Commission Discussion -- Health Care (continued)
INTERIM COMMISSION TO STUDY FISCAL STABILITY
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11:11 AM -- Health Care (continued)
Senator Brophy asked Director Henneberry what amount of money clients share in the cost of their health care. Director Henneberry answered that the federal government sets the allowable co-pay amount based on the client's income. Therefore, only the adult population pays a co-pay, and it is usually nominal. She also indicated that there are studies to identify affordability standards based on gross family income. These studies attempt to calculate an acceptable amount to charge a family for their health care, without sacrificing their ability to pay other necessary expenses. A reasonable level might be set at 5 percent of their annual income to cover provider co-pay amounts and deductibles; however, this is an on-going policy debate.
Senator Brophy concluded that Medicaid recipients basically pay nothing towards their health care. He added that S-CHIP recipients might be paying more. Mr. Bartholomew answered that even in these programs, the yearly premium fee and provider co-pay amounts are still nominal. Senator Brophy asserted that since the private programs are so much more expensive, there could be an incentive for families to discontinue private coverage and enroll instead in the public system. Director Henneberry responded that there are specific eligibility criteria and other incentives to keep low wage workers enrolled in existing private programs through subsidies.
Commissioner Renny Fagan asked about cost recoveries from third party liabilities. What amount of money from third party payers is identified each year and how much of this is actually recovered? Director Henneberry promised to get specific numbers to Mr. Fagan. She answered that the department seeks reimbursements as a result of provider fraud and mismanagement, as well as from uncollected client payments. The department's aim is to be the payer of last resort, and require that all other sources be provided and verified before the state pays its share.
Senator Morse asked how immediate needs are being met to provide a robust safety net? Dr. Sandeep answered that the cuts have not been easy for the providers and that many uninsured clients will be insured when the Health Care Affordability Act is implemented.
Commissioner Kirvin Knox asked about provider availability data. He pointed out that access is most challenging for the rural population and asked if the department coordinates efforts in these areas. Director Henneberry responded that there are programs to provide incentives for providers to operate in these areas, as well as finding alternative medical providers, such as nurse practitioners, to get better access to primary care for populations in rural areas.
Commissioner Amy Oliver-Cooke asked about Cover Colorado. Director Henneberry replied that Cover Colorado is a high risk plan to provide for individuals who are not eligible for a public program, but otherwise cannot afford or are ineligible for private coverage. This program is partially funded via state assistance.
Senator Heath asked the staff from HCPF to provide some numbers for the remaining questions. Mr. Bartholomew answered that $4.2 billion is needed for minimum funding level.
Question #1: What is the department's current funding level?: $4.0 billion overall, $1.6 General Fund, $2.0 billion federal funds, $400 million in cash funds and reappropriated funds.
Question # 2: What minimum funding level is needed to maintain the department's current level of services?: $4.2 billion overall, $1.7 billion General Fund, $2.15 billion federal funds, and $400 million cash funds and reappropriated funds.
Question # 3: What is the funding level that would be needed to provide the highest quality services for the people of Colorado?: Director Henneberry remarked that there are policy questions that need to be answered first. Once it is decided how many people should be covered, the department can calculate the total costs.
Representative Court asked what proportion of the current uninsured should be covered by a public program? Director Henneberry replied that 40 percent of the uninsured would qualify for public assistance, based on data from the 208 commission.
Representative Ferrandino asked what the cost is to implement all of the 208 commission recommendations? Director Henneberry answered that this amount was approximately $1.0 billion in total additional funding.