Congress could learn from Colorado’s 208 Commission

The voice of the American people on healthcare is clear: They want reform, and they want it now. What has been less clear is how America can achieve affordable, high-quality healthcare for every person in this country. This certainly is not an easy task, but none of the great accomplishments in our history have been easy. The time has come to finally embrace the concept that healthcare for every American is a right, and we must start talking about the solution rather than just the problem. I firmly believe that the core of this solution includes a strong partnership between state and federal governments, a reality we have overlooked for far too long.

There is little question that our healthcare system is on life support. Forty-seven million Americans are living without health insurance — 9 million of them are children. One out of every five adults in this country reported they did not receive needed healthcare services because they could not afford them, and our emergency rooms are overflowing as they struggle to serve the primary care needs of people without access to affordable care. Healthcare costs are spiraling out of control, and working families are finding coverage out of reach. These facts have become all too familiar.

So, how does America move forward to fix its broken healthcare system? First and foremost, successful reform will require a meaningful partnership between federal and state governments. A number of states have been laboring to craft innovative approaches to develop affordable health care options for their citizens. Congress is fortunate to have the experience of these innovators to draw on as we address our national healthcare needs, and we must not overlook the exceptional value of this resource. Furthermore, we must remember while there are components of healthcare reform that may be best-addressed by the federal government, there are also elements of reform that are best left to our states and communities.

My home state of Colorado recently embarked on the path to healthcare reform by forming a statewide coalition charged with evaluating creative proposals to ensure affordable healthcare coverage for every Coloradan. The 208 Commission, as it was called, was asked to assess possible approaches to extending affordable healthcare coverage to all Coloradans and present its recommendations to the state legislature for consideration. The group represented a wide range of ideologies and perspectives but its members were still able to find common ground on a complex and contentious issue.

This type of collaboration reminds us that securing access to healthcare for all Americans is a mission so important that it can transcend even the most challenging differences in opinion.

Last week, after a rigorous and spirited exchange of ideas, the 208 Commission shared the fruit of its tremendous effort with policy leaders in Colorado in the form of 32 specific recommendations. Similar to other states’ reform efforts, the Colorado Commission’s approach included many common-sense principles that should be considered as Congress develops a national plan for reform. For instance, the group concluded that the increasing costs in the private healthcare market are driven, in part, by the need to subsidize the lower payments providers receive for treating Medicare and Medicaid patients and the uninsured. As policymakers, this tells us that a successful reform proposal is likely to include all Americans in the same insurance system and that we must consider the ripple effects as Congress and the administration continue to trim payment rates in our federal healthcare programs.

There is no doubt that the path to reform in Colorado, like many other states, will be bumpy. Despite the thoughtful framework that the 208 Commission developed, the challenges and cost of implementing fundamental changes will be daunting and may, ultimately, prove to be an insurmountable obstacle to overcome on their own. The recent events in California clearly illustrate the difficulties states face when trying to provide their citizens with affordable healthcare coverage. Ensuring access to high-quality care is a very expensive endeavor, especially as states face budget shortfalls.

Approaching reform on a state-by-state basis can be confusing and can pose difficulties when designing comprehensive health benefits. And even if a state is able to overcome these hurdles, it faces a patchwork of federal and state laws that can be arduous to reconcile.

It is commendable that states have come so far even as they confront these challenges, but we cannot expect them to tackle health care reform on their own. It is imperative that Congress and the administration forge a meaningful relationship with our nation’s governors and state policymakers to identify the roots of the healthcare crisis and develop concrete proposals for mending our broken system. It is only through strong partnerships — the partnership of state and federal government, the partnership of political parties and the partnership of people and policymakers — that we will succeed in providing American families with the health care services they need and deserve.

Salazar is a member of the Senate Finance Committee.