Senate Committee on Finance (04/02/2009)

Final
STAFF SUMMARY OF MEETING

SENATE COMMITTEE ON FINANCE

Date:	04/02/2009	ATTENDANCE

Time:	10:23 AM to 12:00 PM	Brophy	X
		Heath	X
Place:	SCR 356	Isgar	*
		King K.	X
This Meeting was called to order by		Scheffel	X
	Senator Sandoval	Hudak	X
		Sandoval	X
This Report was prepared by
	Elizabeth Hanson
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
HB09-1293		Amended, Referred to Appropriations

10:24 AM -- House Bill 09-1293

Senator Boyd and Senator Keller, prime sponsors, presented House Bill 09-1293. The bill will create the Health Care Affordability Act of 2009. The Colorado Department of Health Care Policy and Financing is authorized to collect hospital provider fees for the purpose of obtaining federal financial partnership for Colorado's medical assistance programs. Senator Boyd testified that the bill is the next step in health care reform. She stated that the bill is important in the current fiscal climate and enjoys public support from many groups. Senator Boyd said the bill would provide an additional 100,000 Colorado citizens access to health care, and she urged the committee to support the bill.

Senator Keller requested that background information from Legislative Council Staff about revenue and the Referendum C cap be distributed to the committee. It is included as Attachment A.

Senator Keller stated that the bill has been a work in progress with the Colorado Hospital Association. She stated that more than 40 states have implemented a hospital provider fee. Senator Keller provided background information about the financing model for the cost shifting and explained that the bill would give the Colorado Hospital Association the authority to implement the model. She said the bill does not include any taxpayer dollars. Senator Keller also explained that the bill is contingent upon obtaining a waiver from the federal government.

10:32 AM

Senator Keller responded to questions from the committee about taxes and federal funding. Discussion ensued about federal funding and deficits. Senator Keller also responded to questions from the committee about hospitals and the amount of funding they receive from the federal funding. Discussion ensued about cost shifting, hospitals, and private insurance contracts.

10:39 AM

Senator Keller responded to questions from the committee about hospital fees. Discussion ensued about pages 5 through 12 of the reeengrossed bill. Senator Boyd also responded to questions about what citizens would receive additional coverage under the bill and about breast cancer coverage in the bill.

10:45 AM

The committee discussed coverage for the medically indigent and insurance coverage for individuals. Senator Keller responded to questions about how many surrounding states are participating in a similar plan with hospital provider fees.

The Colorado Hospital Association distributed a summary of support for the bill (Attachment B) and a copy of a Denver Post Editorial dated Sunday, March 15, 2009 (Attachment C).

The committee began public testimony. The following persons testified on the bill:

10:46 AM -- Mr. Steven Summer, representing the Colorado Hospital Association, testified in support of the bill. He stated that maintaining access to health care is important in the current economic downturn. Mr. Summer provided background about the federal matching rules and the impacts on hospitals. He stated the bill is an important step in addressing uncompensated care that is provided by Colorado hospitals.

A letter from the Children's Hospital supporting the bill was distributed to members of the committee (Attachment D).

10:51 AM -- Mr. Jim Shmerling, representing the Colorado Hospital Association, testified in support of the bill. Mr. Shmerling is CEO of the Children's Hospital. He discussed the children that do not have access to health insurance coverage, and stated that providing preventative care is necessary. Mr. Shmerling said that providing compensation to hospitals will help to lower health care costs, and he urged the committee to support the bill.

10:54 AM -- Mr. Russ Johnson, representing the Colorado Hospital Association, testified in support of the bill. Mr. Johnson was also representing the San Luis Valley Regional Medical Center. He talked about the San Luis Valley region and the health care issues individuals are facing there. Mr. Johnson stated that 800,000 people in Colorado do not have health insurance, and that Colorado should use the federal and state resources that are available to address this problem.

11:00 AM -- Dr. Patricia Gabow, representing Denver Health, testified in support of the bill. Dr. Gabow stated that Denver Health is the largest provider of health care to uninsured individuals in Colorado and discussed the services that the hospital provides. She added that the hospital's ability to stay financially solvent in the current economic environment is being tested. She stated the hospital is serving more and more individuals without health insurance and that the bill would be a step in addressing this problem.

