Bill Summary for Bill Number HB14-1115

Date: 02/18/2014

Final
BILL SUMMARY for HB14-1115

HOUSE COMMITTEE ON PUBLIC HEALTH CARE & HUMAN SERVICES

Votes: View-->	Action Taken:
Adopt amendment L.001 (Attachment A). The motion p Amend L.001 page 2, line 32, strike "excluded from Amend L.001, page 1, line 38, page 3, line 19, and Amend L.001, page 3, line 7, after "services" add Refer House Bill 14-1115, as amended, to the Commi	PASS Pass Without Objection PASS Pass Without Objection PASS

01:39 PM -- HB14-1115

Representative Stephens introduced House Bill 14-1115. As introduced, the bill establishes the Medicaid Expansion Premium Assistance Pilot Program to provide health care services through the health insurance exchange for up to 2,000 adults with incomes between 100 and 133 percent of the the federal poverty line who are newly eligible for the Colorado Medicaid program. She explained that a strike-below amendment, L.001 (Attachment A), had been prepared for the bill. She explained her goals in carrying the bill and distributed a handout summarizing the provisions of amendment L.001 (Attachment B). Amendment L.001 requires the Department of Health Care Policy and Financing to conduct a study and make recommendations to the General Assembly concerning the feasibility of implementing a program for premium assistance to enroll Medicaid-eligible clients in health insurance programs that are available through the state exchange. Representative Stephens stated that the state needs to start planning for future Medicaid expenses and she walked the committee through the provisions of amendment L.001. She described the specific topics that the study must address, including an analysis of other states' premium assistance programs, a comparison of the benefits offered through the Medicaid program and the benefits offered through health insurance plans offered through the health insurance exchange, an analysis of federal Medicaid law, an analysis of the number of clients who must participate in a premium assistance program for the program to be cost-effective to the state, an analysis of the whether certain populations should be excluded from the premium assistance program, an analysis whether clients enrolled in other health care programs should be included in a Medicaid premium assistance program, an estimate of the state department's administrative costs relating to the implementation of a premium assistance program, and an estimate of the potential cost-savings to the state. Representative Stephens responded to questions from the committee regarding how the bill's fiscal note will change if amendment L.001 is adopted.

14HsePHS0218AttachA.pdf

14HsePHS0218AttachB.pdf

01:52 PM -- Bill Zepernick, Legislative Council Staff, discussed the potential costs of amendment L.001 and responded to questions from the committee.

01:55 PM

Representative Stephens responded to questions from the committee regarding the costs impacts of potentially excluding medically fragile individuals from the study and whether the date for completion of the study should be extended. She further responded to questions from the committee regarding Medicaid wrap-around services and the entities that may provide information as part of the study.

02:19 PM -- Jeff Thormodsgaard, Colorado Academy of Family Physicians, testified in support of amendment L.001. He stated that the academy had questions regarding the bill as introduced, but that the organization is supportive of efforts to conduct the study. He responded to questions from the committee.

02:29 PM -- Mark Simon, representing himself, testified in opposition to the bill and distributed a handout to the committee (Attachment C). He discussed his experience serving on the Blue Ribbon Commission for Health Care Reform, which considered options for health care reform in the state. He stated that the bill potentially creates a two-tiered health care system for medically needy individuals and discussed the availability of primary care providers in the Medicaid program. He discussed his specific concerns regarding amendment L.001 and responded to questions from the committee. He expressed concerns with the private insurance industry and the Department of Health Care Policy and Financing.

14HsePHS0218AttachC.pdf

02:49 PM -- Jose Torres, Colorado Cross Disability Coalition (CCDC) and himself, testified that CCDC shares the concerns raised in Mr. Simon's testimony. He stated his opposition to giving tax dollars to the private insurance industry, and discussed his concerns adding to the responsibilities of the Department of Health Care Policy and Financing and the disabled community. He stated that privatizing Medicaid is a bad idea, and discussed the importance of Medicaid to individuals with disabilities. He responded to questions from the committee. Mark Simon clarified the number of members of the CCDC statewide.

