Mar 03

AG: hospital fees can be enterprise; money helps hospitals with Medicaid, indigent care

BY PETER STRESCINO THE PUEBLO CHIEFTAIN
Published: February 29, 2016; Last modified: March 1, 2016 10:34PM
Colorado Attorney General Cynthia Coffman on Monday said that creating an enterprise designation for the hospital provider fee is constitutional. The program, which raised $1 billion in 2014-15, can be exempted from the Taxpayer’s Bill of Rights computations without violating the amendment.
Coffman’s announcement means she believes the program that collects fees from hospitals to draw matching federal dollars would meet the three tests needed to qualify as a “government-owned business” outside TABOR’s spending limits.

“I think it’s the right decision,” said Mike Baxter, Parkview Medical Center’s president and CEO, who has openly worried about cuts in federal funding coming back to Parkview. The money helps pay costs for uncompensated care. Hospitals pay into the fund. Parkview paid $27 million to the fund and received $43 million after the federal boost. St. Mary-Corwin Medical Center paid $14 million and received $27 million back, according to The Denver Post.

“We’re pleased with today’s opinion from the attorney general,” said Brian Moore, president and CEO of St. Mary-Corwin. “We have been in favor of moving the hospital provider fee to enterprise status in an effort to protect our ability to serve our community.” Continue reading

Mar 02

Hullinghorst to introduce Colorado hospital-provider fee bill despite continued GOP opposition

Colorado House Speaker Dickey Lee Hullinghorst is wasting no time in advancing her efforts to turn the hospital provider fee into an enterprise fund — announcing Tuesday that she will introduce a bill to make that move.

The new bill comes just one day after the state’s attorney general said she considers such a maneuver to be legal and constitutional.
Colorado House Speaker Dickey Lee Hullinghorst and Senate President Bill Cadman speak together in times of more agreement — at the official bill-signing for the 2015-16 state budget.

Bill Cadman & Dickey Hullinghorse

Colorado House Speaker Dickey Lee Hullinghorst and Senate President Bill Cadman speak… more

Ed Sealover | Denver Business Journal

But while Hullinghorst may have a legal opinion on her side from Republican AG Cynthia Coffman, she remains no where close to agreement with the top Republicans in the Legislature, Senate President Bill Cadman. Cadman, R-Colorado Springs, went as far as to say Tuesday that any bill from the Gunbarrel Democrat is dead on arrival if it, like her failed 2015 effort on the subject, it does not reset the Taxpayer’s Bill of Rights revenue cap by pulling the current provider-fee revenues out of the calculations and lowering that cap in future years.

The opposing reactions continue the pattern of the past two months, in which supporters of turning the seven-year-old fee into an enterprise fund — and thus freeing up more money in the budget for transportation and education — believe they have found an opening through which they can move forward, only to be reminded by Cadman that the majority caucus in the Senate feels the proposals to unconstitutional or at least unwise.

The fee, charged to hospitals for each night they keep a patient in a bed, generates more than $1 billion in combined state and federal funds to increase Medicaid rolls in this state, but it also is expected next fiscal year to push the state over the TABOR revenue cap and require the state to refund tax money to residents. Continue reading

Feb 29

Colorado AG: hospital provider fee OK as an enterprise fund; change could help with road funding

Colorado Attorney General Cynthia Coffman issued a formal legal opinion today that says the Legislature can convert the state’s hospital provider fee into an enterprise fund as a way to boost available tax money for road improvements and education.

In an unusual move, Coffman’s opinion backs Democrat Gov. John Hickenlooper’s position rather than her Republican legislative leaders on the controversial issue.

The question posed was whether the General Assembly could establish an enterprise fund with the hospital provider fee revenues and have it be exempt from revenue limitations of the Taxpayers’ Bill of Rights (TABOR).

Coffman wrote in an opinion released today that there are three considerations that determine an entity’s status as a government-owned business, which is one of the requirements for establishing enterprise funds under statute. An enterprise fund has to:

  • Lack the power to tax;
  • Provide government services in exchange for involuntary fees levied on service recipients; and
  • Be financially distinct from its parent agency.

“Today’s formal opinion concerning Colorado’s Hospital Provider Fee is a thoroughly researched legal analysis based on the language of the constitution and informed by Colorado court interpretations of TABOR,” Coffman said in a statement. “It answers a narrow legal question and outlines the minimum requirements under current law to create a ‘government-owned business’ under TABOR.” Continue reading

Feb 20

Health care vs. highways: State leaders at odds over windfall, TABOR limits

Health care vs. highways: State leaders at odds over windfall, TABOR limits

The good news is that the Colorado state-run hospital provider fee program brought in just less than $700 million last year.   

