Category Archives: Hospital Provider Lawsuit

May 22

Partisan posturing trumps a better Colorado

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Perspective

Partisan posturing trumps a better Colorado

By Henry Dubroff and John Huggins
Posted:   05/21/2016 05:00:00 PM MDT

TABOR local leaders discuss changesLocal leaders discuss possible changes to the state’s constitutional initiative process in a small group during the Building a Better Colorado community summit at Northeastern Junior College on Dec. 7. (Sterling Journal-Advocate)

 

The tensions between populism and policymaking that are so evident in this year’s presidential primaries have trickled down to the state level.

In Colorado’s case, major policy reforms — including those that emerged from last fall’s Building a Better Colorado process of town hall meetings — have at times taken a back seat to partisan posturing.

But the Building a Better Colorado reforms remain a key part of the civic agenda, especially in these three areas:

  • Reform or replace the Taxpayer’s Bill of Rights (TABOR), or put in place a “TABOR relief valve” so that the state may keep a bigger share of tax revenue to fund roads, schools and other infrastructure necessary to serve Colorado’s growing population.
  • Reform our primary election process so that the results better reflect the will of voters and also put Colorado where it belongs on the national political map, as the most influential swing state in the Rocky Mountain region.
  • Establish somewhat higher though reachable hurdles for qualifying and approving constitutional amendments, taking into account Colorado’s diverse geographic and demographic interests.

The difficulty in getting TABOR relief approved in the just-finished legislative session underscores how tricky it is to enact reforms in an election year where the Donald Trump and Bernie Sanders insurgencies are having a big impact. In the state Senate, for example, majority Republicans were pushed by the Colorado chapter of the Koch brothers-funded Americans for Prosperity not to tweak the language of the state’s hospital provider fee and exempt it from TABOR limits. The penalty: facing a more conservative primary opponent at the next election.

To read the rest of this Denver Post story about TABOR, click (HERE):

May 13

GOP: Hospital fees under TABOR

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GOP: Hospital fees under TABOR

By Charles Ashby
Tuesday, May 10, 2016

DENVER — Even though it had near universal support outside of the Capitol, Republicans in a Senate committee Tuesday killed a measure that some had hoped would free up money for schools and transportation without raising taxes or fees.

The Senate Finance Committee, on a party-line 3-2 vote, killed a measure to turn the state’s hospital provider fee program, which funds health care programs for the poor, into a state-run government enterprise.

Doing so would free up about $750 million under the revenue caps mandated by the voter-approved Taxpayer’s Bill of Rights, something the 1992 constitutional amendment expressly allows.

But Republicans in the GOP-controlled committee said the idea flies in the face of TABOR’s spending limits, saying it would allow for unlimited growth when it comes to Medicaid spending.

“I do believe it is a major cash transfer, and I believe it was set up accordingly so that it would not come under the strong scrutiny of the voters of Colorado,” said Sen. Tim Neville, R-Littleton, who chairs the committee. “I believe that was not by accident.”

The issue has been a major theme of the 2016 legislative session, which ends today.

It actually started at the end of last year’s session when Gov. John Hickenlooper proposed taking the program out from under TABOR, in part because it’s a fee paid by hospitals and not taxpayers.

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May 13

7 winners and losers: Breakdown of the 2016 Colorado legislative session

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7 winners and losers: Breakdown of the 2016 Colorado legislative session

By: Megan Schrader

May 11, 2016 Updated: May 11, 2016 at 10:45 pm

photo - Colorado State Capitol Building
Colorado State Capitol Building 

The 2016 Colorado legislative session may go down in history as the year of little change.

The politically divided chambers in the General Assembly resulted in neither party having much success with their lengthy agendas.

That’s not necessarily a bad thing for political moderates or independents who don’t care about party agendas, but for everyone else, they’ve got something in the loss column this year.

That means 2017 won’t see major policy changes on things like clamping down on construction defects litigation or equal-pay legislation.

Here is a look at some of the winners and losers from the session, which concluded Wednesday:

WINNERS

The Joint Budget Committee

Any politician who can emerge from 120 days of politicking and still look like a high-functioning, level-headed individual. The three Democrats and three Republicans on the Joint Budget Committee received more than their share of accolades for crafting a 581-page budget that somehow managed to appease both sides. Sen. Kent Lambert, R-Colorado Springs, and Rep. Millie Hamner, D-Dillon, led the committee to a $25.8 billion budget that averted major cuts and – perhaps more significantly – the gridlock all too common across the nation when politicians dig in their heals.

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May 07

Colorado’s hospital provider charge: A tax masquerading as a fee

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(Editor’s note: This synopsis is excerpted from an Independence Institute Issue Paper on the Hospital Provider Fee Cash Fund, which can be found here:  http://www.i2i.org/the-hospital-provider-fee-fund/)

What is the Hospital Provider Fee?

