Good noon to you, Colorado, and welcome to a different version of The Temperature, the one local weather and well being publication to note what you’re doing together with your hair there. It appears good!
I come to you from the groggy morning-after of a late night time listening to the legislature’s Joint Price range Committee. (The committee, itself, didn’t go particularly late, but it surely has an unlucky knack for doing a whole lot of its work throughout child college pickup and bath-time hours, necessitating some past-my-bed-time listening to the audio recordings.)
I believe we are able to all stipulate that partisan politics has gone bonkers. However in the event you consider issues are hopelessly damaged, an antidote might be discovered in these many tedious hours of JBC members making an attempt to determine the price range.
Is it typically partisan? Positively. Is there occasional grandstanding? You guess. However, largely, there are six individuals speaking about what they care about and why and making an attempt to make all of it match collectively below a restricted amount of cash. And that stunning banality is a reminder of what might be achieved by doing two issues that we additionally delight ourselves on right here at The Solar: listening to 1 one other and seeing that we’re all on this collectively.
Or perhaps that’s the large quantities of caffeine in my bloodstream speaking. Let’s simply get to the information whereas my jittery fingers can nonetheless kind.
MEDICAID BUDGET
Colorado lawmakers start slicing the Medicaid price range. It’s excruciating.
It was roughly 4 hours into an arduous listening to of the legislature’s Joint Price range Committee on Tuesday — its second straight day of hearings targeted on the state’s Medicaid price range — when Sen. Barbara Kirkmeyer’s endurance burst.
“I do know it’s robust,” she implored her colleagues. “I do know it’s not enjoyable to make these sorts of choices. I don’t wish to make them myself, both. However (Medicaid) is on its approach to being 40% of our normal fund price range.
“We are able to’t afford it.”
Cash equals influence on the state Capitol, and in the event you hold across the constructing lengthy sufficient you’ll hear loads of proud tales from JBC members concerning the packages they helped construct and the providers they helped present to Coloradans by way of their votes on the price range. However this yr, with the state going through a $1.2 billion price range shortfall, the JBC’s position has flipped from elevating as much as slicing down.
On Monday and Tuesday, members of the committee went line by line with a cleaver by way of the majority of the state’s Medicaid price range to search out issues to cut. And, but, line after line, they discovered it troublesome to decrease the blade.
There was a proposal to avoid wasting $1.6 million by capping the quantity of dental providers that Medicaid would cowl annually for adults. The committee rejected it.
“I simply can’t think about denying care to individuals with ache of their mouths,” committee vice chair Rep. Shannon Hen mentioned.
There was a proposal to avoid wasting $6.3 million by decreasing among the higher-than-average charges that Medicaid pays for providers like maternity care and dialysis. Additionally rejected. A proposal to reduce a fee charge improve to oral well being care suppliers, saving $9.9 million. Nope.
A proposal to avoid wasting $1.6 million by decreasing how a lot is paid to suppliers of behavioral remedy for youths. Right here even Kirkmeyer was opposed.
“I respect you’re making an attempt to search for locations to chop,” she mentioned. “That is simply not one among them.”
(All of those figures are financial savings to the final fund — the discretionary state {dollars} over which lawmakers have essentially the most management. The cuts would cut back complete spending by extra, however solely as a result of the state would additionally obtain much less federal matching cash.)
At one level, Eric Kurtz, the nonpartisan price range analyst for the JBC charged with suggesting attainable cuts, joked sarcastically, “OK, I’m batting a thousand right here.”
As we’ve reported earlier than, the practically $16 billion price range within the present fiscal yr for the state Medicaid company, the Division of Well being Care Coverage and Financing, or HCPF, is greater than a 3rd of the state’s general price range. Take out all of the federal {dollars} that circulation into this system and focus simply on state cash, and Medicaid remains to be the largest company — at $5 billion, it’s the largest recipient of normal fund {dollars}.
To seek out $1.2 billion in cuts this yr to steadiness the price range, it’s nearly unavoidable that the legislature should minimize Medicaid. And but, the explanation Medicaid is so costly is as a result of prices are rising quick to cowl the very individuals this system was designed to serve: people who find themselves disabled or want long-term care. Youngsters make up this system’s subsequent greatest supply of normal fund spending.
“The troublesome place our committee finds ourselves in is wanting desperately to do proper by those that are most weak in our state and ensuring we’re being the very best stewards of taxpayers’ {dollars},” Hen mentioned throughout Tuesday’s assembly.
And so the committee struggled ahead, discovering cuts because it went. It diminished the mileage charge for nonemergency medical transportation providers, saving $13.7 million. It made a tweak to how the division calculates sure prescription drug costs, saving $470,000.
That is nonetheless the drafting stage for the state price range. Every of those cuts — and the selections to skip over others — could possibly be modified because the price range invoice is finalized after which makes its manner by way of the legislature within the coming weeks.
However it didn’t make the method any much less excruciating.
