The (Grand Junction) Daily Sentinel, Jan. 10, on the hospital provider fee:
If you don’t know what the hospital provider fee is, you will soon enough because it’s the fulcrum upon which the see-saw battle over the budget will play out in this year’s upcoming legislative session.
Democratic Gov. John Hickenlooper would like the hospital provider fee converted to an “enterprise” or a government-owned business.
Revenue from the fee counts toward the state’s revenue limit under the Taxpayer’s Bill of Rights. It’s a huge amount of money, projected to be around $690 million this fiscal year. If lawmakers can make it an enterprise fund, it will lower the state’s refund liability under TABOR and free up cap space for discretionary spending that could go toward transportation and education.
But Republican Senate President Bill Cadman has already tried to frame the move as unconstitutional. On Monday he produced a nonbinding opinion from the nonpartisan Legislative Legal Services that the fee can’t qualify as an enterprise - as if to suggest that the matter was now settled and that the legislative session would convene with an eye on spending cuts to balance the budget.
Ironically, as a recent Denver Post editorial pointed out, Republicans were highly critical when Legislative Legal Services rendered an opinion that the hospital provider fee is not a tax requiring voter approval. Now, suddenly, the opinion of the office is beyond reproach?
That’s why Cadman’s stance feels like contrived gamesmanship. There’s a lot at stake with the hospital provider fee. And Mesa County arguably stands to be most impacted by its fate.
Let’s look at the fee itself. It was enacted with legislation in 2009. The hospitals requested it as a means of shoring up their ability to care for uninsured patients. The fee is charged to hospitals that participate in Medicaid. The state collects the fees, which are used to obtain matching federal funds that are used to offset the costs of indigent care.
One of the goals of the hospital provider fee is to reduce “cost shift.” Low reimbursement rates and treating uninsured patients create shortfalls that hospitals make up by charging commercially insured patients higher rates.
As we learned recently, cost shift is a major problem in Mesa County. If lawmakers are unable to convert the hospital provider fee to an enterprise, one of the strategies is to reduce the refund liability to simply reduce how much the state collects from the hospitals. That’s fewer resources to fight against cost shift. The net effect for Mesa County taxpayers may be a meager tax refund, yet increased costs for health coverage that already are among the most expensive in the nation.
But that’s just one of the possible consequences of keeping the hospital provider fee under TABOR. Without more spending latitude. the state won’t be able to make up cuts for K-12 funding and will have to consider cuts for higher education and transportation. The Legislature often looks to cash funds like severance taxes to cover critical spending needs. Is keeping the hospital provider fee under TABOR so vital that lawmakers are willing to set up another raid on severance taxes that should be coming back to the communities where extraction occurs?
The issue deserves more than a brush-off from the state’s top Republican lawmaker.
And it will get one. The governor’s office hasn’t given up on the idea. It plans to get a more formal legal opinion from the Attorney General’s Office, which has informally signed off on the enterprise idea as constitutional, but only if the program were to be redesigned as one, said Henry Sobanet, the governor’s budget director.
Meanwhile the legislative session gets underway with lawmakers looking over their shoulders at the fiscal impact of every bill. Maybe that’s the silver lining. The issue needs some real-world consequences so voters can see that places like Mesa County stand to suffer if lawmakers can’t figure out a solution.
Editorial: https://bit.ly/1mUKDs1
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Denver Post, Jan. 11, on day care regulations:
Five years ago Colorado regulators created a stir with proposed child-care facility rules that sought to micromanage nearly every aspect of operations, from what kind of pictures could be on walls to the ethnic breakdown of dolls, to mind-numbing details of what kinds of toys and how many of each were required.
Even proper eye contact was to be prescribed. It would have to be “culturally sensitive.”
Thankfully, the state backed off on many of the more heavy-handed proposals that had critics howling.
Last month, the Colorado Board of Human Services approved a passel of more reasonable regulations that will go into effect Feb. 1 for the state’s 2,000 licensed child- care facilities that serve about 100,000 kids.
Rules should be smart, achievable and not an overreach, to paraphrase goals enunciated in 2o11 by Colorado Department of Human Services Director Reggie Bicha.
In developing these rules, regulators held public comment sessions in 33 cities with providers and community members. In the process, they listened to feedback and devised a number of generally sensible rules that even some of the loudest critics of the draft version now appreciate.
They are still go into considerable detail, of course, regarding matters such as nutrition, staffing, qualifications and activities, among other things, but don’t go overboard as before.
The new regulations pay particular attention to the vexing problem of childhood obesity.
Unfortunately, for a state that has been hailed as the leanest in the country among adults, children are not faring as well. Colorado ranks as the 23rd most obese state for children and is the second fastest growing in that category, behind Nevada.
The new rules ban sugary drinks from facilities, provide for more physical activity and forbid television viewing for children younger than 2, while limiting viewing to 30 minutes a week for children older than that.
These steps, now codified, are a good way to start kids early with healthy lifestyles.
The rules also call for facilities to provide “individualized social and emotional intervention supports for children who need them.” The changes are aimed at reducing the number of suspensions and expulsions.
