Colorado House Speaker Dickey Lee Hullinghorst introduced her anticipated bill to turn the hospital provider fee into an enterprise fund Monday with two twists — a Republican sponsor in the Senate and a companion bill allocating general-fund money that would be freed up if the bill were to pass.
Created in 2009, the fee is assessed on hospitals for each night that a bed is filled with a patient, and the revenue is used to receive match funding from the federal government and to increase Medicaid eligibility for childless adults.
It has generated billions of dollars in reimbursements for hospitals that treated previously uninsured patients with no capacity to pay bills, but because the revenue counts against the state’s Taxpayer’s Bill of Rights (TABOR) revenue cap, it also pushes the state toward exceeding the cap and having to give taxpayers refunds with money that could otherwise have gone to areas such as education and transportation.
Exceeding the TABOR also endangers about $600 million that otherwise would be transferred from the general fund to transportation needs over the years 2017-20.
It’s unlikely that it would have an immediate impact if passed, as Joint Budget Committee members made enough cuts to next year’s budget proposal that no TABOR refund would be necessary, but Hullinghorst and Gov. John Hickenlooper both have said they still want to see the enterprising happen for the long-term future of state funding.
While House Democrats and business leaders have pushed for the change, Senate President Bill Cadman, R-Colorado Springs, has said he is not interested in any measure that does not adjust the TABOR cap downward to reflect the lack of hospital provider fee revenues that have come in.
Hullinghorst, meanwhile, has replied that Cadman’s proposal is a non-starter because it would do nothing to avert future TABOR refunds or to increase funding for other areas.
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