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Peter MarcusPeter MarcusJune 16, 20176min470
Nurses at Lincoln Community Hospital in Hugo, Colo. attend to patients and administrative duties at the rural hospital on the Eastern Plains. (Peter Marcus/Colorado Politics)

I spent Monday in Hugo, a tiny town on the Eastern Plains that was thrust into the spotlight this legislative session.

Subscribers can read about that online Monday and in our print edition, The Statesman.

Lincoln Community Hospital, located in Hugo in Lincoln County, was highlighted as a rural hospital that would take significant budget cuts if the legislature approved a budget-balancing move that would have reduced the Hospital Provider Fee by $264 million.

The fee is assessed on hospital bed stays to force a match of larger federal health care dollars. Without the federal match, hospitals in Colorado would have lost about $528 million. Lincoln Community had about $300,000 on the table.

Lawmakers were able to reach a compromise that created a 20-year funding program to direct $1.8 billion towards critical infrastructure. Hospitals were protected, but money also is coming in for schools and roads.

The residents of Lincoln County and staff at Lincoln Community Hospital were of course grateful that the legislature was able to spare their hospital from significant cuts. More importantly, they said it shines a light on rural Colorado, something the legislature has forgotten for years.

In this Republican stronghold that is state Senate District 1, residents and hospital employees who I interviewed on Monday said the bipartisanship on the Hospital Provider Fee seen in the legislature should serve as an example to Congress.

It is the standard of rural health care that Lincoln Community provides that hospital staff and locals hope resonates in Congress, where partisan politics plagues healthcare reform.

Republicans in Congress are proposing replacing the Affordable Care Act with a plan that would roll back Medicaid expansion starting in 2019. Federal reimbursements to states would be cut. Instead, the federal government would give states a capped amount of money for each Medicaid enrollee, or let states choose to receive a block grant. Democrats are vehemently opposed to the proposal.

The Colorado legislature, with its compromise on the Hospital Provider Fee this year, could serve as an example to Congress as it works through health care policy discussions.

“It seems like our politicians are too interested in winning arguments rather than developing solutions for our country, for health care in particular,” said Kevin Stansbury, chief executive of Lincoln Community, who added that he leans right politically. “We are absolutely proud of the Colorado legislature.

“A lot of people took some serious courageous positions to do the right thing, and it’s going to mean a world of difference to health care in rural Colorado.”

What Stansbury is worried about is that Congress will make “imprudent” cuts to health care that won’t do anything to reduce the cost of health care over time.

“I’m as concerned about the economic future of this country as anybody. I don’t want my grandkids being saddled with debt… So, to me, the way to do it is let’s invest some money now… We’ve got to have some money, we’ve got to invest in infrastructure, we’ve got to invest in technology.”

As a hospital administrator, Stansbury is worried that Congress will come up with a partisan plan that will only change again when there is another shift in political power in Congress and in the White House.

“We’re wasting money playing catchup rather than taking care of patients and that pisses me off,” Stansbury said. “If they can’t figure out how to reach across the aisle and really try to solve this in the long run, we are going to continue to play that game for the foreseeable future.”

Hugo Mayor Tom Lee, who usually stands with Republicans, is frustrated to see an unwillingness to work across the aisle in Congress.

“I think when they got together up there, a Democrat and a Republican, it worked,” Lee said of Colorado’s effort. “They weren’t playing Washington junk, and that’s the only way it worked.

“We would hope as this hospital progresses and they do whatever they do to upgrade, that it will be a shining star in rural medicine. That’s what we’re working for.”



Peter MarcusMay 10, 20174min1070

It was a difficult pill for many lawmakers to swallow, but in an example of bipartisan compromise, lawmakers on Wednesday advanced a measure to provide money for roads, schools and hospitals.

On a vote of 49-16 – on the last day of the legislative session – the House advanced a measure to create a 20-year funding program to direct $1.8 billion towards critical infrastructure.

Senate Bill 267 serves as an example of evolution, after Republicans for years resisted restructuring the Hospital Provider Fee to free money for state spending.

But 12 Republicans supported the bill during its final vote Wednesday morning in the House, despite facing pushback from outside conservative groups and interests outside the legislature.

“I hate the fact that we have to vote on this bill today because I know that by the time I get back to my desk the Facebook posts will start,” said Rep. Lois Landgraf, a Republican from Fountain, adding that people have been calling her a “Republican in name only,” or “RINO.”

Republicans have felt that the issue should have gone to voters. But by lowering the state spending cap by $200 million to protect taxpayer rebates and by addressing Medicaid reform by increasing co-pays for Medicaid patients, enough GOP lawmakers were able to come around.