In 2009, the Colorado General Assembly passed the Colorado Health Care Affordability Act of 2009, HB 09-1293, which imposed an up to 5.5 percent charge on hospital bills. It created the Hospital Provider Fee Cash Fund and the Hospital Provider Fee Oversight and Advisory Board within the Department of Health Care Policy and Financing (HCPF). Funds raised by the provider charge are deposited in the Cash Fund and do not revert to the General Fund. Payments made to hospitals by the Cash Fund are supplemental payments over and above Medicaid reimbursements made to hospitals for services rendered. The Act stipulates that “a hospital shall not include any amount of the provider fee as a separate line item in its billing statements.”

The provider fee raises revenue for the state

In FY 2014-15 provider charges collected $688 million. The revenue comes from payments of the charge and increases in federal Medicaid matching funds. Suppose a day in the hospital costs $1,000. If the federal match is 50 percent, Colorado Medicaid pays the hospital $1,000 and receives $500 from the federal government. Its net cost is $500. Continue reading →

Apr 29

House OKs hospital provider fee and road funding bills

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A desire to fix roads and fund schools led at least two House Republicans on Thursday to join Democrats to give preliminary approval to a bill that frees up about $700 million in state revenue for those purposes.
The legislation would re-categorize revenue collected under the seven-year-old hospital provider fee, which now goes into the state’s general fund and is subject to spending caps imposed by the Taxpayer’s Bill of Rights.
Colorado House Minority Leader Brian DelGrosso and House Speaker Dickey Lee Hullinghorst debate the hospital-provider fee bill.

Most Republicans question the constitutionality of changing how the hospital provider fee revenue is accounted for, calling it a “magic trick.” The fee program collects money from the hospitals for each patient they treat and leverages the money to bring in the same amount of federal funds.
GOP members argue that the maneuver alsol would cost Coloradans the chance to get Taxpayer’s Bill of Rights refunds for many years.
But House Speaker Dickey Lee Hullinghorst — the Boulder County Democrat who sponsored both the hospital provider fee bill originally said the legislation allocates money that doesn’t come in through tax collections and puts it toward transportation, higher education, K-12 schools and other priorities.

A coalition of more than 100 business and civic groups back the measure. Hullinghorst argued that money that will be put toward these needs will improve the state economy much more than sending small refunds back to residents.
“I believe this bill is the most important we will consider this session for one single reason — its adoption ultimately would touch the lives of every single Coloradan,” Hullinghorst told the House during a roughly 3-1/2-hour debate. Continue reading →

Apr 28

Research & Commentary: Colorado’s Hospital Provider Tax and TABOR Collide

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Research & Commentary: Colorado’s Hospital Provider Tax and TABOR Collide

Matthew Glans –
February 8, 2016
Funding Medicaid programs has proven to be an increasingly difficult task for many states.
In 2009, the Colorado General Assembly passed legislation creating a hospital provider fee (HPF) as part of its effort to provide health care for those Coloradoans who cannot afford private medical coverage and do not qualify for Medicaid. The HPF is assessed on hospitals based on the number of patients they treat and the number of outpatient services provided.

Each hospital pays a different amount for the tax, ranging from millions of dollars to nothing at all. The Denver Post reported preliminary state figures estimate the state’s hospitals paid $688.5 million in fees from October 2014 through September 2015. The federal government matched the fees, paying $1.2 billion.

The provider tax became a more important issue in Colorado after the Affordable Care Act (ACA) was passed in 2010. The Colorado legislature added an expansion of Medicaid to the hospital provider fee program in 2013, growing the program to roughly $2.4 billion during the state’s 2014–15 fiscal year. The fee is matched by the federal government, and it is used to provide expanded Medicaid coverage and increased enrollment in Colorado’s Child Health Plan Plus program.

The amount of revenue generated by HPF has grown rapidly over the past year. Revenue in 2015 increased by around 30 percent compared to the previous year, because the state’s Medicaid program is only now appearing in fee revenue. All told, the program funds an expanded Medicaid population of around 300,000 people.

Linda Gorman of the Independence Institute argues HPF has generated controversy ever since its inception. The original legislation creating the tax attempted to hide the true nature of the tax by calling it a “fee.” Even the federal government referred to the provider fee as a tax in a letter approving its payment.

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Apr 28

Colorado Legislators May Push HPF Through Constitutional Loophole

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Colorado Legislators May Push HPF Through Constitutional Loophole

April 27, 2016
 A bill that would exempt Colorado’s Hospital Provider Fee (HPF) program from the state constitution’s Taxpayer’s Bill of Rights (TABOR) has advanced to hearings on the House floor.

The House Committee on Appropriations voted 7–6 on March 29 to refer House Bill 1420, sponsored by House Speaker Dickey Lee Hullinghorst (D-Boulder County) and Sen. Larry Crowder (R-Alamosa County), to the Committee of the Whole.

