DENVER -
Gov. Bill Ritter Tuesday signed a bill into law that will provide Medicaid coverage to up to 200,000 uninsured Coloradans without spending any taxpayer money -- the " Colorado Healthcare Affordability Act" that Ritter touted as "the most significant health care legislation to be passed in decades".
But many who low-income families that rely on Medicaid coverage, as well as the doctors that provide it, worry that it won't matter, not in light of the cuts proposed in the budget passed last week that will slash the amount of state money that goes to reimburse Medicaid providers.
With just weeks remaining until the close of this year's wild legislative session, Tuesday's was the rare case of one apparent legislative triumph being at least somewhat obscured by a legislative necessity.
"The problem is we just don't have the money to solve the problem," said Dr. Steve Federico, a pediatrician at Denver Health. "The Healthcare Affordability Act is a great thing, maybe the biggest thing this state has done to improve health care in decades. But, it's happening just as we're proposing budget cuts that will make it almost impossible for doctors to provide Medicaid coverage. Essentially, we're putting more people on Medicaid and reducing the money the state pays to doctors to provide it. So, for doctors, it actually compounds the problem."
Ritter, who signed House bill 1293 into law Tuesday at a ceremony outside Children's Medical Center, said that lawmakers are still talking about ways to restore at least some of the proposed cuts in the Medicaid provider reimbursement rate.
"We're in a downturn, and we're trying to figure out how to balance the budget, so provider rate increases is one of those things that has experienced a cut," said Ritter. "We're still looking at ways we may be able to build back some of that. But remember that we've put a $100 million increase into provider rates over the past two years. So that will at least soften some of the impact if we can't offset the cuts."
An hour before the bill signing, Medicaid recipients, many of them in wheelchairs, rallied a few blocks away at the Children's Medical Center on Marion Street in protest of the budget proposal which would cut nearly $73 million from Medicaid provider reimbursement and safety net provider rates.
"We shouldn't be balancing the budget on the backs of people who are poor and on the backs of people who are sick," yelled Sen. John Morse, D- Colorado Springs, to the gathered crowd.
Morse, the only lawmaker to attend the rally, argued that Colorado's hands are tied when it comes to funding Medicaid and health care programs because of the Arveschoug-Bird spending cap, which Morse is trying to undo with Senate bill 228.
Established in 1991, Arveschoug-Bird says that the state can only increase general spending, which includes health care and education, by six percent from year to year; under the provision, revenue surpluses above that six percent cap are automatically allocated to transportation. Moreover, when revenues dip, as they have this year, the scale ratchets down -- and revenues can only grow six percent annually above the lowered level of spending.
"This is what keeps our state from recovering after a recession," Morse said. "This is what is forcing us to make these cuts that will make it too expensive for doctors to provide the care you need."
To Robin Bolduc, that may be the difference between having her husband, Bruce Goguen, who's suffered from multiple sclerosis since 1985, at home receiving special care or in a treatment center at greater cost to the state.
"Having him home with us, there's nothing more important than that," Bolduc said. "But home health services are getting rate cuts, which jeopardizes his ability to live with us at home. Those providers are losing money so we're losing doctors that will provide what we need."
But many who low-income families that rely on Medicaid coverage, as well as the doctors that provide it, worry that it won't matter, not in light of the cuts proposed in the budget passed last week that will slash the amount of state money that goes to reimburse Medicaid providers.
With just weeks remaining until the close of this year's wild legislative session, Tuesday's was the rare case of one apparent legislative triumph being at least somewhat obscured by a legislative necessity.
"The problem is we just don't have the money to solve the problem," said Dr. Steve Federico, a pediatrician at Denver Health. "The Healthcare Affordability Act is a great thing, maybe the biggest thing this state has done to improve health care in decades. But, it's happening just as we're proposing budget cuts that will make it almost impossible for doctors to provide Medicaid coverage. Essentially, we're putting more people on Medicaid and reducing the money the state pays to doctors to provide it. So, for doctors, it actually compounds the problem."
Ritter, who signed House bill 1293 into law Tuesday at a ceremony outside Children's Medical Center, said that lawmakers are still talking about ways to restore at least some of the proposed cuts in the Medicaid provider reimbursement rate.
"We're in a downturn, and we're trying to figure out how to balance the budget, so provider rate increases is one of those things that has experienced a cut," said Ritter. "We're still looking at ways we may be able to build back some of that. But remember that we've put a $100 million increase into provider rates over the past two years. So that will at least soften some of the impact if we can't offset the cuts."
An hour before the bill signing, Medicaid recipients, many of them in wheelchairs, rallied a few blocks away at the Children's Medical Center on Marion Street in protest of the budget proposal which would cut nearly $73 million from Medicaid provider reimbursement and safety net provider rates.
"We shouldn't be balancing the budget on the backs of people who are poor and on the backs of people who are sick," yelled Sen. John Morse, D- Colorado Springs, to the gathered crowd.
Morse, the only lawmaker to attend the rally, argued that Colorado's hands are tied when it comes to funding Medicaid and health care programs because of the Arveschoug-Bird spending cap, which Morse is trying to undo with Senate bill 228.
Established in 1991, Arveschoug-Bird says that the state can only increase general spending, which includes health care and education, by six percent from year to year; under the provision, revenue surpluses above that six percent cap are automatically allocated to transportation. Moreover, when revenues dip, as they have this year, the scale ratchets down -- and revenues can only grow six percent annually above the lowered level of spending.
"This is what keeps our state from recovering after a recession," Morse said. "This is what is forcing us to make these cuts that will make it too expensive for doctors to provide the care you need."
To Robin Bolduc, that may be the difference between having her husband, Bruce Goguen, who's suffered from multiple sclerosis since 1985, at home receiving special care or in a treatment center at greater cost to the state.
"Having him home with us, there's nothing more important than that," Bolduc said. "But home health services are getting rate cuts, which jeopardizes his ability to live with us at home. Those providers are losing money so we're losing doctors that will provide what we need."
