Sometimes we become immune to acronyms in the world of health policy. Case in point: I first wrote this sentence to start the blog: “The JBC approved CDPHE’s request to fund LARC, including IUDs.”
While that will make sense to many of you, let’s translate into plain English here.
The Joint Budget Committee (JBC), the six-member, bipartisan group in charge of putting together the state’s budget, has been conducting “figure setting” hearings for all state departments. The JBC is considering budget requests and recommendations from the departments and voting on what to support, change or deny.
There’s still time to alter funding decisions before the Long Bill, or full budget, is introduced in the House. (Each year, the two chambers alternate who reviews the budget first.) But these votes can impact whether some funding items are more likely to be challenged or accepted later on the House or Senate floor.
In the Department of Public Health and Environment (CDPHE) hearings, we were particularly watching the discussions related to the family planning program and the Colorado Commission on Affordable Health Care. CDPHE’s family planning program includes funding for long-acting reversible contraception (LARC), including intrauterine devices (IUDs) and birth control implants.
The program attracted a great deal of attention last year when the Senate killed a bill to allocate state money to continue providing LARC, which was needed because outside grant funding had ended. This year, it was determined that a separate bill is not actually needed to make the switch from private to public funding, and advocates seem to be taking a much quieter route to gaining state money this time around.
After posing some tough questions and delaying the vote to consider more information about who is served by the program, Rep. Bob Rankin (R) once again voted with the JBC’s three Democrats to approve the $2.5 million funding request. It remains to be seen if Senate Republicans will fight it when it’s their turn to vote on the budget.
The JBC approved partial funding for the Cost Commission. The request for $424,000 was cut to less than $180,000 after questions were raised about the group’s transparency and productivity. The committee asked for a bill that would require the Commission to come back to the legislature more often for further funding, if applicable. The next report from the Commission is due in November.
The JBC also supported more than $7 million in funding for a youth substance abuse prevention program and a proposed change to screen more young women for cervical cancer. Screenings are currently for women 40 and over, but CDPHE hopes to lower the age to 21.
In other news, House Bill 1054 , which would have enacted the Colorado End-of-life Options Act, was abruptly tabled for the year, surprising many who expected to see a debate.
The bill’s sponsors, Rep. Joann Ginal (D) and Rep. Lois Court (D), concluded that they did not have enough votes to pass the House. Many legislators were agonizing over how to vote on this emotional issue, and Ginal and Court agreed to spare their colleagues a recorded vote on the House floor when it became clear that they were short on needed support. The bill was laid over, or delayed, until June 1, a symbolic move that kills the bill by removing it from the schedule until after the end of the legislative session in mid-May.
According to radio reporter Bente Birkeland, a frustrated Court told her House colleagues, "The choice we made today was to give you the relief from having to have this conversation. . . . We are doing you this favor, to not have this debate, but make no mistake the voice of the people of this state will be heard."
Attention turns now to a ballot initiative that would legalize aid in dying in Colorado. The deadline to file such a measure is March 25, and multiple groups are exploring the option to put something on the ballot. It is likely that the issue will go to voters in November, but it’s unclear how closely an initiative would mirror HB 1054.
Wondering about noteworthy votes on health care bills in the past week? We’ve got you covered.
- The House Health, Insurance, and Environment Committee delayed consideration of HB 1160, which would continue the requirement that surgical technicians and assistants must register with the state. Otherwise, the requirement will sunset, or end. We don’t normally pay much attention to sunset reports, but in light of the recent story about a former Colorado hospital employee who stole drugs and infected patients with blood-borne illnesses, it may be politically unpopular time to loosen regulations.
The committee also considered HB 1195, which hopes to expand the availability of qualified home modification services to more people with disabilities, and HB 1164, a bill that proposes to have the state (rather that students’ schools) review requests for student immunization exemptions. HB 1195 passed 10-3 and moves next to House Appropriations. After hours of debate, HB 1164 advanced Thursday night on a 7-6 party-line vote.
- The House Public Health Care and Human Services Committee voted unanimously to kill Senate Bill 39, which would have included mental health professionals in collaborative services teams, after advocates for the bill decided it needed to be rewritten. In addition, the committee narrowly approved HB 1079, which asks to create a state-approved label for marijuana grown without pesticides. The bill heads to House Finance thanks to a 7-6 vote and is up for a hearing there next week.
- For the second year in a row, the House Finance Committee said no to a bill to create a home services tax credit for seniors. Though HB 1065 had been changed since last year to make the financial impact smaller, it failed 6-5, with all Republicans in favor of the bill and all Democrats opposed.
- The Senate Health and Human Services Committee showed lots of agreement yesterday, passing two bills unanimously. SB 135 proposes to allow insurance plans to cover services provided by pharmacists as long as they meet certain requirements. HB 1148, which has been heavily amended, would give the Legislative Exchange Oversight Committee greater authority over the state insurance marketplace, Connect for Health Colorado.
- The Senate State, Veterans and Military Affairs Committee is living up to its reputation as the end of the road for many bills. SB 118, a bill that would have required the state to adopt a screening questionnaire for prenatal substance use, failed 3-2.
- The Senate Business, Labor and Technology Committee approved SB 127, which would repeal a 2010 law that established the Medical Clean Claims Task Force. The committee recommended it be placed on the Senate’s consent calendar for non-controversial bills.
- And HB 1063, which would allow mental health professionals to disclose concerns about a client if that client makes or implies threats against a school, passed the House 51-12 and is on to the Senate.
Votes we’ll be watching next week:
- House Finance will hear two bills. HB 1142 would create a new tax credit, capped at $1,000 per year, for up to 300 rural preceptors who train students to become primary care providers in high-need areas. The bill has passed the Public Health Care and Human Services Committee. HB 1266 would allow the state to seize and destroy any marijuana that contains unauthorized pesticides.
- House Health, Insurance, and Environment will hear HB 1101, which would allow doctors to serve as the decision-maker for an incapacitated patient if no family or friends can be found.
- House State, Veterans and Military Affairs will hear HB 1146, which would define a fetus or infant as “born alive,” regardless of the stage of development, for abortions as well as natural births and cesarean sections.
And we’ll be keeping an eye on three new bills:
- HB 1277 has bipartisan support. It would require the Department of Health Care Policy and Financing (HCPF) to provide 20 days of advance notice to Medicaid enrollees if their benefits are going to be paused, altered or terminated. It would also extend the time window for an enrollee to appeal from within 30 days of receiving such a notice to within 60 days.
- HB 1278 would allow the courts to require anyone on probation to participate in a residential drug treatment program. Currently, only people sentenced to probation for drug offenses can be required to participate in such treatment programs.
- HB 1294 would direct all health insurance plans to provide no-cost coverage for contraception services without any restrictions or delays. This would include family planning counseling, birth control pills and methods such as IUDs, and voluntary sterilization.
We’ll also continue watching the JBC’s figure-setting hearings. CDPHE’s may be done, but HCPF and others are coming up in the next few weeks. Without much wiggle room in the budget, there are plenty of tough decisions ahead.
FWIW, look for blogs on these TBD decisions. TTYL.