For this to work, the state must keep its promise to make mental health consultants available at no charge and provide training on how to handle challenging children.
These are indeed smart rules crafted in a conscientious manner with a goal of keeping kids healthy and safe.
Editorial: https://dpo.st/1mVZwuV
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The Durango Herald, Jan. 11, on regulating mine cleanups:
If anything was made clear by last summer’s Gold King Mine spill, it was that the laws governing hardrock mining cleanup are woefully inadequate to respond to the vast economic and environmental liabilities perched above mountain communities throughout the West. The regulatory environment that governs how mining occurs - and the responsibilities assigned to various parties for reclamation, damage and other liabilities - has been outdated for more than a century.
Adding to that is the liability that would be assigned should any clean-up endeavors go awry. The combined effect, exacerbated by insufficient government and private funding, is a system ill-equipped to meaningfully address acid mine drainage. Fixing the problem requires a multi-faceted legislative approach.
Rep. Scott Tipton, R-Cortez, is absolutely correct in asserting the importance of Good Samaritan legislation, which would protect those who take on mine clean-up from the liability associated with the effort - or the particular mine’s problems in the first place. He and his Colorado colleagues across the rotunda agree and have been attempting to enact such a measure for years. Sen. Michael Bennet, D-Denver, and former Sen. Mark Udall carried a bill that would have protected third party clean-up groups from liability under the Clean Water Act, but that measure did not pass the Senate. Tipton had sponsored companion legislation in the House. Now, Sen. Cory Gardner, R-Yuma, has taken up the cause along with Bennet and Tipton. The three are right to do so.
Protecting those who are eager and equipped to take on such an effort - a wholly public good - is an obvious step toward encouraging mine clean-up. But Tipton is wrong to say that it is the only legislative attention needed. In order to get at the fundamental issue in the matter - largely, funding - Congress must at long last take on the 1872 Mining Act and bring it into, at least, the 20th century, if not the 21st. Tipton has balked at the subject, while Bennet is championing its need.
The Hardrock Mining and Reclamation Act of 2015, which Bennet and New Mexico Democratic Sens. Martin Heinrich and Tom Udall introduced in November, would reform the regulatory environment governing hardrock mining, including a royalty requirement for the activity. Unlike natural gas or coal mining, where operators must pay for the privilege of extracting minerals, no such rules bind hardrock mining. That further compounds the problem of paying for cleanup when situations like the Gold King Mine spill - or those at any of the approximately 500,000 mines across the West - occur. Bennet’s bill would apply a 2 to 5 percent royalty on hardrock mining, direct some funding to states to use in mine cleanup projects and allow the Interior Secretary to exempt a company from the royalty should there be a proven hardship. It is a sensible and much-needed complement to the Good Samaritan protection that is also long overdue.
The multifaceted circumstances that led to the Gold King Mine blowout describe clearly the correspondingly involved response required. While Congress ought to protect parties who wish to clean up problematic mines, ensuring that there are adequate resources to do so, as well as preventing the circumstance from intensifying into the future is essential. Good Samaritan legislation is necessary, but so is a fundamental reform of the mining laws that created the landscape we are, at long last, addressing.
Editorial: https://bit.ly/1OhGjMR
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The Reporter-Herald, Jan. 12, on choices for the 2016 Legislature:
By all accounts, 2016 should have been a pretty good year for the Colorado General Assembly. Through 2015, unemployment in the state has been inching downward, and along the Front Range, where the majority of the state’s residents live, communities are experiencing strong growth.
Too bad the legislative session won’t reflect that reality.
Instead, the reality facing lawmakers this year is that through accounting and policy choices, the state is going to run a surplus of money but require budget cuts because of provisions of the Taxpayer’s Bill of Rights.
Republican legislators and the Democratic aides in Gov. John Hickenlooper’s office disagree about the exact amount needing to be cut, but the state revenue shortfall comes in between $150 million and $225 million, approximately. One solution, for the state to move a “hospital provider fee” to an enterprise fund, not subject to TABOR, will be an interesting litmus test regarding the tough choices legislators have to make.
If lawmakers were to make such a move, it could answer many of the budget issues at stake - at the expense of the small refunds being sent to taxpayers. All senators and representatives should have to go on record about the issue, rather than sending it to a committee for a quiet death.
Lawmakers could address other issues that have put the state behind the curve on important issues. Compromise legislation on condominium defect laws could help spur construction of entry-level housing in several communities where rents and home prices continue to climb beyond the reach of the working class. Open records laws could be updated to reflect the world in which Coloradans now live, not the one of the 1990s under which the rules about outdated technology were created.
And finally, the General Assembly could have the conversation about one of the key components under members’ control: state transportation spending. If the state is going to invest in the roads and bridges to make it competitive into the 21st century, lawmakers are going to have to address how to pay for them - either through new funding sources such as taxes or through drastic cuts to other programs, such as K-12 education and higher education.
Legislative sessions hinge on questions about what kind of state do our leaders want to live in now and hand down to our children and grandchildren.
Tough choices loom, but that’s why they were selected to make them.
Editorial: https://bit.ly/1ni1dTb
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