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Within the 2022 legislative session, Colorado lawmakers handed a measure to evaluation Medicaid supplier funds extra ceaselessly as a part of a broader push to spice up well being care employee pay at a time of widespread staffing shortages.
The invoice ramped up the evaluation timeline for dozens of publicly funded well being care providers to each three years from 5, a transfer meant to allow the state to reply extra shortly to medical suppliers in monetary disaster.
The charges are tied to a share of what the federal authorities pays for Medicare providers, and fluctuate by medical specialty. When reimbursement charges for some providers fall behind, the evaluation requires focused will increase to deliver their pay again to market ranges.
Now in 12 months two of the accelerated evaluation schedule, Colorado funds writers fear they may fall up to now behind they might by no means catch up.
Colorado’s Medicaid Supplier Price Evaluation Advisory Committee this 12 months really useful a $585 million reimbursement fee bump for 19 classes of well being providers up for evaluation this 12 months, a bunch that features home-based care staff, EMTs and personal obligation nurses. A lot of that might come from matching federal {dollars}, with the state basic fund on the hook for $287 million.
Gov. Jared Polis’ funds request requires a fraction of that — simply $140,000 basically fund cash to extend funds to house and community-based providers — and cuts to others, like autism remedy suppliers who acquired focused pay bumps inside the final 12 months.
And that’s only for the specialties up for evaluation. His funds additionally proposes no across-the-board fee enhance, that means Colorado’s Medicaid suppliers would truly see their reimbursement charges for low-income sufferers shrink subsequent 12 months relative to inflation.
Colorado funds writers worry the state’s Medicaid program is on a monetary path to one thing akin to a brand new detrimental issue — the previous identify of the Okay-12 funding shortfall that endured from the Nice Recession till this faculty 12 months.
“It’s like we’ve created a brand new detrimental issue for Medicaid,” Joint Price range Committee Chair Jeff Bridges stated at a November listening to. “I’m not joyful about it, however I feel that’s the place we’re in for the long-term future.”
Technically, lawmakers wouldn’t must create one other detrimental issue (later renamed the funds stabilization issue) in state legislation. That’s as a result of in contrast to Okay-12 training, there’s no constitutional requirement to extend spending on Medicaid annually.
Nonetheless, the state’s Medicaid program could also be headed down the same path that faculties have been in 2009, with the governor and lawmakers going through stress to forgo common inflationary will increase to steadiness the funds. And annually that lawmakers don’t fund fee will increase that suppliers say are wanted, the monetary toll will solely compound when the following group of medical providers will get reviewed within the following 12 months.
“We’re in a scenario now with our funds, that it’s unlikely, except one thing important adjustments, that we’re going to have the ability to match the MPRRAC suggestions actually ever, shifting ahead,” stated Bridges, a Democrat from Greenwood Village.
“I’m glad that we have a look at all of them each three years in order that we’ve got appropriate information as we’ve got these discussions,” he added. “However I don’t see a world the place we hit these numbers.”
A NEW NORMAL UNDER TABOR?
The state has to chop round $1 billion in spending subsequent 12 months to steadiness the funds earlier than the brand new fiscal 12 months begins July 1 — a deficit that’s pushed partly by Medicaid sufferers merely utilizing extra care than they’ve in years previous.
On the similar time that Medicaid prices are rising extra shortly, the state income cap beneath the Taxpayer’s Invoice of Rights is rising extra slowly as a consequence of cooling inflation, limiting how a lot the state can enhance its funds.
That mixture led Polis to restrict will increase in well being care prices in his proposal for the 2025-26 fiscal 12 months funds. However his plan is drawing fierce scrutiny from the JBC, which worries that the state’s well being security web already faces a monetary disaster.
Federal stimulus {dollars} are drying up on the similar time Medicaid enrollment has fallen under pre-pandemic ranges. Lots of those that drop off the Medicaid rolls wind up uninsured, leaving some hospitals and clinics with their highest ranges of uncompensated care since earlier than the state expanded Medicaid beneath the Inexpensive Care Act.
In a funds listening to final month, Sen. Barbara Kirkmeyer, a Brighton Republican, stated she would push for deeper cuts to different areas within the funds to extend Medicaid supplier charges as an alternative.
“Our well being programs … they’re on the sting and they’re closing, they’re chopping employees, they’re decreasing providers,” Kirkmeyer stated. “So for us to not take into account this our most pressing want on this funds I feel could be irresponsible.”