Kirkmeyer’s frustration got here out when her colleagues balked at stopping a yet-to-be-implemented plan that will permit youngsters to stay repeatedly enrolled in Medicaid for the primary three years of their lives, slightly than their households having to re-apply annually. The change was projected to avoid wasting $5.6 million. (The committee voted to start drafting a rollback invoice, although it’s unclear if it should have the votes to even be launched.)
Subsequent up, the committee debated whether or not to suggest a invoice eliminating a program that gives well being protection to youngsters with out authorized immigration standing. This system, often called Cowl All Coloradans, solely simply launched in January and has enrolled round 10,000 youngsters who wouldn’t have in any other case been insured for a health care provider checkup. Reducing it might save $19.2 million in subsequent yr’s price range.
“These are youngsters,” Sen. Judy Amabile pleaded. “This was the proper factor to do once we did it, and it’s nonetheless the proper factor to do now.”
The committee requested for extra choices on methods to scale back this system’s prices.
“Public well being care coverage, on the whole, is a satan’s alternative,” mentioned Sen. Jeff Bridges, the committee’s chair.
That proved particularly poignant when the subsequent merchandise got here up: equine remedy for individuals, largely youngsters, who’re disabled. In different phrases, taking ponies away from youngsters.
Medicaid in Colorado solely within the final yr started protecting the service, which makes use of horses to assist with bodily, behavioral and speech therapies. However, as Kurtz, the price range analyst, defined, the remedy is usually not lined by personal insurance coverage or Medicare, making Medicaid’s protection an outlier. In his briefing doc to the committee, Kurtz wrote that the thought of ending protection for the remedy illustrates “the absurdity of the alternatives out there.”
Reducing it might save a mere $198,014 of state normal fund {dollars} — 0.0165% of the state’s complete price range shortfall.
After Kurtz completed presenting the thought, 10 seconds of silence ticked by.
“I’ve seen this in motion,” Bridges lastly mentioned. “I’ve, um, seen the influence this has on, um, these of us, particularly the children.”
His voice grew angrier.
“I hate this. And it’s solely $200,000. However I — it feels prefer it ought to be a lever that we are able to pull if we have to.”
Moments later, the committee voted unanimously to start drafting a invoice to chop the protection. Bridges banged the gavel, then dropped it, letting it rattle on the dais. His microphone remained open.
“I hate the HCPF price range,” he mentioned. “I HATE the HCPF price range.”
PHARMA
A battle royale over pharmaceuticals heats up on the Capitol
How a lot the 340B program generates for Colorado hospitals per yr
If all the pieces sticks to schedule, two heavyweight well being care payments will step into the ring on the state Capitol on Thursday for his or her first committee hearings.
Each cope with a federal program often called 340B, which requires pharmaceutical producers to offer hefty reductions on sure medicine to hospitals that deal with numerous Medicaid sufferers. The hospitals can then cost sufferers or insurers their regular retail value for these medicine, producing an additional chunk of money for the hospitals to make use of for his or her charity care packages or simply to shore up their backside line.
This system quantities to about $700 million for hospitals statewide, mentioned Julie Lonborg, the Colorado Hospital Affiliation’s senior vice chairman and chief of employees. Nationally, hospitals saved about $57 billion in 2023 by shopping for medicine on the 340B value versus the checklist value, mentioned Katelin Lucariello, the deputy vice chairman of state advocacy on the pharmaceutical commerce group PhRMA.
Citing this system’s fast development and saying that it’s being utilized by hospitals as a approach to enhance earnings with out benefiting sufferers, the pharma trade has begun making an attempt to impose limitations on it throughout the nation.
“I’d say there are good and unhealthy actors in this system, and the unhealthy actors which might be rising their profitability by abusing this system are in the end on the forefront of this dialog,” Lucariello mentioned throughout a January interview.
We’ve already written about one of many payments up for committee this week: Senate Invoice 71, which might prohibit these pharma restrictions. That invoice is supported by hospitals, which say 340B is a crucial life preserver for among the state’s hospitals most vulnerable to drowning.
The second invoice, Senate Invoice 124, is a measure that will require hospitals to make use of the financial savings from the 340B program to scale back prescription drug prices and different out-of-pocket prices for lower-income sufferers. The invoice is supported by at the least a handful of pharmaceutical corporations, in line with the secretary of state’s lobbying database.
Lonborg, with the hospital affiliation, mentioned Senate Invoice 124 would place such a burden on hospitals — each by way of accounting and by way of not having the ability to use the cash in different methods — that many would choose out of this system.
“In the end, we expect it’s pharma’s try to chop this system,” she mentioned.
What makes this struggle so attention-grabbing (other than its contributors — hospitals vs. pharma!) is that each payments have bipartisan sponsorship in each chambers, so it’s not simple to see how they may cut up the legislature.
The payments are scheduled to be heard at 1:30 p.m. Thursday within the Senate Well being and Human Companies Committee.