11:05 AM

The witnesses, who appeared together, responded to questions from the committee. Mr. Johnson responded to questions about public concern and the new funding mechanism. Dr. Gabow also responded to questions about public concerns raised about the bill. Mr. Summer and Mr. Shmerling also responded to questions about cost shifting.

11:10 AM

The witnesses responded to questions about the bill's potential impact on emergency room services and costs. Discussion ensued about health care costs and emergency rooms. The witnesses also responded to questions from the committee about federal funding, cost shifting, and federal deficits.

11:18 AM -- Ms. Joan Henneberry, representing the Colorado Department of Health Care Policy and Financing, testified in support of the bill. She stated that the bill is a step forward in health care reform in Colorado. Ms. Henneberry discussed provider fees passed by the General Assembly. She also discussed children's access to health care. Ms. Henneberry stated that Colorado cannot improve its health care system if uninsured and health coverage is not addressed. She provided background information about how much Colorado citizens are spending as a result of the uninsured.

11:25 AM -- Mr. Don Kortz, representing Colorado Concern, testified in support of the bill. Mr. Kortz provided his background about his involvement in health care issues and business. He stated that cost shifting is creating a tax on the business community because of uncompensated care. He also discussed the provisions of the bill and stated that the bill is an opportunity to both lower health care costs and to provide health insurance to Colorado citizens. He responded to questions from the committee about accepting federal matching dollars.

11:35 AM -- Ms. Deborah Colburn, representing All Kids Covered, testified in support of the bill. Ms. Colburn distributed a letter from All Kids Covered to the committee (Attachment E). She testified that Colorado has the seventh highest percentage of uninsured children in the nation. She stated that the bill would help to address health care coverage to these children.

11:38 AM -- Ms. Dede dePercin, representing the Colorado Consumer Health Initiative, testified in support of the bill. She distributed a list of the organization's members and partners (Attachment F). She testified that Colorado should address the uninsured children and adults. She also testified about the expansion of Medicaid coverage to childless adults who do not have health insurance. Ms. de Percin also discussed cost shifting and stated that the bill will give Colorado a mechanism to address cost shifting.

11:44 AM -- Mr. Arthur Powers, representing THRIVE! Persons Living with HIV/AIDS Initiative of Colorado, testified in support of the bill. Mr. Powers stated that the bill represents an opportunity to address the health care issues in Colorado. He said that the funding stream for the Medicaid buy-in program is supported the members of THRIVE.

11:47 AM -- Mr. John Barela, representing himself, testified against the bill. He stated his concerns about primary care providers that are not included in the bill and increasing costs. He also stated his concerns about potential costs that for-profit hospitals would shift to consumers.

11:50 AM

Senator Sandoval closed public testimony. The committee received a copy of Amendment L.044 (Attachment G) and L.045 (Attachment H).


BILL:	HB09-1293
TIME:	11:50:36 AM
MOVED:	Brophy
MOTION:	Refer House Bill 09-1293 to the Committee on Health and Human Services. The motion failed 3-4.
SECONDED:
		VOTE
	Brophy	Yes
	Heath	No
	Isgar	No
	King K.	Yes
	Scheffel	Yes
	Hudak	No
	Sandoval	No

Not Final YES: 3 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:	HB09-1293
TIME:	11:51:51 AM
MOVED:	Heath
MOTION:	Refer House Bill 09-1293, as amended, to the Committee on Appropriations. The motion passed 4-3.
SECONDED:
		VOTE
	Brophy	No
	Heath	Yes
	Isgar	Yes
	King K.	No
	Scheffel	No
	Hudak	Yes
	Sandoval	Yes

Final YES: 4 NO: 3 EXC: 0 ABS: 0 FINAL ACTION: PASS


BILL:	HB09-1293
TIME:	11:54:38 AM
MOVED:	Brophy
MOTION:	Adopt Amendment L. 045 (Attachment G). The motion failed 3-4.
SECONDED:
		VOTE
	Brophy	Yes
	Heath	No
	Isgar	No
	King K.	Yes
	Scheffel	Yes
	Hudak	No
	Sandoval	No

Not Final YES: 3 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: FAIL


BILL:	HB09-1293
TIME:	11:53:16 AM
MOVED:	Hudak
MOTION:	Adopt Amendment L.044 (Attachment F). The motion passed without objection.
SECONDED:
		VOTE
	Brophy
	Heath
	Isgar
	King K.
	Scheffel
	Hudak
	Sandoval

Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

12:00 PM

The committee recessed.