HB 1420 would establish the Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) as a government-owned business to administer the state’s HPF. HPF is the vehicle by which Colorado expanded Medicaid under the Affordable Care Act (ACA) in 2014 and by which the state collected almost $700 million in revenue the following year.

CHASE’s designation as an “enterprise” would exempt the program from the state constitution’s TABOR, which mandates voters shall decide at the ballot whether Colorado must refund to taxpayers surplus revenue collected by the state, except when the surplus comes from a state “enterprise.”

If passed, CHASE will take effect on July 1, 2016, provided the federal Centers for Medicare and Medicaid Services (CMS) determine the program complies with federal law, according to the bill’s fiscal note.

Word Games

Linda Gorman, director of the Health Care Policy Center at the Independence Institute, says the bill manipulates the meaning of “enterprise” in order to circumvent the state’s constitution.

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Apr 20

Colorado’s Budget Settled, But Debate Coming On Taxes, Refunds

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Colorado’s Budget Settled, Debate Coming On Taxes, Refunds « CBS Denver .

April 19, 2016 1:57 PM

Speaker Dickey Lee Hullinghorst and other Democrats, including Gov. John Hickenlooper, want the fee set aside to avoid refunds under the Taxpayer’s Bill of Rights, free millions of dollars for Colorado’s underfunded roads and schools, and give momentum to pending ballot initiatives that would ease TABOR’s grip on state finances.

It’s a debate that some thought settled well before both chambers approved the $27 billion budget last week. Not so, said Hullinghorst, a Boulder Democrat.

“In this budget we managed to get by, but next year it will be twice as bad with cuts in education and higher education,” she said. The House could debate her bill this week.

Hullinghorst said reclassifying the fee can provide at least five years’ flexibility to spend more on schools and roads, and tackle TABOR and other constitutional restrictions on budget writers’ room to maneuver.

TABOR requires refunds whenever total state income surpasses a cap that’s based on inflation and population, not the economy’s performance.

 

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Apr 03

Budget fix still crucial for Colorado

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Budget fix still crucial for Colorado

Lawmakers should reclassify hospital provider fee

By The Denver Post Editorial Board

POSTED:   04/01/2016 05:00:00 PM MDT

Colorado legislators are seeking to reclassify the state hospital provider fee into a separate enterprise fund that would allow Colorado to remain below

Colorado legislators are seeking to reclassify the state hospital provider fee into a separate enterprise fund that would allow Colorado to remain below revenue limits imposed by the Taxpayer s Bill of Rights without refunding money. (Steve Nehf, Denver Post file)

Yes, Colorado lawmakers, it’s still important to deal with a projected budgetary crunch triggered by future tax refunds even if they are no longer likely in the next fiscal year.

The problem is only being delayed for one year. Refunds will almost certainly be required in the following years under the Taxpayer’s Bill of Rights unless the economy entirely tanks. And yet they will come at the expense of critical transportation, capital maintenance and education funding. Indeed, transportation funding is already slated to decline in next year’s budget.

In other words, lawmakers still have urgent reason this session to reclassify the hospital provider fee into a separate “enterprise fund” to allow the state to remain below TABOR revenue limits without refunding money.

To read the rest of this story, click (HERE):

 

 

Mar 30

Business leaders battle Republican lawmaker in hospital-fee bill hearing

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Business leaders battle Republican lawmaker in hospital-fee bill hearing

Denver Traffic cars

KATHLEEN LAVINE | DENVER BUSINESS JOURNAL

Overcrowded highways like this stretch of C-470 near Yosemite would be a primary beneficiary of the hospital-provider fee bill, business leaders argue.

Colorado business leaders charged into the state Capitol Tuesday to advocate for a newly introduced change in the hospital provider fee that they believe will increase funding for transportation and education — and ran right into a key Republican legislator who questioned whether they would be taking revenues illegally from companies and individuals that need them more.

House Speaker Dickey Lee Hullinghorst’s long-planned bill to pull some $700 million out from under the Taxpayer’s Bill of Rights (TABOR) revenue cap and turn it into an enterprise fund received its first hearing in the House Appropriations Committee Tuesday, one day after it was introduced.

Committee Democrats passed it onto the House floor over the objections of Republicans, the first of several steps in what is expected to be a weeks-long fight over one of the most watched measures of this legislative session.

The seven-year-old provider fee charges hospitals for each night a bed is occupied, leverages that money to get an equal amount of federal matching funds and expands the eligibility of childless adults for Medicaid, reducing the burden of uncompensated care on hospitals.

By turning the fee into an enterprise, it frees a lot more room for the state to collect new revenues without reaching its TABOR cap and having to give back any excess money as tax refunds.

 

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