POLLING
A brand new ballot reveals large help for one drug invoice. However who’s the group behind it?
Talking of these prescription drug payments, a brand new ballot claims that 84% of Coloradans would help a legislation like Senate Invoice 124 that requires hospitals to make use of 340B proceeds to decrease prescription prices for sufferers.
The ballot, performed by native agency Keating Analysis, which usually works with Democrats, surveyed 800 lively, registered voters over the telephone and on-line and has a margin of error of plus or minus 3.5 proportion factors. All of that’s fairly regular wanting. It’s the group behind it that’s extra mysterious.
The ballot was commissioned by Our Well being Fairness, a roughly year-old nationwide group that claims it really works on making certain entry to inexpensive treatment, clear water, high quality meals and charity care. The group has, at the least prior to now couple of months, turn out to be particularly lively in lobbying on 340B, together with towards payments in Oregon and Michigan that will have clamped down on pharma efforts to limit this system.
Laura Brod Hameed, the director of Our Well being Fairness, mentioned in an interview that the group isn’t against 340B however needs to see extra money going to scale back affected person prices. Hameed is predicated in Minnesota and beforehand served in that state’s legislature as a Republican consultant. She mentioned she had only in the near past joined Our Well being Fairness.
The group itself is a mission of a nonprofit known as the Home Coverage Caucus, which lists a very peculiar array of pursuits on its web site: opposing government-owned broadband networks, supporting a nationwide well-liked vote, opposing rate of interest caps on loans, backing infrastructure funding in Massachusetts, and combating towards a clear transportation commonplace in Minnesota.
The Home Coverage Caucus beforehand popped up in Colorado in a nationwide well-liked vote poll measure, the place it was linked to a darkish cash group with an analogous identify.
Hameed declined to say who funds Our Well being Fairness.
“We don’t disclose any of our funders,” she mentioned when requested whether or not pharma corporations have donated to the group. “What I can say is we’re not representing any of these large behemoth organizations. Our group is concentrated on representing the individuals most in want.”
BILL SIGNING
Extra accessible buildings are on their manner in Colorado
Advocates for individuals with disabilities cheered Tuesday, as a invoice so as to add enhanced accessibility requirements to constructing codes was signed into legislation.
Lt. Gov. Dianne Primavera, performing as governor whereas Gov. Jared Polis is out of the state, signed Home Invoice 1030 at a ceremony within the governor’s workplace. The invoice, which is able to take impact at first of 2026, requires native governments when adopting new constructing codes or updating current ones to make sure that the codes meet or exceed the accessibility requirements in worldwide constructing codes.
“Each Coloradan deserves the liberty to reside in areas they will navigate and luxuriate in,” Primavera mentioned in a press release. “By aligning our constructing codes with the present worldwide accessibility requirements, we’re not simply assembly authorized necessities — we’re reinforcing Colorado’s dedication to inclusivity and equal alternative.”
There have been already accessibility requirements within the legislation. However advocates say the brand new legislation is essential as a result of these present requirements aren’t sufficient.
“For too lengthy, the outdated and naked minimal necessities of the Truthful Housing Act have set the bar too low for accessibility,” Kelly McCullough, a co-legal director for Incapacity Regulation Colorado, mentioned in a press release. “This laws strengthens accessibility requirements in constructing codes to raised meet the wants of individuals with disabilities and make sure that buildings, together with multi-family housing, are designed for everybody.”
MORE ENVIRONMENT AND HEALTH NEWS
Republicans in Congress, as a part of a bundle spending reductions and tax cuts, need to probably make deep cuts to Medicaid. In accordance with a brand new ballot, voters don’t need them to.
A ballot from the nonpartisan well being coverage suppose tank KFF discovered that 82% of U.S. adults need to see Medicaid funding both stored the identical or elevated. Assist was robust even amongst Republicans and individuals who voted for President Donald Trump, with 69% and 65%, respectively, desirous to see Medicaid funding unchanged or boosted.
Solely 9% of U.S. adults — and 19% of Trump voters — need to see Medicaid spending decreased by rather a lot.
In different questions, the ballot discovered that 96% of U.S. adults consider that Medicaid is considerably or crucial to their communities, whereas greater than half of adults say both they or a member of the family has at one level been lined by Medicaid. Assist for work necessities in Medicaid is powerful, although a majority of individuals incorrectly consider that almost all working-age adults on Medicaid are unemployed.
You’ll be able to study extra concerning the ballot on KFF’s web site.
Hey, we made it to the underside! Who’s prepared for a nap?
Thanks for hanging with us this week. Let’s do that in particular person quickly, huh? Tickets are on sale now for Colorado SunFest 2025 on Could 16 on the College of Denver. Nice panels, nice individuals, nice conversations. It ought to be a whole lot of enjoyable.
Extra info and tickets can be found at ColoradoSun.com/Colorado-SunFest.
See ya subsequent week.
— John & Parker
Corrections & Clarifications
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