The money, which was matched almost dollar-for-dollar by the federal government, is targeted to increase funding for hospital care for Medicaid and uninsured clients, improve care for clients serviced by public health insurance programs and reduce cost-shifting to private payers.

As a state program, the hospital provider fee (HPF) requires hospitals to pay in an amount that’s based on the number of overnight patient stays and how many outpatient services they were provided.   

Even though revenue generated through the HPF program is a welcome addition to the cause of keeping Colorado healthy, it’s creating a controversy in the capital for other impacts it has and could have on the state.

Fee tips TABOR scales

Weighing in as high as it does, revenue from the HPF program adds a generous amount to the state’s revenue.  And although that sounds like a good thing, the program is raising issues about how that amount will negatively impact other state spending.

At the base of the controversy is the fact that HPF funds are slated for a particular purpose, and yet they can substantially reduce the amount Colorado will have available for many other projects.

Background to the concern goes back to 1992.  At that time, Colorado voters approved the Taxpayer’s Bill of Rights (TABOR), a constitutional amendment designed to keep growth in the hands of the people rather than in the hands of the government. 


Hospital Provider Fee

• What is it?

The hospital provider fee (HPF) requires hospitals to pay in an amount that’s based on the number of overnight patient stays and how many outpatient services they were provided. It raised almost $700 million in 2015.

What is its current status?

Funds from the hospital provider fee currently count against spending limits imposed by the Taxpayer’s Bill of Rights. That status will force tax refunds, thereby mandating cuts in other programs.

What is the proposal?

Gov. John Hickenlooper proposes reclassifying the hospital provider fee as an “enterprise,” thereby removing it from counting against TABOR spending limits.

What are the arguments against this proposal?

Opponents argue that the hospital provider fee does not meet the definition of an “enterprise,” that tax refunds should go forward, and that the state pursue budgetary efficiencies and cost-cutting to pay for the refunds.


TABOR prohibits tax increases without a vote of the people and places strict limits on how much revenue the state can keep and how much it can spend. Under TABOR, state spending is only allowed to increase at the rate of population growth plus inflation. 

If the state collects revenue that exceeds TABOR’s revenue limits, that amount must be refunded to taxpayers, according to the amendment. 

At this point, the HPF is tipping the scales in favor of exceeding those limits.   

It’s not that taxpayer refunds — estimated to be in the range of $25 to $125 per individual — would be a bad thing.   

Those in favor of the reclassification, however, are looking at rerouting funds as a way of filling in gaps of the 2016 state budget.  They see the result of that as being of a greater benefit to all.   

The projects that would escape cuts and be allowed to continue moving forward include education, transportation and road maintenance.

Workaround and end-around?

In an attempt to balance the issues — HPF revenue, TABOR limits and the state budget — Democratic Gov. John Hickenlooper has set forth a legislative action that would reclassify how HPF is legally regarded. 

The intent is to reduce the amount of budget woes the state will have to reconcile. 

In response to the initiative, Republican Senate president Bill Cadman and other conservatives have taken the stance that the reclassification is unconstitutional and an effort to water down TABOR.

At this point, opposing parties are at a standstill.  It’s been more than a month since Hickenlooper requested that Republican attorney general Cynthia Coffman decide about the constitutionality of reclassifying the billion-dollar hospital-fund program.

The current response from Coffman’s office is that the decision still is under review.

While the wait continues, other voices are weighing in on the subject.

On Feb. 11, legal counsels for two former governors released a legal brief that said reclassification of the HPF would be legally sound and fiscally responsible.

Jon Anderson and Trey Rogers, former counsels to Republican Gov. Bill Owens and Democratic Gov. Bill Ritter, completed the legal analysis at the request of a coalition called Fix The Glitch.

The coalition, a group of Colorado business organizations, is requesting that the Colorado General Assembly move forward on the reclassification.

“Regardless of our differing political views on the HPF, we are all strongly supportive of legislation that places HPF funds in an Enterprise Fund. The original law comingles HPF funds with general State revenue, inaccurately impacting revenue growth and creating significant unintended consequences that limit the state’s ability to meet core infrastructure investment priorities,” the group states.

The group’s petition said that HPF funds have begun “to crowd-out road and bridge funding.  CDOT right now has more than $3 billion in backlogged road projects.”

Koch-funded opposition

On the other side of the controversy is the conservative political advocacy group initially funded by the Koch brothers —  Americans for Prosperity.

Standing in opposition to making the HPF an enterprise, the group’s state director, Michael Fields, responded to Hickenlooper’s challenge for a better solution to close state budget gaps in January.

“With the state budget for next year adding up to an astounding $27 billion, the state should have more than enough money to take care of its core responsibilities.

