Last year, state Sen. Irene Aguilar got to know her fellow lawmakers up close. She checked their blood pressures. Then she cautioned them about the dangers of hypertension. After all, what group of professionals has the potential for higher blood pressure than politicians at the capitol? And, after all, Aguilar is a doctor.
“I’ve sort of established myself as being willing to provide medical advice and guidance to people,” said Aguilar, the only licensed physician in the Colorado legislature.
“In addition, when there are things that are being proposed that I really think there isn’t good evidence behind, I’m willing to get up there and say, ‘This is not a place where we should be spending our money.’ ”
The 2012 session will be best remembered for its rancorous last-minute battle over civil unions. Yet Aguilar, finishing her second year in office, has quietly built alliances across ideological boundaries. Those alliances helped her pass unusual bipartisan legislation that makes health care more affordable and accessible.
“I’m sort of known as the doctor who wants to give everybody quote, unquote ‘free health care’, which is a little bit of an exaggeration,” said the Democrat from Denver. “I’d just like it to be affordable for everybody.”
One of Aguilar’s successful bills this year, Senate Bill 74, allows parents who are caregivers to their disabled children over age 18 to receive Medicaid support.
Another success, Senate Bill 134, levels the playing field for middle-class and working poor Coloradans, allowing them to pay the same rates as lowest-paid private insurers for hospital procedures. Hospitals have often charged people without health insurance more than those with insurance – sometimes twice as much.
The bill had broad support, including from the Colorado Hospital Association and the Colorado Consumer Health Initiative – and co-sponsor Rep. Cindy Acree, an Aurora Republican who has experienced the reality of being uninsured and in the emergency room. When her husband died, Acree lost her health insurance and learned firsthand what many consumers don’t know – that out-of-pocket costs for the same procedures can be dramatically higher for the uninsured.
“Most of us want the same things out of life,” Acree said. “We want to take care of our families. We want to make a living. We want to have the ability to take care of our health care needs and get jobs. We differ sometimes on the model and the tools we use to get there.”
There were also compromises in the final version, including reducing the number of people the law will help. Initially, Aguilar wanted the bill to cover people making 400 percent of the federal poverty level, or about $92,000 for a family of four. But when some hospitals balked, the amount was reduced to about $57,000 for a family of four, or 250 percent of the federal poverty level.
“In the rural areas, they (the hospitals) didn’t want it to be much higher than 250 percent of federal poverty level, because in rural areas oftentimes that’s what the top income is for people anyway,” Aguilar said. “So they wanted it to be at an area that would allow them to continue to recover as much of their costs as possible.”
When he signed the bill into law on May 7, Gov. John Hickenlooper praised Aguilar and Acree’s bipartisan solution that “provides real relief for vulnerable Coloradans who are facing excessive medical debt and, in many case, are, again, forced into bankruptcy.”
Sen. Kevin Lundberg, a Larimer County Republican who serves with Aguilar on the Health and Human Services Committee, calls his colleague a “smart lady.” Lundberg and Aguilar are often on opposite sides of the political spectrum, but Lundberg says he occasionally turns to the doctor for advice.
“[Aguilar] really does work with people well -- and that’s to her credit,” he said. “It’s good to get a doc’s perspective.”
Aguilar says her political style is the same as her medical style. When making a diagnosis, she says, she likes to consult others.
Aguilar was born and raised in Chicago to Mexican immigrant parents who originally settled in Texas and later moved north to seek factory jobs over farm labor. She did well in school and graduated from the University of Chicago Pritzker School of Medicine. For more than two decades, she has served as a primary care physician at Denver Health Westside Family Health Center. She is married to Dr. Thomas W. Bost and has three children.
Although she represents District 32 in south Denver, her vision for legislation usually extends far beyond her own constituency.
Aguilar backs the idea of a voter-approved statewide nonprofit health insurance cooperative, which she says has the potential to drive down health insurance costs. The idea still needs to be fleshed out, including developing a business plan.
Other local programs that offer affordable health care – which could potentially be replicated – also are piquing her interest. One of them, Health Access Pueblo, is a community health plan in which employers pay $60 a month, employees pay $60 month and Health Access Pueblo, a nonprofit, contributes $60 a month. The plan has no deductibles.
Another concept Aguilar likes is creating a new tax on products with high sugar content. Such a tax could help fight obesity, Aguilar argues, and reduce dental problems. Many people, she says, don’t realize how much sugar there is in juice drinks alone. And, with fewer people smoking, the state’s revenue from tobacco taxes is declining; a tax on sugary drinks could fill that void.
Asked if she’d consider running for higher office or to seek a higher appointment, Aguilar says only if it would mean she could improve access to health care.
“My goal when I came in here was to try and help everyone in Colorado have access to health care. Until I do that, I’ll feel like I still have work to do,” she said.