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Survey finds rural Colorado conservative strongholds support Hospital Provider Fee change

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A well-known Republican pollster found majority Republican and rural support to restructure the Hospital Provider Fee to free money for state spending, Colorado Politics has learned.

Dave Sackett of the Tarrance Group conducted a statewide poll of 500 voters between Feb. 25-28.

By a 51-39 percent margin, likely Republican voters support placing the fee in a separate fund to avoid hitting constitutional state spending limits under the Taxpayer’s Bill of Rights. Those polling numbers hold strong in conservative rural districts.

By an even wider margin, 64 percent to 28 percent, the total sample of voters in the poll supported restructuring the fee as an enterprise fund, or government-owned business. Support stands at 60 percent or better in every region of the state, including the Colorado Springs region.

The margin of error for the poll was 4.5 points.

The survey, touted by the Colorado Hospital Association, comes as the legislature considers tackling the thorny Hospital Provider Fee issue.

It is an issue that has seen some Republican support in the legislature, though Republican leaders have opposed the effort. Former Senate President Bill Cadman of Colorado Springs viewed it as a nonstarter last year, and at the start of the session this year, President Kevin Grantham of Canon City similarly opposed the move.

But that was before it became apparent that rural conservative districts are facing dire funding situations worse than originally anticipated.

Sen. Jerry Sonnenberg, R-Sterling, the Senate president pro tem, proposed a bipartisan bill with Senate Democratic Leader Lucia Guzman of Denver that would shift the hospital fee to an enterprise fund, while also lowering the overall base of state tax revenue by $670 million to protect taxpayer rebates.

Senate Bill 267 is scheduled for a discussion by the Capital Development Committee on Thursday. It is scheduled for its first hearing by the Senate Finance Committee on April 11.

The 57-page bill also would require the governor’s office to seek a 2 percent mostly across-the-board cut to state executive departments.

But it is the Hospital Provider Fee component that is the most difficult hill to climb. The fee is assessed on patient stays to force a match of federal health care dollars.

State budget writers proposed a $264 million reduction of the fee to eliminate surplus taxpayer rebates and free money for spending on other budget issues. The budget passed the Senate this week and will be considered by the House next week. Without a fix, the legislature’s hands are essentially tied.

With the federal match, hospitals in Colorado stand to lose about $528 million. Some hospitals have said they would close.

By enterprising the fee and exempting it from contributing to the state’s spending cap, the move would free money for state spending and likely save rural hospitals.

Senate Bill 267 would also direct $1.2 billion towards state roads and highways and $150 million would be used for capital construction. At least 25 percent of the money would have to go towards projects in rural Colorado, with county populations of 50,000 or less.

So, where does $1.3 billion come from? The legislation would secure up to $100 million per year for 20 years to cover up to $1.35 billion by authorizing lease-purchase agreements for state facilities. It would allow the state to use its buildings as assets to leverage immediate revenue.

The Hospital Association and others who are pushing for the Hospital Provider Fee change hope to use the poll to convince Republican lawmakers that supporting the maneuver wouldn’t be as controversial as some think.

“We think the poll sends an exceptionally clear message – Republican voters in the most conservative regions of the state want their legislators to fix the unintended consequences of the original HPF law,” said Trampas Hutches, chief executive of Melissa Memorial Hospital in Holyoke, a rural hospital that is likely to lose money if a solution is not reached.

“Doing nothing would be tantamount to the legislature turning its back on rural Colorado.”

The survey revealed that few Coloradans are familiar with the Hospital Provider Fee, so much of the advocacy work comes in the form of educating voters.

The poll highlighted that the move received the legal blessing last year of Republican Attorney General Cynthia Coffman. Her opinion conflicted with a legal memo from nonpartisan legislative counsel that said it would be illegal to restructure the fee without voter approval or legislation that would allow the legislature to create a new TABOR-exempt enterprise.

“This designation will bring state revenues under the TABOR spending limit, eliminate TABOR rebates, and allow the state to invest in K-12 education and road and bridge maintenance and repair,” the survey explained to voters.

In order to get an accurate read, the poll over-sampled Republican voters in the conservative strongholds of the 3rd Congressional District along the Western Slope, the 4th Congressional District in the Eastern Plains and the 5th Congressional District in Colorado Springs. Pollsters took 50 extra Republican interviews in those districts.

Republicans in the 3rd District support restructuring the fee 51-38 percent; 46-40 percent in the 4th District; and 48-43 percent in the 5th District.

Even among voters who disapprove of the original fee in general, 41 percent would be in favor of legislative action to put it in a separate fund.

For TABOR supporters, 51 percent say they would still favor the fee restructuring, while 40 percent would be opposed. A majority of Republican voters throughout the state do not view the proposal as a TABOR dodge, but view it as specifically permitted and authorized under the terms of TABOR, according to the poll.

But Jon Caldara, president of the libertarian-leaning Independence Institute, who is mentioned in the survey, said the poll questions are so loaded that voters were duped.

The setup for the poll is this: “Some people, including TABOR author Doug Bruce and Independence Institute President Jon Caldara say that the proposal to (put) Hospital Provider Fees in a separate fund is a TABOR dodge and stalking horse to promote more government spending …”

It goes on to say, “Other people, including rural Republican State Sen. Larry Crowder and Republican Mayor of Colorado Springs John Suthers, say the Taxpayer’s Bill of Rights specifically permits the proposed law that would place the Hospital Provider Fee in a separate fund. Many of the most respected leaders across rural Colorado say the legislature has an obligation to fix the unintended consequences of the Hospital Provider Fee in order to spare deep cuts to rural hospitals, rural road and bridge repair programs, and rural K-12 schools.”

“The way that was worded, I would vote against my own position,” Caldara quipped.

“If that is the case, if it’s so strong, then do the right thing and put it up for a popular vote. That’s the way it should be handled.”

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