Bridges, nevertheless, steered he isn’t certain the state can afford to do way more for Medicaid beneath TABOR with out sacrificing issues lawmakers worth extra, like Okay-12 training. Normal fund spending by the Division of Well being Care Coverage and Financing not too long ago surpassed that of the Division of Schooling for essentially the most of any state company. And well being care accounted for greater than half of the state’s basic fund development within the present funds 12 months, which ends June 30.
“That is the cap,” Bridges stated. “That is what the federal government is restricted to spend. If we had the Medicaid utilization we had final 12 months, possibly we will hit this (requested enhance) — however we don’t.”
Historic shifts in Colorado’s presidential election outcomes this 12 months
The presidential election in Colorado this 12 months introduced some large shifts in county-level outcomes.
Listed below are among the numbers that caught out to us:
THE SHIFTS FROM 2020
Trump fared higher this 12 months than he did in 2020 in various Colorado counties. The highlights:
Harris beat Trump in Colorado by 11 share factors this 12 months. In 2020, Biden beat Trump in Colorado by 12.5 factors.
ANOTHER NOTABLE PUEBLO RESULT THIS YEAR
One other notable end in Pueblo that flew beneath the radar was within the District 2 Pueblo County commissioner race.
Commissioner Daneya Esgar, a Democrat and the previous state Home majority chief, misplaced her reelection bid to Republican Paula McPheeters, a political newcomer.
Esgar was appointed to the seat in 2023 after the resignation of fellow Democrat Garrison Ortiz.
Additionally unseated Nov. 5 was Commissioner Eppie Griego, who’s unaffiliated. He will likely be changed by Democrat Miles Lucero.
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CAMPAIGN FINANCE
Defeat Boebert PAC, the federal tremendous PAC that raised and spent cash this 12 months to unseat Republican U.S. Rep. Lauren Boebert, modified its identify on Nov. 28. The group will now be often known as the Defeat the Excessive Fund.
Scott Martinez, a Democratic operative and the previous Denver metropolis lawyer, continues to be listed because the Florida-based group’s designated agent.
NEW STATE-LEVEL SUPER PACS
Two state-level tremendous PACs have shaped in current weeks in search of to affect the 2026 election.
Defend Our Vote was created Monday with the said objective of teaching “the citizens on varied officeholders and to affect the 2026 choice, nomination, election or appointment of Democratic candidates for statewide public workplace in Colorado.” Scott Martinez is listed because the group’s registered agent.
The Service First PAC shaped Oct. 31 with the said objective of serving to elect Democrats. Its registered agent is Justin Lamorte, a Democratic political guide who’s working intently with Democratic U.S. Rep. Jason Crow, who’s mulling a 2026 gubernatorial bid in Colorado.
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Jared Polis ignites one other firestorm on social media
Colorado Gov. Jared Polis could have caught his keyboard in his mouth — once more.
The Democrat was fast Sunday to show to social media to criticize President Joe Biden for pardoning his son Hunter.
“Whereas as a father I actually perceive President @JoeBiden’s pure need to assist his son by pardoning him, I’m dissatisfied that he put his household forward of the nation,” Polis wrote on X. “It is a unhealthy precedent that might be abused by later presidents and can sadly tarnish his status. While you turn out to be president, your function is Pater familias of the nation. Hunter introduced the authorized bother he confronted on himself, and one can sympathize along with his struggles whereas additionally acknowledging that nobody is above the legislation, not a president and never a president’s son.”
The blowback from the left was swift:
Polis’ publish was quoted in The Related Press, The Hill, Fox Information, Washington Examiner and New York Submit, to call a number of retailers.
It comes after he was panned for supporting Robert F. Kennedy Jr.’s choice as secretary of the Division of Well being and Human Providers. Many commenters on social media pointed to Polis’ Kennedy publish in reacting to his tackle the Hunter Biden pardon.
Nevertheless, a number of different high-profile Colorado Democrats weighed in on the pardon Monday and criticized Biden:
ANALYSIS: The governor has all the time been one to voice his opinion on social media. However sometimes his scorching takes are about nerdy issues, like “Star Wars” and “Mork and Mindy.” Sharing scorching takes about delicate political points is dangerous — and it undermines his go-to response to robust news-of-the-day questions that he’s a governor, not a pundit.
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Corrections & Clarifications
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