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Proposals imperil Colorado women’s health care | OPINION

By Carol Cox and Catrina Bubier Apr 10, 2024

As obstetric gynecologists, we provide high-quality health care to women from all walks of life in Colorado. We conduct cancer screenings, monitor high-risk pregnancies, deliver babies and much more. Yet our ability to continue this life-giving — and lifesaving — work is under attack by a series of proposed ballot initiatives that threaten to make care more expensive, harder to access and less safe.

Championed by trial attorneys seeking astronomical jury awards, Initiatives 150 and 277 would eliminate reasonable limits on the amount of money people can collect from suing a health care provider. Patients who experience negligence or adverse outcomes absolutely deserve to be compensated fairly, which is why there’s no limit on the amount of money someone can be awarded for economic damages such as lost wages and chronic medical treatment. However, there should be limits on how much they can receive in addition to economic damages for intangible, non-economic damages like inconvenience, pain and suffering.

Eliminating the cap on non-economic damages would raise insurance premiums for medical professionals and inflate statewide health care costs by an estimated $155 million per year, according to COPIC, a Colorado-based medical liability insurance carrier. In states without non-economic damage limits, plaintiffs and their lawyers are awarded tens or even hundreds of millions of dollars, which is 50% to 200% higher than the national average according to the U.S. Department of Health and Human Services.

The ripple effects of spiraling health care costs would be disastrous. Not only would patients be confronted with larger health insurance premiums and out-of-pocket costs, but care would become harder to find, especially in rural areas and low-income urban neighborhoods — both of which already experience these provider shortages. This is because physicians like us, who treat patients with the most complex medical challenges, already face higher risks of adverse outcomes and litigation. Rising costs and the specter of unlimited jury awards could lead us and our fellow specialists in obstetrics, neurology and surgery, for example, to opt out of higher-risk procedures, to charge much more for such services or to leave our practices altogether — exacerbating the already serious problem of “health care deserts.”

Take Summit County. One of us practices at a clinic there that has patients who drive hours from places like Salida and Buena Vista to give birth because there are no obstetric providers or labor and delivery units closer to home. If these harmful proposals move forward, small rural clinics like these couldn’t afford to keep their doors open. If you take us out of the picture, those patients would have to travel even further to find care.

The result would be growing “maternity deserts” and worsening maternal mortality, which is already higher in the United States than in the rest of the developed world and disproportionately affects women of color and women in rural areas. We entered obstetrics to protect women and babies from preventable tragedies, not stand by while unmanaged health conditions claim their lives.

We also entered the field because we love spending time with our patients. Rising insurance premiums would worsen the already challenging scenario of growing medical costs paired with lower insurance reimbursements for providers, forcing us to spend less time with each patient to recoup financial losses — something no provider wants to contemplate. Already, wait times for specialties are increasing and attributed to a fast-growing population and a health system stretched thin. Any further negative impacts could be catastrophic.

Three other measures proposed by trial attorneys — Initiatives 274, 275 and 276 — threaten quality of care in Colorado by significantly altering and, in some cases, eliminating professional protections that allow health care professionals to confidentially review cases to learn from one another to improve patient safety and the quality of care. Taken together, these proposed measures would create a health care environment that make talented physicians not want to practice medicine in the state we love.

The bottom line is physicians, medical experts and patient advocates — not attorneys with dollar signs in their eyes — should shape the laws governing the practice of medicine in Colorado. That’s why we are asking the state legislature and Gov. Jared Polis to support the reasonable alternative to these ballot measures, Senate Bill 130. Senate Bill 130 would raise the cap on non-economic damages from $300,000 to $500,000 over a 5-year period, putting Colorado in line with the majority of states that cap non-economic damages. This solution ensures patients can fairly recoup losses after an adverse event while also protecting all Coloradans’ access to affordable, quality health care.

Join us in calling lawmakers to oppose these harmful ballot measures and support Senate Bill 130 instead:

Dr. Carol Cox, MD, FACOG, is an obstetrician and partner at Swan Mountain Women’s and Family Clinic in Summit County; Dr. Catrina Bubier, MD, is an obstetrician and managing partner at Women’s Health Care Associates and vice chair of the Colorado Section of the American College of Obstetricians and Gynecologists.