Denver Business Journal
Bill to expand health coverage in Colorado debuts Denver Business Journal
- February 26, 2009
A bill designed to provide health coverage to more than 100,000 Coloradans without insurance was being introduced Thursday. Called the Colorado Heathcare Affordability Act, the measure has been several months in the making. It charges a fee to hospitals to generate about $600 million a year to provide coverage to the uninsured. In return, federal health care programs will provide roughly $600 million in matching funds that will go back to the state’s health care system. In total, the proposal generates an additional $1.2 billion — enough to cover more than 100,000 Coloradans through Medicaid and the Colorado Indigent Care Program, according to a fact sheet about the proposed bill.
The plan also expands the Children’s Health Plan Plus program for kids and pregnant women up to 250 percent of the federal poverty level.
The proposal also raises reimbursements for inpatient and outpatient services up to the maximum allowable rate under Medicaid. Colorado hospitals have long complained that Medicaid reimbursements are insufficient and fail to cover the real cost of health care services.
The measure has been in the works by Colorado Gov. Bill Ritter and his health policy analyst since mid 2008. But despite the endorsement of the Colorado Hospital Association, which worked with the governor and the Colorado Department of Health Care and Financing on crafting the legislation, not all local hospital systems are crazy about the idea, health policy experts say. Ritter has long maintained that there will be winners (hospitals that get more from the fee than what they put forward) and losers (hospitals that don’t) in the proposal. But Ritter’s spokesman, Evan Dreyer, said that as the bill is written, 87 percent of Colorado hospitals will “break even or come out ahead” with the fee.
Among the potential losers are the HealthOne-HCA, the Denver-area’s largest hospital system, and the nonprofit health system Kaiser Permanente in Colorado. Kaiser, which provides both health insurance and medical services, doesn’t treat uninsured patients and could have limited access to government subsidies under Ritter’s plan. But hospitals that provide services for a high number of uninsured or Medicaid patients stand to gain from the proposal, including Denver Health and hospitals in the Centura Health and Exempla Healthcare system. While the legislation was being drafted, private insurers wanted assurances that Ritter’s plan won’t create yet another cost for the health care system that ultimately would be paid by their members, whose insurance premiums have risen by double-digit margins in recent years.
However, several insurance providers, including Anthem, Cigna and UnitedHealthcare, wrote letters supporting elements of the concept. Dreyer said there are provisions in the bill to ensure that the fee is not shifted back to patients and insurers. The bill prohibits line-item billing of the fee. It also creates an oversight committee which to evaluate hospital finances. Supporters also say that the practice of cost-shifting will grow higher without the plan. The Metro Denver Chamber of Commerce issued a statement Thursday in support of the proposal as now drafted. “The Colorado Healthcare Affordability Act seeks to increase Medicaid dollars in Colorado by drawing down additional federal matching funds, enabling better reimbursement rates to Colorado hospitals, expanding coverage to the uninsured and reducing the cost shift to business from uncompensated health care,” the chamber said. “We support the draft, because we believe it includes many of the recommendations that are crucial to working toward a better Medicaid system for our state. … We look forward to reviewing the bill as introduced and the dialogue and discussion that will follow,” the chamber added. The bill is sponsored by members of the Joint Budget Committee, including Sen. Moe Keller, D-Wheat Ridge, Rep. Don Marostica, R-Loveland and Rep. Jim Riesberg, D-Greeley. If approved by the Colorado Legislature, the plan will be submitted to the federal Centers for Medicare and Medicaid Services for final approval.
© 2009 American City Business Journals, Inc.
