Governor Previews a Heavy Agenda for Health

Governor John Hickenlooper delivered a State of the State address this morning that was heavy on health policy — starting with a call to modify the Hospital Provider Fee to control costs and help rural hospitals and clinics.

Hickenlooper also pledged to put up a fight for the gains Colorado has made under the Affordable Care Act (ACA) while the Republican Congress considers repealing it.

“If changes are inevitable, I will fight for a replacement plan that protects the people who are covered now and doesn’t take us backward,” Hickenlooper said.

Health highlights of the 2017 State of the State:

  • Hickenlooper called for a rewrite of the Hospital Provider Fee to use the money to address cost control and rural health care.
  • He praised the Affordable Care Act (ACA) for extending coverage to 600,000 Coloradans, by his administration’s count, and raising Colorado’s insured rate to nearly 94 percent. If Congressional Republicans repeal the ACA, he pledged to fight for a replacement that covers at least as many people as the current law.
  • He announced — without providing details — a set of proposals led by Lt. Gov. Donna Lynne to lower health insurance costs, provide more choices and increase transparency in health care.
  • He called for the creation of a statewide behavioral health plan to make the mental health system easier to access and more efficient.
  • The governor pushed to use marijuana tax money to police illegal sales by home medical marijuana growers and to address chronic homelessness.

The governor also sensed opportunity from the new leadership in Washington. Speaker of the House Paul Ryan has proposed converting federal Medicaid funding into grants to the states with fewer strings attached.

“It’s clear that the new administration and Congress seek a different relationship between the federal government and the states,” Hickenlooper said. “In the coming years, we expect more responsibility to be directed our way. But in Colorado, we’ve always been trailblazers.”

A day earlier, the Republican leader of the state Senate laid down a different marker on health policy.

President Kevin Grantham signaled a serious Republican push to shut down Connect for Health Colorado, the state’s online insurance marketplace.

“It is time for us to shed some of the dead weight of failed government policy. Senator Smallwood (R-Parker) will introduce Senate Bill 3 which will repeal the Colorado Health Care Exchange. This is long overdue,” Grantham said in his opening day address.

Although Republicans had introduced bills to repeal the marketplace in past sessions, they died quickly because they were introduced in chambers where Democrats held the majority. This is the first time that a repeal bill has a chance to pass at least one chamber, even though it has little chance of passing the Democratic-controlled House.

Here’s a more detailed look the various health policy goals Hickenlooper discussed during his State of the State address.

Hospital Provider Fee

The fee is projected to push the state above the revenue limit specified by the Taxpayer’s Bill of Rights (TABOR) by more than $250 million. That would require a tax refund paid out of the General Fund.

When Republicans retained their Senate majority, they all but guaranteed failure for Hickenlooper’s desire to remove the fee from TABOR calculations.

Instead, Hickenlooper called today for a rewrite of the provider fee to use its money to advance the state’s health goals.

“Let’s see if we can take a fresh look at the Hospital Provider Fee itself, and see if it can be modified as a vehicle to control costs, to build more transparency and accountability and better serve rural clinics and hospitals,” he said.

ACA Repeal

The governor’s tone was notable here. He strongly defended coverage gains made under the ACA and also made a moral case for protecting coverage.

“We believe that basic health care is a right, not a privilege,” Hickenlooper said.

Behavioral Health and Substance Use

The state should create a comprehensive behavioral health plan to make the system more efficient and easier to use.

“Behavioral health demands our attention at all points, and not just as one-off efforts when problems get too big to ignore,” he said.

Hickenlooper also weighed in on the controversy over the link between Colorado’s liberal marijuana laws and homelessness.

Joe is Manager of Public Policy Outreach at CHI.