado hospitals have some of the highest profits in the country.
In pitching his big idea Tuesday, Polis did not shy from what is expected to be the biggest fight of the legislative session and proposed something he hopes will address both of those truths: a public health insurance option.
Polis’ version of this idea would give state regulators the authority to limit what hospitals can charge to people covered by the public option. Lower prices for care would mean that insurers could charge people less for coverage.
And “public” option is also something of a misnomer. Unlike the plans being pitched on the presidential campaign trail that would allow people to buy into government health coverage plans like Medicare, Colorado’s public option would be administered by the insurance companies, themselves — meaning they take on the risk, not the state budget, but also meaning that the state government won’t be selling a product in competition with private companies.
Polis said the general idea of a public option harkens back to his time in the U.S. House of Representatives, when the House passed a version of the Affordable Care Act that had a public option included.
“This is something that should have been done a long time ago,” he said. “Sometimes what’s old is new.”
But that doesn’t mean it will be an easy sell at the legislature. Some lawmakers have expressed skepticism — even though the bill to implement the public option is still being written — and state House speaker KC Becker has been notably cool to the plan.
Hospitals and insurance companies would have to participate in the program to really make it work — something they are not happy about. Groups tied to both industries are already spending big money on mailers and ads against the idea.
But Polis isn’t backing down.
“That’s really exciting to me,” Polis said of the opposition campaign. “That means we must be getting something right if they’re that worried about it.”
Big Idea: A ban on flavored vaping products
State Rep. Yadira Caraveo plans to introduce legislation in the coming weeks to ban flavored vaping products as a way to curb what officials say are crisis levels of teen e-cigarette use in Colorado.
“These flavors are targeted toward children, and really are meant, in my opinion, as a way to addict a new generation after all the strides we made against cigarette smoking,” said the Thornton Democrat who is a pediatrician.
Caraveo cites statistics from a Food and Drug Administration study showing that a majority of teens who vape in the U.S. say that flavored products are one of the main attractions. She also points to a study showing that almost every teen who vapes says they started off with a flavored product.
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Other states, like New York, have banned flavored vaping products, though through executive action by their governors.New Jersey’s legislature this week passed a package of legislation outlawing flavored vaping products.
One potential hurdle that could spoil Caraveo’s plans: Gov. Jared Polis, who has shown a libertarian streak on health issues, including vaccines.
In a statement to The Colorado Sun in September, Polis’ spokesman, Conor Cahill, hedged about the idea of a flavored vaping ban. “The governor supports personal freedom and the ability for adults to make well-informed decisions for themselves. And in order to do that, the governor believes consumers deserve transparent and accessible information.”
Caraveo doesn’t think, however, that Polis’ door is necessarily closed on the issue.
“We have had conversations, just sort of generally, between offices,” she said. “He said that we would continue to talk about it once legislation is introduced, but hasn’t told me an absolute yes or no.”
Colin Larson, a Littleton Republican who has worked across the aisle on vaping issues at the Capitol before, is leery of the state telling adults what they can and can’t do.
“The way I always philosophically approach this issue is: I want to reduce teen and youth usage. But the second we get into talking about people out of high school and people that aren’t kids anymore … there are all kinds of things that aren’t good for us that we as a society tolerate, like alcohol, fatty foods,” he said. “And I’m a big believer that adults have a right to enjoy these kinds of products.”
Big idea: A free annual mental wellness checkup
Going to the doctor for an annual physical is pretty standard for children and adults. But what about a once-a-year, 60-minute mental wellness checkup?
A proposal from Rep. Dafna Michaelson Jenet, D-Commerce City, would require health insurance plans to cover an annual mental health exam for people of all ages.
Under her plan, patients could see any type of licensed mental health professional — from general therapist to marriage counselor to substance abuse specialist — once each year with no copay and no deductible requirement.
“I am not mandating people in Colorado have an annual mental wellness exam. I am just making it available to them,” Michaelson Jenet said.
The idea was sparked by conversations the lawmaker had with school officials, parents and young people while on the legislature’s interim committee on school safety.
“What we had been hearing over and over, and what we’d heard many times from our impacted families, is that they didn’t know that their child was struggling or suffering,” she said. “How is it that we don’t know? Because we are treating our mental health on a crisis-by-crisis basis.”
People go to their physician regularly to make sure their blood pressure and cholesterol are in check. They visit dermatologists for skin cancer screens and gynecologists for annual exams. “We need to be doing the exact same thing with our mental health,” Michaelson Jenet said. “We need to radically rethink the way we do mental wellness care.”
She imagines a health care system where mental checkups are commonplace, where people learn coping mechanisms for stress, how to improve relationships, or get help dealing with a new baby by learning to identify different types of crying. If someone is going through a midlife crisis or experiencing bullying at school, “we can take care of those and nip them in the bud early,” Michaelson Jenet said.
