Colorado bill allows access to direct primary medical care

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(The Center Square) - The Colorado Senate Health and Human Services Committee is postponing consideration of a bill to allow Medicaid recipients to choose "direct primary" care.

Members voted 4-3 Thursday to delay action indefinitely on the  House Bill 26-1096, the CO Medicaid Access to Primary Care Services bill, after public speakers told the committee they liked the legislation, but said some issues needed to be addressed. In February, the bill passed in the Colorado House by a vote of 40-22.

The bill is designed to remove barriers in Colorado that prevent Medicaid members from accessing primary care providers. 

Direct primary care is an alternative form of care that does not accept insurance, including Medicaid, but it allows customers to pay a set monthly fee for access and appointments. Direct primary care is often conducted in smaller facilities with fewer patients and frequently characterized as a more intimate connection between doctor and patient. The option is more common in rural areas, where residents often have less access to primary care providers, according to the National Institutes of Health.

Under the new bill, Medicaid still would not cover direct primary care, but Medicaid recipients could choose to pay for that kind of care out of pocket.

The state's bipartisan bill is aimed at filling a gap in primary care for certain Medicaid members who lack reliable access to primary care covered by insurance, especially for residents in rural areas. The measure was postponed in the committee after a long series of public comments and several new amendments.

“This bill could reduce both human suffering and long-term costs to taxpayers,” said Colorado state Sen. Janice Rich (R-7th District), who co-sponsored the bill, during the committee hearing Thursday.

Multiple public speakers at the hearing expressed support for the intention of the bill, but opposed the legislation without certain amendments.

“As currently drafted, the bill raises a few important concerns related to member confusion, care coordination, and affordability,” said Kevin McFatridge, executive director of the Colorado Association of Health Plans.

“For example, without clear guardrails, there is a risk that members may not fully understand that direct primary care services are not covered by Medicaid and cannot be billed to the program,” said McFatridge. “This could lead to individuals paying out of pocket for services they already have access to and that are already covered.”

All of the speakers in opposition expressed support or potential support for the 12 total amendments proposed during the hearing

If HB26-1096 is reconsidered by the committee and passed, it will go to the full Senate for consideration.