By Katie Kerwin McCrimmon
Tea Party activists helped propel a bill forward in the Colorado House Tuesday that opponents said would essentially dismantle Medicare while allowing Colorado to opt out of implementing the federal health law.
At stake would be an estimated $9 billion in annual health spending in Colorado. Under HB 11-1273, known as the HOPE Act, Colorado would join states in an interstate compact that would supersede federal health laws.
Opponents said the bill would essentially gut Medicare while supporters said the bill merely allowed Colorado to take back control over health spending decisions that should be made locally.
“It’s not a renegade kind of thing,” said House Majority Leader Amy Stephens, R-Monument, one of the sponsors of the measure. “States have the right to get together and decide these issues together.”
Stephens conceded that using an interstate compact to try to govern health care is an entirely new strategy. In the past, compacts have been used to manage shared resources, like water in the West, or transportation matters in the Washington Beltway region.
If the bill passed, Colorado would then opt out of implementing the Affordable Care Act. Instead, Colorado and the other compact states would get fixed block grants of money to control their own health spending from Medicare, which provides health care to the elderly, to Medicaid and CHP, which are public health insurance programs for the poor, disabled people and children.
“That’s an enormous public policy matter…and one that warrants significant conversation,’’ said Elisabeth Arenales, director of health programs for the Colorado Center on Law and Policy, who urged House members to vote against the measure.
Among others who spoke were Tea Party activists from Craig to Canon City. Some of them clutched instruction booklets, distributed by a national group called Health Care Compact Alliance. The Alliance is being supported and funded nationally by the Tea Party Patriots, the nation’s largest Tea Party group, and a Texas construction company heir, Leo Linbeck III, whose family has supported conservative causes ranging from a “Fair Tax to the Swift Boat Veterans for Truth.
The Alliance’s how-to manuals told supporters how to push the Compact legislation in their state, gave them legislative drafts, sample press releases and instructed them on how to win over their local elected members and spin their message.
But, when the activists spoke, their message splintered. One man said he was a Tea Party member, but opposed an edict from the national Tea Party since local control is a vital value of the movement. He urged lawmakers to oppose the compact alliance. Another Tea Party activist spoke in support of the bill. She said Colorado needed to take control of health spending because she’s on Medicare and fears that the national health law includes provisions which would allow her doctors to kill her to save money. (The Affordable Care Act does not include any so-called death panels.)
The 3 ½ hour hearing also featured dueling constitutional experts. One came from Texas, where the movement is being funded. Another from Colorado opposed the legislation, saying that while the bill’s language claims that compacts need only be approved by Congress, compacts must be approved by the president. In this case, President Barack Obama would never support a compact that seeks to upend his signature health bill.
Ultimately, the Republican-dominated committee voted to send the measure to its next committee, Appropriations, by a 7-to-6 party line vote.
The Republican sponsors of the measure, Majority Leader Stephens, and Majority Whip, B.J. Nikkel, R-Loveland, sprang a new version of their bill on committee members and opponents just before the hearing. The new language — which parallels language in the how-to manuals — turns the bill into a copycat measure of a bill recently passed in Georgia and makes it nearly identical to a draft being pushed in legislatures around the country.
Stephens and other supporters sought to downplay the implications of a compact.
“It provides flexibility on funding,” said Stephens. She insisted that any major changes approved by an interstate compact would then come back to the Colorado legislature for approval.
Stephens, meanwhile, is simultaneously supporting a bill that would establish a Colorado Health Exchange. That bill passed the Colorado Senate this week and now moves to the Republican-controlled House. Stephens has predicted that the exchange bill will pass the legislature. While most experts see a health exchange as the first step of implementing the Affordable Care Act, Stephens believes it’s a free-market measure that will help small businesses find more affordable health care options. She believes a health insurance exchange could thrive even if Colorado opts out of implementing the Affordable Care Act.
Among the experts who testified on Tuesday was Mario Loyola of the Texas Public Policy Foundation.
Loyola testified that interstate compacts have a long history in our country. He said 200 are currently in force. He said compacts require congressional consent, but could be an excellent strategy for helping states withdraw from provisions of the health law so they can “regulate health care in the way they see most fit.”
Lawmakers on the committee questioned why Colorado needed to opt out of the health law since a majority voted in November not to opt out.
Loyola testified that the framers of the constitution never gave the federal government the power to regulate health care.
“All Americans would be better off if health care regulation were returned to the states,” Loyola said.
Opponents of the interstate compact produced their own expert.
Scott Moss, an associate professor at the University of Colorado Law School, testified the Colorado law would be unconstitutional because of its claim that it wouldn’t need presidential approval. He submitted a letter to committee members.
“My sense is that if it’s enacted, it will go nowhere because the president won’t sign it,” Moss said.
What’s more, he said the compact would be unlikely to be approved unless President Obama is voted out of office in 2012.
“There’s no circumstance where I can see that Congress keeps the Patient Protection and Affordable Care Act and allows this compact,” Moss said.
What’s more, he said that backers were wrong to claim that a compact could easily be changed after it’s adopted.
“Once a federal compact is enacted, it can’t be amended (without Congressional consent),” Moss said.
Among the lawmakers who was most divided Tuesday was Rep. Laura Bradford, R-Collbran in Mesa County. The Grand Junction area has become known as a national model for providing affordable health care to both the indigent and people with insurance.
“My constituents are afraid of any interference (from either the federal government or the state),” Bradford said. “It is with great trepidation that I will vote yes on this and let it go to the House floor for further debate.”