The 2015 Session: Small Changes With a Hint of a Big Deal to Come

Another legislative session is in the history books. It’s going to be a short entry. Maybe a sentence or two, especially when it comes to health policy.

Democrats and Republicans split control of the House and Senate. But narrow majorities in each chamber did not prevent wide partisan splits on many issues. Health bills that did pass tended to be non-controversial and have overwhelming support.

The Colorado Health Institute tracked 65 health-related bills. Just 34 passed, a rate that is much lower than previous years, but that mirrors the success of legislation in general. We will look in greater detail at the session’s major health bills in our annual Legislation in Review, coming soon.

A few successful bills that stand out include:

• Making it easier for advanced practice nurses to qualify to write prescriptions. This was controversial among doctors until a compromise was reached. (Senate Bill 197)
• Auditing Connect for Health Colorado, the state’s insurance marketplace. This plan failed in 2014 when Democrats said a performance audit wasn’t necessary. But a critical financial audit last winter pushed legislators into near-unanimous support of a full review. (Senate Bill 19)
• Parity for telehealth services in urban areas. Previously, insurance companies had to cover telehealth like a regular office visit in rural counties. Now the same requirement will apply in urban counties. (House Bill 1029)
• Marijuana caregiver reform. A large portion of the marijuana sold in Colorado comes from medical marijuana caregivers, who were very lightly regulated. This bill requires them to register with the state and places some limits on the number of plants they can grow. (Senate Bill 14)

These are important changes that aim to make government work better and to stretch the health care workforce to expand delivery of services. But none of them will introduce radical changes to lower costs or improve Coloradans’ health.

However, the session did give us a preview of a potentially big change involving health policy. Gov. John Hickenlooper proposed putting the Hospital Provider Fee beyond the reach of the Taxpayer’s Bill of Rights (TABOR). The change could keep an extra $600 million or more for the state budget by reducing TABOR refunds. The respected Colorado Futures Center predicts that changing the provider fee would eliminate TABOR refunds for the foreseeable future – a game-changer for the state budget.

The provider fee is used to pay for a pre-Affordable Care Act expansion of Medicaid and to compensate hospitals for charity care. But in an era of TABOR refunds, it crowds out hundreds of millions of dollars that could be spent on schools, highways and other priorities.

Hickenlooper’s proposal lost this year after failing to attract any Republican support. The governor has already said he plans to bring it back next year, and we expect that, sooner or later, legislators will not be able to resist the prospect of such a large pot of money becoming available at the stroke of a pen.

Those of us who watch the legislature can join in the refrain already being echoed by Colorado Rockies fans: Wait until next year.