Federal and state laws require insurance companies to provide mental health parity, meaning coverage of mental health conditions should equal those of physical health. But in practice, this rarely occurs.
Mental health coverage is typically “diagnostic-based” — a mental health diagnosis is required for insurance to cover a mental health visit, said Sarah Davidon, research director with Mental Health Colorado. Parity laws did not go far enough to “ensure that annual mental wellness visits would be covered without a diagnosis just as annual physical exams are covered,” she said.
If the legislation — House Bill 1086 — passes, it will affect not only private insurance companies but the state Medicaid division. The bill would not require that medical doctors in private practice hire mental health professionals, but Michaelson Jenet said she is hopeful the legislation would encourage that collaboration.
Big Idea: Rewarding top-performing teachers with bonuses
As school districts across Colorado struggle to fill their classrooms with quality educators, teacher pay is emerging as a key education issue among lawmakers this legislative session.
Sen. Paul Lundeen, R-Monument, is proposing a bill that would reward highly effective teachers with annual bonuses of about $2,000.
“When you want more of something, you reward it,” Lundeen said. “We want more highly effective teachers, so we should reward those we have.”
The legislation would require about $50 million from the state and would benefit about half of Colorado public school teachers – 47% are currently rated as highly effective, according to Lundeen.
Lundeen’s bill, introduced Monday, is largely based on a similar piece of legislation he sponsored last year but that was rejected by Senate Democrats.
Because school districts control the salary schedule for educators, bonuses are the most significant measure that the Legislature can take to increase teacher compensation.
Bonuses for highly effective teachers would be awarded every year the state makes an appropriation, Lundeen said.
However, Lundeen said that because the state doesn’t determine how education money is spent, the funds would be funneled to districts with no strings attached. Districts would have to report exactly how the funds were spent and Lundeen said he is confident the money would be used for its intended purpose.
Lundeen proposed the bill within a broader package of education legislation unveiled by Republicans last week. The package included another measure aimed at boosting how much pay teachers take home by establishing an income tax credit for teachers who spend their greater than $250 and less than $750 of their own money on classroom supplies.
Democrats are also eager to elevate teacher salaries but are taking a different approach. Sen. Jessie Danielson, D-Lakewood, has introduced a bill that would create a dedicated incentive fund for teacher pay.
The Colorado Education Association, in a news release, announced that it is supporting the legislation behind the incentive fund, which would help districts increase minimum teacher salaries and wages and would prioritize districts with the most significant need.
Big Idea: Bringing business into the student debt conversation
Student loan debt in Colorado has grown by 176% since 2007, reaching $26.4 billion, according to the Bell Policy Center.
State lawmakers have struggled to find ways to address the growing problem. Sen. Jack Tate, R-Centennial, thinks businesses can be a part of the solution.His idea, similar to a U.S. Senate bill introduced in 2019, is to encourage businesses to offer up to $5,250 per year in tax-exempt tuition and student loan reimbursements.
“This idea would fit nicely into a company’s benefits,” Tate said. “It will help attract and retain employees and get alignment between education investments, and what the businesses need.”
Only Colorado residents whose education aligns with their job description would be eligible. Tate said he’d leave the rest — like how long someone would have to be at a company to qualify or how long you would have to stay to cash in — up to the businesses.
The biggest obstacle to Tate’s idea?
Under current federal tax law, the tuition reimbursement would be considered income and therefore taxable. Tate’s proposal would create a state tax credit program for participants. Depending on the employee’s yearly income, they would get some of that money back as a tax credit, capped at $1,100 per individual, per year.
“We need so much innovation to tackle this issue, the more ideas the better,” Angie Paccione, executive director of the state Higher Education Department, said.
Though Paccione stressed the need for a mutual agreement between businesses and employees to ensure there is a return on investment, and that individuals utilizing the student loan reimbursement remain in Colorado.
Tate says his idea, which is still in its early stages, acknowledges that some students prioritize paying their own debt.
“If someone is promising student debt relief, those folks that took time off in college or worked during college to help pay for school might not feel like that program is fair,” Tate said. “…That’s why I like this idea, because it moves into a different area of fairness.”
Though there is already a small percentage, about 4%, of private companies offering student loan repayment assistance for their employees –– including big businesses like Hulu, Aetna and Fidelity Investments –– Tate says that his proposal would incentivize more Colorado employers to offer the benefit.
“If businesses are willing to take the risk and invest in their employees in order to build the workplace pipeline, we are all for it,” Aikta Marcoulier, Executive Director of Pikes Peak Small Business Development Center, said.
Another potential hurdle: critics say that siphoning more tax revenue out of Colorado’s tight state budget will threaten policies in other arenas.