02:59 PM -- MaryKathryn Hurd, Department of Health Care Policy and Financing, discussed increases in provider enrollments in Medicaid in recent years, and clarified the number of providers providing care in the Accountable Care Collaboratives. She clarified the eligibility requirements for children in Medicaid and the Children's Basic Health Plan and explained that recent changes to these requirements are intended to reduce the number of children who are coming on and off the programs. She stated that the department is fine with the bill moving forward as amended by amendment L.001, and discussed the information the department provided for the development of the bill's fiscal note. She asked that the report's due date be moved back a year to allow for additional data to be obtained. Ms. Hurd responded to questions from the committee regarding whether the department would hire additional staff to conduct the study, noting that the department would hire a contractor to complete the study. Committee discussion ensued regarding the bill's costs and the scope of the study authorized by amendment L.001.

03:26 PM -- Brita Darling, Office of Legislative Legal Services, came to the table to address committee questions regarding the bill's title.


BILL:	HB14-1115
TIME:	03:28:25 PM
MOVED:	Stephens
MOTION:	Adopt amendment L.001 (Attachment A). The motion passed on a vote of 7-5, with 1 member excused.
SECONDED:	Singer
		VOTE
	Conti	Yes
	Everett	Yes
	Ginal	No
	Joshi	Excused
	Landgraf	Yes
	McCann	No
	Schafer	No
	Singer	Yes
	Stephens	Yes
	Tyler	No
	Wilson	Yes
	Young	No
	Primavera	Yes

YES: 7 NO: 5 EXC: 1 ABS: 0 FINAL ACTION: PASS


BILL:	HB14-1115
TIME:	03:35:56 PM
MOVED:	Primavera
MOTION:	Amend L.001, page 1, line 38, page 3, line 19, and page 3, line 24, strike "2015" and substitute "2016". The motion passed on a vote of 7-5, with 1 member excused.
SECONDED:	Stephens
		VOTE
	Conti	No
	Everett	No
	Ginal	Yes
	Joshi	Excused
	Landgraf	No
	McCann	Yes
	Schafer	Yes
	Singer	Yes
	Stephens	Yes
	Tyler	No
	Wilson	No
	Young	Yes
	Primavera	Yes

YES: 7 NO: 5 EXC: 1 ABS: 0 FINAL ACTION: PASS


BILL:	HB14-1115
TIME:	03:37:40 PM
MOVED:	Singer
MOTION:	Amend L.001, page 3, line 7, after "services" add "and client use of emergency departments." The motion passed without objection.
SECONDED:	Stephens
		VOTE
	Conti
	Everett
	Ginal
	Joshi	Excused
	Landgraf
	McCann
	Schafer
	Singer
	Stephens
	Tyler
	Wilson
	Young
	Primavera

YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	HB14-1115
TIME:	03:42:07 PM
MOVED:	Ginal
MOTION:	Amend L.001 page 2, line 32, strike "excluded from" and substitute "included in." The motion passed without objection.
SECONDED:	Stephens
		VOTE
	Conti
	Everett
	Ginal
	Joshi	Excused
	Landgraf
	McCann
	Schafer
	Singer
	Stephens
	Tyler
	Wilson
	Young
	Primavera

YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	HB14-1115
TIME:	03:43:55 PM
MOVED:	Stephens
MOTION:	Refer House Bill 14-1115, as amended, to the Committee on Appropriations. The motion passed on a vote of 7-5, with one member excused.
SECONDED:	Landgraf
		VOTE
	Conti	Yes
	Everett	Yes
	Ginal	No
	Joshi	Excused
	Landgraf	Yes
	McCann	No
	Schafer	No
	Singer	Yes
	Stephens	Yes
	Tyler	No
	Wilson	Yes
	Young	No
	Primavera	Yes

FINAL YES: 7 NO: 5 EXC: 1 ABS: 0 FINAL ACTION: PASS

03:53 PM

The committee adjourned.