House advances three bills to save Coloradans money and improve access to prescription drugs
DENVER, CO - The House today advanced legislation that will reduce health insurance premiums for Colorado Option plans and make prescription drugs more accessible and affordable.
“Saving Coloradans money on health care and prescription drugs is one of our top priorities this session,” said Rep. Chris deGruy Kennedy, D-Lakewood, sponsor of HB23-1225. "This bill will reduce out-of-pocket costs for prescription drugs by extending the Prescription Drug Affordability Board’s cost saving measures to more medications. Passing this legislation will help more Coloradans afford the medication they need to survive and put more money back into the pockets of hardworking families.”
“This legislation removes arbitrary limitations so the Prescription Drug Affordability Board can implement cost-saving measures that drive down prescription drug prices,” said Rep. Ruby Dickson, D-Centennial, sponsor of HB23-1225. “With these improvements to our 2021 legislation, the Prescription Drug Affordability Board will be more effective in doing its job to save Coloradans money on affordable, quality health care.”
HB23-1225 increases the effectiveness of the Prescription Drug Affordability Board (PDAB) to help lower out-of-pocket prescription drug costs for Coloradans. In 2021, lawmakers passed the Prescription Drug Affordability Board to evaluate and place upper price limits on the highest cost prescription drugs. The legislation introduced today will increase the impact of the Prescription Drug Affordability Board to save people money on out of pocket prescription drug costs. It removes the limit on setting no more than 12 Upper Payment Limits (UPLs) per year in the first three years of the PDAB, and improves the criteria for selecting drugs for an affordability review.
“I’m proud of the work we’ve done to provide Coloradans affordable health care plans that work for them through the Colorado Option,” said Rep. Kyle Brown, D-Louisville, sponsor of HB23-1224. “This legislation will reduce premiums on the individual and small group markets and make it easier for Coloradans to find high-value health care plans that are affordable and cover the services they need.”
HB23-1224 will lower insurance premiums and make it easier for consumers to shop for high value standardized health plans that work for them and their families. The updates to the Colorado Option strengthen the Division of Insurance’s (DOI) ability to hold carriers accountable for the premium rate reduction requirements on Colorado Option Standardized Plans by granting the DOI the authority to:
Limit factors such as as excessive profit and administrative expenses;
Structure the public hearings process efficiently while ensuring all parties have the opportunity to participate;
Help consumers easily find and compare plans that could lower their out-of-pocket costs.
“As someone who lives with an invisible disability, I know how important it is to receive timely care that improves your quality of life without breaking the bank,” said Rep. Iman Jodeh, D-Aurora, sponsor of HB23-1224 and HB23-1183. “HB23-1224 will save Coloradans money and reduce premiums for Colorado Option plans, which are increasing access to care for Coloradans who have disproportionately faced barriers to the care they need. Too many Coloradans put off seeking health care because of the hoops that they have to jump through and high copays. These bills help connect Coloradans to affordable health care plans and prioritizes patients over profits.”
“Step therapy requires patients to spend weeks or months trying alternative medications before their insurance company will cover the originally prescribed medication, threatening the health and wellbeing of those who need medication for treatment,” said Rep. Emily Sirota, D-Denver, sponsor of HB23-1183. “This bill creates step therapy exemptions for those with serious health conditions who are served by Medicaid.”
In 2022, Representatives Iman Jodeh and Emily Sirota passed a bill limiting when a patient has to try and fail a treatment preferred by their insurance company before they can access the treatment originally recommended by their doctor. HB23-1183 would require the Department of Health Care Policy and Financing to exempt patients with serious or complex medical conditions from the step therapy requirement if the alternative drug would likely cause negative side effects, the alternative drug is unlikely to be effective based on the patient’s history, or if the patient is already using a prescription that has clinical documentation of being effective. The bill passed the House by a vote of 59-3.