WASHINGTON — Congress sought answers Thursday to the opioid crisis that is killing more people every year in Colorado and elsewhere. Opioids are painkillers that can become addictive with continued use. An overdose can be deadly, killing as many as 33,000 people in the United States last year, according to National Center for Health Statistics. […]
Tri-partisanship is on life support in Washington, D.C. The nation’s health-care system now has three irreconcilable options: Obamacare, RyanCare and MitchCare. It’s barely possible to see a path to WeAgreeOnThisOneCare.
In our own square state, bipartisanship perked up at the end of the 2017 session, even though the bill that most carries the bipartisan brand is messy. Work on the issues within the bill show under what conditions legislators will come together.
Issue one was the hospital fee put in place to support hospitals that provide lots of uncompensated care. From spring 2010 to September 2016, hospitals received $1.4 billion to make up for Medicaid and other patients unable to pay their medical bills, according to the Colorado Department of Health Care Policy and Financing.
That’s a lot of get-to-even money for mostly rural and urban hospitals. But the funding comes with a catch. The hospital fee, if considered a tax, pushes state tax revenues into Taxpayer Bill of Rights (TABOR) restrictions.
State Sen. Larry Crowder, R-Alamosa, has long supported exempting the uncompensated care hospital fee from TABOR. At one time, he was the one Republican Senate vote that could preserve the fee.
Many GOP lawmakers do see the fee as a tax. If it is a tax, hospitals take a double hit because the state has to reduce the fees and thus matching federal dollars to ensure that total tax revenues don’t trip TABOR limits.
Rural hospitals and the citizens they serve argued to their Senate and House legislators, including Republicans Jerry Sonnenberg, senator from Sterling, and Jon Becker, representative from Fort Morgan, that they absolutely needed all the fee money or they would have to close. That position put the anti-taxers Sonnenberg and Becker, along with Crowder and some other rural Senators, in conflict with their pro-TABOR colleagues.
Then came the second big issue: state transportation funding. HB17-1242 would create a transportation funding initiative to bring sales tax dollars to save the state’s degraded infrastructure. The bill passed the Democratic House with some GOP votes but couldn’t get out of the Republican Senate, killed in the Finance committee by Republican Senators Tim Neville, Jeffco; Jack Tate, Arapahoe, and Owen Hill, El Paso.
It looked like the provider fee would lose and transportation was done. But Sonnenberg and Becker hooked up with two Democrats, Senate Minority Leader Lucia Guzman and House Majority Leader K.C. Becker, as sponsors for the Sustainability of Rural Colorado bill.
In the last days of the 2017 session, the sponsors had to get creative. They came up with a $2 billion tax go-around using state buildings for lease-to-purchase deals and a new Healthcare Affordability and Sustainability Enterprise for the provider fee.
Democrats and some Republicans went with the plan, including Sens. Owen Hill and Jack Tate, who earlier voted against the sales tax initiative in Senate Finance. Democrats added some education money, but the pinch on affected lawmakers hurt enough to get enough to “yes.”
A world of urgent hurt for a large majority of constituents can get lawmakers to bipartisanship. That may end up the only ticket at the national level. Lots of constituents and interests from all over the nation are stirring the health care stew and the heat is on high.
… what other state agencies might have a similarly freewheeling approach with the public’s checkbook. So surmises conservative blog Colorado Peak Politics.
ColoradoPolitics.com’s Peter Marcus reported earlier this week on a state audit that found none of the $1.9 million in incentives awarded to film projects shot in Colorado had met all the criteria for the subsidies. Marcus writes that the audit “identified $129,000 for projects that did not qualify for incentives and another $1.8 million for projects for which the Office of Film, Television, and Media ‘lacked documentation to substantiate they qualified.'”
Colorado Department of Public Health and Environment
Some of targets are repeat offenders and invite follow-up scrutiny by the lights of Republicans and conservatives. For example, Health Care Policy and Financing (you may know it as “HickPuff”; no relation to the guv), which manages Medicaid for the state; Peak notes a 2016 audit found some Medicaid recipients were ineligible but not removed from the rolls.
And then there’s the Energy Office, much unloved by Republicans who are ever wary of the office’s original green-energy-promoting mandate. Peak observes:
This is the office that lost like $200 million a few years ago. The state auditor just finished up an audit in January, but for the love of God, you lose $200 million, you should be audited always.
… Thirty Years Ago This Week in the Colorado Statesman … According to Don Barbarick, state meteorologist with the Colorado Department of Health’s air pollution division, the Town of Parker was a relative “fail-safe area” for Denver’s “brown cloud," the notorious billow of air pollution that settled across Denver's skyline. Parker was deemed safe because of its elevation, the general direction of winds, and because the brown cloud tended to veer towards the foothills west of Parker, according to experts.
“It’s an entire metro-area problem,” said Charles Stevens, a physical scientist with the Environmental Protection Agency. “It’s not just Denver. You guys say, ‘I’ll move out and get away from it’ and pretty soon there are 10,000, 20,000, 30,000 people who move out to the same area and then you’ve got your own brown cloud.”
By nearly five to one, physician members of the Colorado Medical Society said they would vote against Amendment 69, the ColoradoCare single payer health care program, if the Nov. 8 general election were held today.
The findings from an opinion poll of 795 interviews of member physicians, representative by specialty and geography across Colorado and conducted Aug. 6 through Sept. 2, were used by the society board of directors to vote to oppose the amendment on Sept. 16. Survey details were discussed on Monday, Sept. 26.
Last week the leadership of the General Assembly approved my request for an interim committee, to meet between the 2016 and 2017 legislative sessions, to study the client notifications and client correspondence sent by the Department of Health Care Policy and Financing.
For years, I have received complaints from Coloradans all around the state, documented by actual letters from HCPF, that show we have a real, live bureaucratic nightmare in our state government.
Colorado, like the rest of the United States, faces an unprecedented demographic shift over the next several decades. By 2031, the State Demography Office estimates that Colorado’s 65-and-older population will be 181 percent larger than in 2010 — growing from approximately 550,000 to more than 1.5 million people — and represent 21.9 percent of the state’s total population, double the 10.9 percent it represented in 2010.
This rising tide of seniors will have economic and social impacts that our state and country are not fully prepared to address and we will be challenged to meet the needs of our older citizens, including the funding and delivery of quality long-term care services and supports.