Budget Bill Proposes Billions in Health Spending

The annual long appropriations bill always has significant ramifications for health care in Colorado, and this year is no different.

The $24 billion budget proposal from the Joint Budget Committee (JBC) includes major investments in behavioral health, oral health, Medicaid, health care technology, research grants and other initiatives. Debate on the bill wraps up in the Senate on Friday, April 4.

Some of the bill’s health care spending highlights:

• Major Investments in Behavioral Health: The legislature’s heightened focus on behavioral health continues this year with millions of dollars proposed for mental health and substance abuse programs. The Department of Health Care Policy and Financing stands to get a 36.3 percent increase in funds for behavioral health programs – a $147 million boost. This would help cover the behavioral health needs of the growing Medicaid population – a result of Colorado’s decision to expand Medicaid eligibility last year – as well as to fund a new substance abuse treatment benefit for Medicaid enrollees. The Department of Human Services also would get a boost in behavioral health funding, including $37.1 million for community programs aimed at indigent mentally ill clients, $6.7 million in substance abuse block grants, $750,000 for enhanced mental health first aid programs, and $25 million for a statewide mental health crisis response system, which was approved last session but has since experienced legal-related delays.

• Enhanced Oral Health Benefits:  While last year’s legislature approved a limited dental benefit for Medicaid adults, this year’s long bill includes $5 million to provide incentives for dentists to take on new Medicaid patients. The JBC approved the coverage of full dentures for Medicaid adults at a cost of $26.7 million. For children in Child Health Plan Plus (CHP+), the JBC approved enhanced oral health benefits to bring the program into compliance with federal law.

• Health Technology Upgrades and Incentives: The budget proposal includes upgrades to Colorado’s Health Information Exchange, as well as funding to encourage Medicaid providers and local public health agencies to adopt electronic health records and get connected to the Health Information Exchange. The bill also allocates $40.2 million to modernize Colorado’s Benefits Management System, as well as $537,000 for medical providers to acquire telehealth technology that allows for remote consultations, which proponents say will improve access to specialty care in rural areas.

• Increases in Medicaid Reimbursement Rates: The JBC proposes a 2 percent across-the-board increase for most Medicaid providers, with bigger rate increases for some specific services. Among them: a 20 percent rate increase for pediatric hospice services, a 10 percent increase for After Hours care centers, a 191 percent increase for transitional living programs for brain injury clients and a 50 percent increase for pediatric developmental assessment services. The bill also proposes that reimbursements for mammography and other “high-value” specialist services be increased to 80 percent of Medicare rates. 

• And More: Other notable health expenditures include funding to provide Medicaid and CHP+ coverage for eligible pregnant women and children who are legal immigrants; funding to improve the process that counties use to determine Medicaid eligibility and process applications; and $54 million for school-based health programs that provide preventive and primary care for low-income children. The Colorado Department of Public Health and Environment also stands to get tens of millions in grant money including funds for tobacco prevention and cessation programs; grants for chronic disease and cancer research and prevention; and, new this year, research grants to study the effect of medical marijuana on various health conditions.

After a lengthy debate, the long bill passed the House last week on a 37-27 vote, with all Democrats and one Republican voting in favor. After it moves through the Senate, the JBC will reconcile differences between the two chambers before introducing a final version of the bill for approval the week of April 7.