The impetus for the bill was saving rural hospitals. The bill would reverse a budget move this year that reduced the Hospital Provider Fee by $264 million in an effort to balance the budget. The fee is assessed on hospitals to force a match of larger federal health care dollars. With the federal match, hospitals in Colorado stand to lose about $528 million. Some rural hospitals said they would close.

Senate Bill 267 would require that at least 25 percent of the money from bonding go toward projects in rural Colorado, with county populations of 50,000 or less.

The bill also comes after lawmakers failed to pass meaningful transportation funding by either advancing a tax increase to voters or using existing resources and a bond program. The state faces a $9 billion shortfall in transportation funding.

Schools were also a critical component of the bill. The measure would allocate $30 million to rural districts over three years. Lawmakers have proposed paying for the school funding by raising marijuana taxes from 13 percent to 15 percent.

It also would aim at avoiding a cut to the Senior Homestead Exemption, while also including a credit for businesses paying taxes on business equipment. Marijuana money would also help with that.

“Let us never allow a fear to decide what is best for the state for years to come,” said House Speaker Crisanta Duran, D-Denver. “Today, Senate Bill 267, it is not a long-term solution, and we still have many issues that we need to be able to grapple with, but this is a moment … it shows the power of collaboration.”



Joey BunchJoey BunchMay 7, 20177min960

Wednesday’s end of the Colorado legislative session feels a little like Christmas, but with liquor and bitterness instead of the milk of human kindness. It’s not going to be a happy new year.

Lawmakers knew they had to get  big things done before May 10, because that’s 120 days from when they started, just like Christmas follows Thanksgiving.

The session opened on Jan. 10 full of promises about finding bipartisanship: They would find billions of dollars for transportation. They would bury talks of restructuring a fee that means critical federal matching dollars for rural hospitals. They would rally around the common cause of education.

Now 117 days later, none of those things are yet true.

House Bill 1242, the months-in-the-making transportation compromise to address traffic jams, died in a political street fight in the Senate. Simmering inner-party tensions among Republicans over asking voters to approve a sales tax in November was the fuse. “The knives are out,” a Senate Republican told me of his caucus as the bill Senate President Kevin Grantham signed his name to was being killed in front of him.

The School Finance Act — legislation that must pass to fund schools each year — is in utter turmoil. The bill’s sponsor, Republican Owen Hill of Colorado Springs, inserted language to give charter schools an equal share of tax dollars that normally favor traditional public schools.

That was the ghost of legislation not-past, Senate Bill 61. Hill’s bipartisan effort to accomplish the same thing passed the Senate on March 14 and has been waiting in the House ever since. It’s on the Monday House Education Committee calendar, but doubtful it will survive.

Hill has played a gambit with the School Finance Act, but that’s a bill where deals will have to get done in a hurry as the session slips away, or else 178 school districts across the state are going to be in a world of hurt and lawmakers will be coming back for a special session.

Then there’s reclassifying the Hospital Provider Fee, the thing we were told was never going to happen. In January, House Speaker Crisanta Duran all but laid a wreath on the idea Democrats had pushed for two sessions. The idea was to reclassify the state’s Hospital Provider Fee, paid on using a hospital bed, to an enterprise fund. That would move it out from under a revenue cap that triggers refunds under the state Constitution’s Taxpayer’s Bill of Rights.

That had been a non-starter for Republicans. This session it’s been embraced by some on the right, but not all, thanks to plums Democrats have put into the conservative pudding: a $20 million tax break for businesses, tapping marijuana for more money, doubling Medicaid co-pays and reducing the TABOR spending cap by $200 million.

If they’re selling out TABOR, as they’ve characterized fiddling with the Hospital Provider Fee in the past, the GOP dealmakers got a very good price.

The deal would put $1.9 billion over 20 years into transportation, while keeping $528 million for hospitals and providing aid to schools.

Supporters say they have the votes to pass it in both chambers. They better be sure, because the clock is against them. The Senate gave preliminary approval to the bill Friday. It still has to pass on a roll call vote in the upper chamber.

When it bounces quickly to the House, it has to pass at least one committee then twice on the floor with no amendments. Just one amendment lands it in a House-and-Senate conference committee to work out a compromise, then both chambers have to pass it. This is making me dizzy.

In its favor is the fact that lawmakers are within days of having to explain what they accomplished this session, and nothing breeds bipartisanship like shared desperation.

Meanwhile, those most engaged on the state’s transportation say the bill doesn’t do what voters are expecting to relieve interstate traffic. Both transportation bills, they contend, steer way too much money off the interstates and into transit, bike trails and communities more familiar with cattle crossings than rush hours.

The truest quote I’ve heard this session was said Friday by Sen. Lois Court, the college government instructor and Denver Democrat who schools me and the Republicans often about the Constitution.

