Rep. Amy Stephens, House Majority leader, has mystified some legislators with her two health care bills, HB11-1273, which passed the House Health and Environment committee, and SB11-200, which got through the Senate on third reading.  If both bills pass, unlikely but possible, the state may go in two completely different directions with health care.  

HB-1273 is close to Stephens' heart and mind.  It will yank Colorado out of "Obamacare," the GOP term for the Patient Protection and Affordable Care Act (the Act) passed by Congress in 2010. It will eliminate Medicare and Medicaid as currently provided, turning both into "block grant" programs administered by the state.  The bill was passed by the committee on a 7-6 party line vote in about three hours.  Its next stop is House Appropriations.

Online health care exchange v. vaporized Medicare/Medicaid 

SB-200, co-sponsored with Sen. Betty Boyd, D-Lakewood, will set up online health care exchanges, offered by the state, to enable individuals and businesses to compare health insurance plans for price and coverage.  The bill was put together in a cooperative effort by business interests and public health care advocacy groups.

No major players from the business community testified in favor of HB-1273, though some sat stoically in the committee room. 

Stephens and HB-1273 co-sponsor Rep. BJ Nikkel, R-Longmont, flew in Mario Loyola, a consultant from a Texas free-market think tank to lecture the Colorado H&E committee on the US Constitution's 10th amendment. 

HB11-1273 relies on US constitution 10th amendment

The 10th amendment lays out the Constitution's principle of federalism.  It provides that powers not granted to the federal government or prohibited to the states are reserved to the states and the people. Loyola argues that Colorado can use the 10th amendment to duck out of the federal Act, and any other federal health care law, to join with other states in an "interstate compact" to provide health care.  The interstate compact would act in a manner similar to the 1930 Colorado River Compact that allows states to divvy up Colorado river water, Loyola says.

The bill doesn't identify the other states that might join the compact. It does say that the legislature will put together a health care program funded by approximately $8.97 billion comprising all the state's tax money for Medicaid and CHPS+ from the general fund, and from Medicare via FICA taxes.  Rep. John Kefalas, D-Ft.Collins, says that $8.97 billion will not be nearly enough, as the state's real health care costs are over $30 billion.

Texas expert for 1273 v. Colorado expert against 1273

The bill will face other challenges at the federal level, as interstate compacts must be voted on by Congress and signed into law by the President, even though Loyola said that the 10th amendment doesn't specify the President's role.  Scott Moss, a University of Colorado law school professor not from Texas, told the committee any interstate compact will definitely require passage by Congress and a President's signature.

The state's Tea Party challenged the HB-1273 as too much government.  Rick Barnes came down from Craig, Colorado representing the Bears Ears Tea Party Patriots and other Tea Party groups. "This bill puts more government into health care at the state level.  We're taking a stand on the principle of limited government."

HB11-1273 called 'right wing' strategy

Dede de Percin, executive director of the Colorado Consumer Health Initiative representing 50 health care organizations, says the bill presents the "right wing" national strategy of the American Legislative Exchange Council (ALEC), "not a Colorado strategy."  "The people of Colorado weighed in with Amendment 63," says de Percin, citing the 53% vote in 2010 supporting the federal health care law.

Stephens reminded de Percin not to slur ALEC with the "right wing" appelation. ALEC is "one of many think tanks supporting this."

HB11-1273 takes out Medicare for states' rights

Others who object to the bill include the AARP and the Colorado Center on Law and Policy (CCLP). Elizabeth Aranales of the CCLP said "dismantling Medicare and Medicaid is an enormous policy discussion, and that's the direction this bill takes us in. The implications on policy are extraordinary."

Aranales listed numerous questions that emerge, unanswered, from the bill.  "What will be the base funding for health care in Colorado"; "are we exempting ourselves from large federal funding that goes to health care"; "what will be the duties of the interstate commission" that helps to administer the compact; "what other states are going to be a part of the compact"; "what are we doing here that will be helpful"?

Two Stephens health care bills in the pipeline - which will come out?

The state will have more flexibility, Nikkel says, and "we can follow the will of the people" by having government "closest to the people" deliver health care. To which Barnes from Craig says hooey.  "This bill furthers government interaction with health care... Let's bring everything back to the people."

SB-200, meanwhile, much narrower in scope and retaining Medicare, Medicaid, and CHPS+, moves on to the House.  No one is sure how Stephens will vote on that bill. PEN  4/26/11

This post was published on April 26, 2011. Permalink »