Public Health in Peril? A Legislative Update

Health policy in Washington seems to be stalled as the new presidential administration takes shape. But health issues are well underway at the Colorado legislature.

The Colorado Health Institute team is taking an all-hands-on-deck approach to covering the debates in Denver and Washington this year, and we have a lot to report this week.

First, several public health programs seem to be at risk of losing their funding. Among them: The Healthy Kids Colorado Survey, which saw the Joint Budget Committee deadlock 3-3 along party lines. The survey ­– fielded every other year asking public school students about a range of health and social behaviors –  needs at least four JBC votes to make it into the budget, although it might be possible to overrule the committee and add funding later this year if a few Senate Republicans join with Democrats.

This survey fought off an attempt last year by a conservative bloc on the state Board of Education to discontinue it. Public health advocates are concerned because the survey is the best source of data about health risks to Colorado’s kids.

Several other public health programs did not receive a JBC vote yet, including funding for the state immunization registry, school-based health centers and care coordination pilot projects for Medicaid members.

We expect all these issues to resurface in the JBC in the next month. But it’s safe to say that Republican skepticism of the value and propriety of public health projects is shaping up as one of the major themes of the 2017 session.

Here’s a look at action on other health bills, courtesy of my CHI colleagues: 

Senate Bill 3 – Repealing Connect for Health Colorado

  • What the bill proposes: Shutting down the state health insurance marketplace and defaulting to the federal exchange, healthcare.gov.
  • What happened: The bill passed the Senate Finance Committee on a party-line vote Feb. 7, with Republicans in favor. Its next stop is the Appropriations Committee, but a hearing has not been scheduled.
  • Sponsors: Sen. Jim Smallwood (R) and Rep. Patrick Neville (R)

Senate Bill 64 – Freestanding emergency departments 

  • What the bill proposed: This bill would have regulated freestanding emergency departments (FSEDs) — emergency departments that are not attached to a hospital and are being built with increasing frequency, especially across the Front Range suburbs. They would have needed a new license and been subject to rules regarding safety and care standards, staffing requirements, improved transparency in billing and other requirements. In addition, Colorado would not license any new FSEDs until July 2019, unless that facility served an area with limited access to emergency care.
  • What happened: The bill failed 2-3 in the Senate State, Veterans and Military Affairs Committee. Separate legislative action on FSEDs may return this session, however, as the governor’s office is expected to take up this topic soon.
  • Sponsors: Sen. John Kefalas (D) and Rep. Susan Lontine (D)

Senate Bill 74 – Opioid treatments

  • What the bill proposes: SB 74 would create a medication-assisted treatment (MAT) pilot in Pueblo and Routt counties. The goal is to train and support nurse practitioners and physician assistants to prescribe medications such as buprenorphine to opioid-dependent clients.
  • What happened: The bill passed unanimously out of the Senate Health and Human Services Committee and is on to Senate Appropriations.
  • Sponsors: Sen. Leroy Garcia (D) and Rep. Daneya Esgar (D)

Senate Bill 17 – Medical marijuana for stress disorders

  • What the bill proposes: This bill, recommended by the Committee on Cost-benefit Analysis of Legalized Marijuana in Colorado, adds “acute stress disorder” and “post-traumatic stress disorder” to the list of conditions approved for using medical marijuana.
  • What happened: The Senate amended the bill to add “disabling medical condition” to the reasons a physician may refer a patient to use medical marijuana. It defines disabling medical condition as acute stress disorder or post-traumatic stress disorder. It passed the full Senate 35-0 and was assigned to the House State, Veterans and Military Affairs Committee.
  • Sponsors: Sen. Irene Aguilar (D) and Rep. Jonathan Singer (D)

Senate Bill 65 – Direct pay health price transparency

  • What the bill proposes: The bill would require health care professionals and facilities to make available to the public the prices they charge for common health care services.
  • What happened: The Senate amended the bill to include language about providers who are part of an HMO. It passed the Senate and moved on to the House, where it has been assigned to the Health, Insurance and Environment Committee.
  • Sponsors: Sen. Kevin Lundberg (R) and Rep. Susan Lontine (D)

Abortion-related bills

  • What the bills propose: Three abortion-related bills were brought to the House Health, Insurance and Environment Committee and were heard on the same day. HB 1086 requires the dissemination of information about “abortion pill reversal” medication to women seeking a chemical abortion. HB 1085, the “Women’s Health Protection Act,” introduces new regulations on clinics which provide abortions. And HB 1108 makes providing an abortion in most cases a class 1 felony.
  • What happened: All three bills failed 5-6 on party-line votes, with Democrats voting against them. 

House Bill 1094 – Telehealth

  • What the bill proposes: HB 1094 modifies the existing requirements for health benefit plans to cover services delivered via telehealth. Most changes are clarifications on what is required from insurers; for example, insurance plans can’t restrict reimbursement based on the type of technology or application used to deliver telehealth care. But the service must include an audio-visual component, so care delivered via text message, for instance, won’t be covered.
  • What happened: The House passed the bill, and it was assigned to the Senate Health and Human Services Committee.
  • Sponsors: Reps. Perry Buck (R) and Donald Valdez (D) and Sens. Larry Crowder (R) and Kerry Donovan (D)

House Bill 1057 – Interstate physical therapy license compact

  • What the bill proposes: An interstate agreement would allow physical therapists and assistants licensed or certified in a member state to obtain a license or certificate to practice in Colorado.
  • What happened: The bill passed unanimously out of the House Health, Insurance and Environment Committee and then passed the House Finance Committee 12-1. Its next stop is House Appropriations.
  • Sponsors: Reps. Faith Winter (D) and Larry Liston (R) and Sens. Bob Gardner (R) and Andy Kerr (D)

Joe is Manager of Public Policy Outreach at CHI.