“I tell my students all the time that the most important letter in the word democracy is not the d,” she said in support of the Hospital Provider Fee deal. “It’s the two c’s, for complex and compromise. If you don’t acknowledge the complexities of the issues that face our state and aren’t willing to compromise to address them, nothing’s going to get done.”

That can still happen. Last year the biggest change to state liquor laws since Prohibition went down to the wire. ‘Tis the season.

Year after year this happens. And year after year, the legislature delivers more tube socks than model trains.


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Paula NoonanPaula NoonanApril 7, 20175min810
Paula Noonan
Paula Noonan

Colorado’s population in 1992 was 3.5 million. Census projections put the state’s population in 2017 at 5.5 million. In 1992, 812,308 citizens — 53.68 percent of voters — said yes to the Taxpayer Bill of Rights (TABOR), and 700,906 citizens — 46.32 percent of voters — said no.

Not to make too fine a point, but the 1.5 million 1992 voters on TABOR would comprise 27 percent of today’s population. And many of those 1.5 million people are no longer living in Colorado. Yet here we are, 25 years later, juggling TABOR limitations at the Capitol.

As background, the state in 1992 was in a deep recession from the oil and real estate bust of the 1980s. Front Range citizens especially were in an economic pit.

Downtown Denver was a dump: no Coors Field, no Pepsi Center, no new Mile High Stadium, no new Auraria Campus, no lightrail, no fancy Union Station, no pedestrian bridge over to the Highlands, no condos in LoDo or RiNo, downtown shopping fleeing to the suburbs, and prominent Denver retail names gone bankrupt.

Colorado Springs was hit hard as its real estate expansion of the ’80s died. Banks were on the brink of going out of business across the state.

After the anti-tax 1992 TABOR vote, Denver metro citizens did a 180-degree reverse and voted to build Denver International Airport. Then citizens voted for Coors Field and Mile High Stadium. With help from Gov. Bill Owens, RTD got a tax for light rail.

These investments set the stage for Colorado’s current economic vibrancy. The investments occurred based on a good feature of TABOR — let the people decide what projects and programs merit their money. Yet TABOR’s bad features, still in place, are wreaking havoc on the state’s budget.

Senator Andy Kerr, D-Lakewood, was among five legislators who voted against SB-254, the budget appropriations Long Bill. He’s asking people to take a long view back and forward: “It’s a vote to raise the TABOR issue once again. We’re not funding our schools, oil and gas inspectors, renewable energy, or filling in gaps from cuts from D.C.”

It’s esoteric for newcomers to know that Colorado’s current budget is based on the 2009-2010 recession years due to TABOR. “Unlike other states, because of TABOR’s ratchet down effect, Colorado doesn’t get to make up for downturns and come back,” says Kerr.

When the state gins up more tax revenues, as it has, the budget base doesn’t move up. Its budget level continues at the 2009-2010 recession point, forcing refunds of extra tax dollars.

The Hospital Provider Reimbursement Fee portrays the problem. The health care fees, considered a tax, push state revenues above TABOR limits. The Legislature’s Joint Budget Committee put up SB17-256 to reduce provider fees by $264 million, which causes an additional $264 million loss in federal matching funds.

The provider fee reimburses hospitals for delivering care to people who can’t pay. Without the fee, some hospitals, particularly in rural counties, don’t have enough money to operate. When those hospitals close, uninsured and insured alike lose care.

Four Democratic Senators, Irene Aguilar, Kerry Donovan, Matt Jones and Andy Kerr, and Republican Sen. Owen Hill, voted against the budget Long Bill. Also affected by TABOR is the ongoing $880 million annual negative factor that lowers public K-12 education spending. House members get to vote next.

So the question is, when will today’s citizens get the chance to vote on tax policy for today?


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Mike McKibbinMike McKibbinMarch 21, 20175min820

Here's a whatever-happened-to update: If you remember Martha Ezzard from her time as a Colorado legislator, you should probably check out the story in the Denver Business Journal. A couple of decades ago, Ezzard and her husband, Dr. John Ezzard, moved to Georgia to run an Ezzard family farm. They turned it into a pretty successful winery and are now selling it and moving back to Colorado. Welcome back, Martha and John!


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Sen. Lucia GuzmanSen. Lucia GuzmanMarch 20, 20174min690

Delta. Montrose. Lincoln. Teller. Fremont. Las Animas. Morgan. Garfield. These are a handful of counties in rural Colorado that are home to hospitals. Hospitals that not only provide access to life-saving health care for residents, but are most likely the area’s largest employer. These hospitals are typically smaller than their urban counterparts, but they are pillars in their communities, empowering people to build their lives in the towns they have called home for years.