“By cutting waste, finding efficiencies and re-examining priorities within the budget, we will be able to find more than enough money for important projects like fixing roads, building bridges and adequately funding our schools — without the need for Hickenlooper’s illegal plan to dismantle the Taxpayer’s Bill of Rights.”

The expected revenue from HPF in 2016 is $756 million, according to the economic outlook reported by the Governor’s Office of State Planning and Budgeting. 

In contrast, the state fiscal year budget shortfall is $373 million.

In his 2015 State of the State Address, Hickenlooper said that our budget rules aren’t working. 

“Coloradans know we’re not fully funding education.  They’re fed up with traffic congestion, they’re fed up with potholes and they’re fed up with our inability to expand our highway system,” he said.   

“Virtually every chamber of commerce and editorial board across the state … all agree that fixing the Hospital Provider Fee makes sense.”

TABOR practicality challenged

Changing the fee to an enterprise was actually laid out in the TABOR constitutional amendment, according to individuals and groups that see the change as a good one.

The TABOR Amendment defines an enterprise as “a government-owned business authorized to issue its own revenue bonds and receiving under 10 percent of annual revenue in grants from all Colorado state and local governments combined.”

Proponents of the reclassification argue that the action has already been used to the benefit of the state.   

Current Colorado enterprises include the state lottery and Colorado Parks and Wildlife.

Keeping the money generated from the HPF out of state revenues would allow it still to be used in the way it was initially intended while keeping TABOR intact and money available to put into other state programs. 

If the HPF stays as it is, and TABOR caps are reached, however, the overflow will by law go toward taxpayer refunds, and the budget will demand cuts. 

“We have enterprises that run lotteries, and build bridges and manage state parks.  The one we propose provides services to our health care system that it can’t provide on its own — and they want to pay us for them,” said Hickenlooper in his state of the state address.

“If we can’t make this very reasonable change — like many already allowed under TABOR — then what choice do we have but to re-examine TABOR?”

http://bizwest.com/health-care-vs-highways/

 

 

Feb 17

Colorado Senate president rebuffs legal opinion on hospital fee, road funding

Colorado Senate president rebuffs legal opinion on hospital fee, road funding

Feb 16, 2016, 5:23pm MST

Ed Sealover Reporter Denver Business Journal

A new bipartisan legal opinion regarding the constitutionality of a plan to boost Colorado transportation funding has failed to move Republicans in the state Legislature on the issue.

That makes it appear increasingly likely that House and Senate leaders will be unable to agree on a solution to what Gov. John Hickenlooper has called one of the most pressing problems in this session.

Bill Cadman

Colorado Senate President Bill Cadman points on Jan. 6, 2015 to an oversized copy of a… more

Ed Sealover | Denver Business Journal

The plan involves excluding the state’s hospital provider fee from revenue limits set by the Taxpayer Bill of Rights, or TABOR, as a way to create more room in the general fund for transportation and education spending.

Senate President Bill Cadman, R-Colorado Springs, said Tuesday that he gives no credence to an opinion issued last week by Jon Anderson and Trey Rogers, who served respectively as legal counsels for former Republican Gov. Bill Owens and former Democratic Gov. Bill Ritter.

The Anderson-Rogers opinion stated, in contrast to one issued in December by the nonpartisan Office of Legislative Legal Services (OLLS), that turning the hospital provider fee into an enterprise fund — thereby excluding it from TABOR’s terms — would be constitutional because the fee serves the business purpose of helping hospitals defray their cost of providing patient care.

Cadman, however, said that the only reason that the attorneys produced the opinion is because they were paid to do so, though he did not identify any groups that may have funded the effort. Continue reading

Feb 12

Lawyers for two ex-Colorado governors say Hickenlooper hospital plan is legal

Lawyers for two ex-Colorado governors say Hickenlooper hospital plan is legal

Lawyers for two ex-Colorado governors say Hickenlooper hospital plan is legal 

As Coloradans wait for an opinion from Republican Attorney General Cynthia Coffman over what’s become the biggest political debate in Colorado, two former executive branch lawyers are weighing in with their own conclusion.

At issue is whether it would be constitutional to reclassify a billion dollar hospital program so money generated from it will not push general fund revenue over mandated limits under the state’s Taxpayer’s Bill of Rights. Democratic Gov. John Hickenlooper and many Democrats in the legislature want a program called the hospital provider fee redesignated so there’s more money in the budget to fund roads, education and other programs.

In a legal review released today by former attorneys for past governors Bill Ritter, a Democrat, and Bill Owens, a Republican, they say the Hickenlooper plan would be “legally sound and fiscally responsible.”

The lawyers are Jon Anderson and Trey Rogers who worked for Owens and Ritter respectively. They did the legal analysis at the request of a coalition called Fix The Glitch, which is made up of business groups, higher education institutions, and other organizations whose interests stand to lose out.

