DENVER (AP) — Colorado state senators clashed over government control of health care pricing and affordability in their first debate Tuesday on a bill that would require insurers to offer a standard health plan to individuals and small businesses -- and sanction hospitals and other health care providers that don’t participate.

The so-called “Colorado Option” sponsored by Democratic Sen. Kerry Donovan and Reps. Dylan Roberts and Iman Jodeh is much smaller than the state public health care option long sought by Donovan, Roberts and Democratic Gov. Jared Polis. It has seen numerous changes and incessant lobbying by the health care industry as well as patient advocacy groups since its inception, and it underwent more modifications Tuesday.

The bill would require insurers to offer a to-be-developed standard health plan for individuals and businesses with fewer than 100 employees -- roughly 15% of Colorado’s health insurance market -- by 2023. It would require premium reductions for that plan of at least 12% by 2024 and 18% by 2025 from plans now offered. And it would give the state insurance commissioner power to fine hospitals that refuse to participate up to $10,000 per day, increasing to $40,000 daily after 30 days.

Advocates argue the bill will expand health care affordability, especially among underserved communities that include minorities and rural residents, whose troubles accessing health care have been exacerbated by the coronavirus pandemic.

A tearful Donovan, whose rural Rocky Mountain district has long seen some of the nation’s highest insurance premiums and fewest choices, insisted the bill -- years in the making -- wasn’t about penalizing the health care industry but about the financial security and well-being of Coloradans.

“This isn’t a silver bullet,” noted Sen. Steve Fenberg, the majority leader. “We have to start thinking about the humanity that originally was behind health care.”

Senate Minority Leader Chris Holbert and fellow Republicans argued it would chase many physicians and specialists who refuse to participate out of the state. Democratic Sen. Rhonda Fields, whose Aurora-based district is home to several leading hospitals, said it penalizes those institutions at a time when they have been on the frontline fighting the coronavirus pandemic.

In a major compromise, Donovan offered an amendment removing proposed fines of up to $5,000 a year for doctors refusing to participate. Fellow Democrats, including Fields and Sen. Joann Ginal, warned that no other U.S. state mandates that health care professionals take any kind of insurance, including Medicaid or Medicare. “Mandating them would not be ethical,” Ginal said.

Senators approved the amendment, but not before Republican Sen. Bob Gardner argued that the insurance commissioner could still take physicians to court. “It’s good for lawyers. It isn’t good for physicians,” Gardner said.

Lawmakers approved another Donovan amendment removing the threat of revocation of a hospital’s license for not meeting plan goals. Fields and Republicans argued that didn’t go far enough and that a provision in the bill that says a hospital’s license could be suspended should be eliminated as well.

“We’re just coming out of COVID 19, and we’re going to use language like ‘revoke’ or ‘suspend’? I still think it’s too punitive,” Fields said.

GOP Sen. Barbara Kirkmeyer offered amendments to eliminate penalties affecting hospital licenses; exempt providers that offer elective procedures; and implement a plan only if premiums grow faster than medical inflation. All were defeated.

The bill has seen numerous changes in its journey through the Democrat-led House and its initial steps in the Senate, with more possible when the Senate again takes it up.

“If I want to be honest, this bill has been a job creator for lobbyists,” said Democratic Sen. Julie Gonzales, insisting the public messaging and intense lobbying by numerous interest groups, including hospital, physicians and political organizations, has overshadowed the goal of increasing health care access and affordability.

Washington state was the first state to enact a public option bill in 2019, with coverage beginning this year.