 

Continue reading

Feb 12

Bipartisan legal opinion surfaces regarding Colorado’s hospital fee and road funding

Bipartisan legal opinion surfaces regarding Colorado’s hospital fee and road funding

Feb 11, 2016, 2:56pm MST Updated Feb 11, 2016, 3:53pm MST

Ed Sealover Reporter Denver Business Journal

Former legal counsels for the past two Colorado governors opined Thursday that the Legislature can turn the hospital provider fee into an enterprise fund and create more room in the general fund for transportation and education spending — a development that business leaders hope will convince some Republicans who may be sitting on the fence to back the move for such a change.

The release of the opinion came just hours after Gov. John Hickenlooper told a meeting of the Colorado Municipal League that if he can convince legislators to back his idea about turning the fee into an enterprise fund, he would like to use some of the newly freed revenue stream to sell bonds and raise $4 billion to $5 billion for immediate transportation solutions.

Hickenlooper speaksColorado Gov. John Hickenlooper speaks to a Colorado Municipal League meeting on Feb. 11,… more

Ed Sealover | Denver Business Journal

Republican legislative leaders did not react immediately to either the opinion or to Hickenlooper’s bonding plan.

But Kelly Brough, president and CEO of the Denver Metro Chamber of Commerce, said that GOP leaders to whom she has spoken in favor of the enterprising plan have promised her to keep an open mind. And if the constitutionality of the enterprise plan was the tipping point for anyone to oppose the idea, she thinks the new arguments might be enough to push them the other way.

“For those for whom this truly is a legal issue, it could make a big difference,” Brough said. “Now we have two additional attorneys coming out and saying that they feel that the enterprise fund is legal.” Continue reading

Jan 21

Johnson: Conservatives, beware of Building a Better Colorado’s spending agenda

Johnson: Conservatives, beware of Building a Better Colorado’s spending agenda

Donald E.L. Johnson

Donald E.L. Johnson

Colorado conservatives who want to control spending and taxes in the state should keep a close eye on the bipartisan Building a Better Colorado.

Its mission is pretty clear to anyone who has attended one of its some 20 “summits” that have been held around the state and has read its handouts and website.

Building a Better Colorado is intent on making it easier for politicians to increase spending and raise taxes. That is, it wants to repeal TABOR), which has helped keep spending in check in Colorado since it was passed in the early 1990s.

Further, BABC wants to make it harder to amend the state constitution by requiring a “super majority” of somewhere between a 50 percent to 66 percent majority to amend the constitution. Today, it is as easy to amend the constitution as it is to pass a referendum that creates a new law or set of laws that can be changed by the General Assembly.

 

Continue reading

Jan 20

Roberts: Colorado can’t balance its budget by ignoring its constitution

“My legislative duty includes necessarily upholding constitutional requirements.” – Senator Ellen Roberts

We’re past the ceremonial days of the 2016 legislature and the only tasks we must complete in a session, based on the state’s constitution, are to pass the budget and the school finance act. Although a short list, these two pieces of legislation require months of noodling, number-crunching and negotiations. This year will be no exception. The budget touches every essential — and many nonessential — governmental services, and will be the biggest challenge we face over the next 120 days.

In their opening speeches, Gov. John Hickenlooper and House Speaker Dickey Lee Hullinghorst, both Democrats, already assigned blame to the Republicans for budget battles brewing on the horizon, saying there’s only one path to reconciling the mess and that’s with their workaround on the Taxpayer Bill of Rights. Their speeches highlighted the word “compromise,” but in a way that suggested perhaps neither has read the book Getting to Yes. There’s an art to compromise, including listening and incorporating the input of others, something sorely missing here.

It’s important to note that the top 2016 challenge in all U.S. state legislatures is balancing their budgets. Unlike Colorado, more than a dozen states failed to meet their 2015 deadlines to balance their budget. So, while the spending limitations of TABOR and other constitutional requirements are hard to reconcile, it’s not TABOR causing the big squeeze, but, as experienced across the country, the very long lists of state spending that are exceeding available revenue. Continue reading

Jan 20

Guest Commentary: An unlawful swipe at TABOR on hospital provider “enterprise”

By Penn Pfiffner
Penn Pfiffner is a former Colorado legislator. He is chairman of the TABOR Committee.

Here’s a bad idea: hide a state government function off-budget and sock citizens with a big tax increase in the doing.

That’s what the Hickenlooper administration wants to do with its proposal to redefine the state’s hospital provider charge as an “enterprise.”

Colorado’s tax system is set up so that in a good economy, taxes are collected at a pace faster than growth in population and inflation. When government over-collects taxes, the Taxpayer’s Bill of Rights (TABOR) forces it to return the surplus to taxpayers.

Click (HERE) to read the rest of this story