By Katie Kerwin McCrimmon
Tuesday’s election results ensure that implementation of Obamacare will proceed on a fast track in Colorado and Democratic lawmakers want to move ahead with Medicaid expansion that could bring health coverage to nearly a quarter million low-income Coloradans.
“We would like to push to get health care to as many people as possible because that’s going to reduce the costs for everyone,” said Rep. Mark Ferrandino, D-Denver, who is expected to take the reins of the Colorado House in January after Democrats recaptured control of it on Tuesday.
Gov. John Hickenlooper is more circumspect. While he supports expanded access to health care, Hickenlooper refused to say whether he’ll support adding additional low-income people to Colorado’s Medicaid program. He continues to say that Colorado and the rest of the country must find a way to pay for ever-increasing health care costs.
One little-known aspect of the Affordable Care Act, Hickenlooper said, is that it foists cost dilemmas onto states.
“It puts tremendous burdens on the shoulders of governors. For decades, the (U.S.) House and Senate, the Congress, could not find ways to control costs because they couldn’t deal with all the different, large self interests: the pharmaceutical companies, the insurance companies, the hospital providers, the doctors, all of these different elements,” Hickenlooper said.
He thinks that by failing to rein in costs, members of Congress tacitly approved perpetual increases of 9 or 10 percent a year in health costs.
“That’s no longer an option. We need to put all hands on deck and figure out how we control costs. It’s not going to be easy. It’s going to take several years,” Hickenlooper said.
Republican lawmakers spent much of election night huddled in suites at Sports Authority Field at Mile High, where they held what was supposed to be an election night celebration. Instead, GOP activists reacted with shock and tears as news emerged that President Obama had won reelection and that Republicans would lose the Colorado House which they had seized from Democrats in 2010.
House Speaker Frank McNulty, R-Highlands Ranch, was not available for comment Tuesday night or early Wednesday to discuss how health issues or the rest of the Democratic agenda will fare in the legislature.
He released a statement Wednesday night saying, “We will continue to push for an agenda that is focused on job creation and economic recovery. That is precisely what the people of Colorado expect from their elected officials.”
Republicans may not pose problems for Hickenlooper. Rather, he may have to decide how to negotiate with newly powerful Democrats in Colorado. While Hickenlooper spent his first two years tilting to the right to accommodate a divided legislature, he now must adjust to Democrats who are ready to steam forward with a full progressive agenda on issues ranging from health care and gay rights to environmental issues and education.
Ferrandino expects plenty of action on health issues.
“Obamacare — the Republicans are going to regret they ever called it that — is in very good shape to be implemented in a strong and robust way,” said Ferrandino, who will also become Colorado’s first openly-gay Speaker of the House.
One of the most pressing issues is the decision on how much to expand Medicaid, the public health insurance program that provides coverage for children, the poor, the disabled and elderly people in nursing homes.
“Our hope is that we can expand Medicaid to the full levels under the federal health care reform,” said Ferrandino.
He cautioned that he’s “a budget guy” and will want to scrutinize impacts on Colorado’s budget carefully before making a final decision.
Prior to the U.S. Supreme Court ruling on the Affordable Care Act, all states were required to expand Medicaid to poor adults. But the justices gave states an out when they ruled that the health reform law was legal, but that the U.S. government could not compel states to expand Medicaid since they would have to pick up part of the costs.
To encourage expansion, the federal government will pay 100 percent of the tab from 2014 to 2016. Then, starting in 2016, states have to pay a gradually larger share of the costs, capping out at 10 percent.
Nationwide, the Medicaid expansion could help cover up to 25 million uninsured people. But, Republicans including Colorado Attorney General John Suthers have previously warned that costs to soar to a billion dollars between 2016 and 2021. Suthers declined to comment now. An Urban Institute analysis in May of 2010 for the Kaiser Commission on Medicaid and the Uninsured estimated that between 2014 and 2019, Colorado would spend about $470 million to cover additional uninsured people. Since then the economy worsened, however, and Medicaid rolls across the country and in Colorado have increased. Next year, Colorado is expected to have more than 700,000 people on Medicaid.
Ferrandino said state officials are busy trying to determine exactly how much Medicaid expansion would cost.
He said he’s eager to hear specific rulings from the federal government on whether states can partially participate in expansions.
“With the feds picking up 100 percent in the beginning…I think there’s a great opportunity for innovative solutions to make sure we can fund the health care expansion,” Ferrandino said. “I feel pretty confident we’ll be able to do it.”
Hickenlooper said with Obama’s re-election, the Affordable Care Act will be implemented. “That horse is out of the barn.”
Now he wants Colorado to lead the nation in comprehensive preventive programs that cut obesity and chronic diseases like diabetes.
“Colorado could be the first state to do this on a national level,” Hickenlooper said. “We have a great urgency to begin to figure how we control costs. Four years from now, you’ve got to look down the road. If we don’t figure out how to control (health care) costs, we’re going to be upside down.”
Health care and women’s advocates celebrated Tuesday’s results as a victory for the uninsured and for women’s health.
“President Obama’s re-election last night ensures that health reform will remain on track to meet the needs of Colorado’s five million residents,” said Dede de Percin, executive director of the Colorado Consumer Health Initiative which represents more than 50 health care groups and an estimated 500,000 consumers in Colorado.
She said the new health benefits exchange should be open on time in less than a year and expects it to become an “easy-to-use health insurance marketplace for families, individuals, small businesses and nonprofits.
“It will be easier to understand their options, compare plans, make choices and purchase insurance. In some cases, individuals and businesses will qualify for tax credits to help afford insurance, including up-front financial assistance for low-income people. Phone and in-person navigators will be available to further help Coloradans make the health coverage that is best for them,” de Percin said.
Birth control, abortion, rape, women’s health issues and Planned Parenthood, itself, had all become hot topics in the 2012 campaign.
Vicki Cowart, president and CEO of Planned Parenthood Votes Colorado called Tuesday’s results “a resounding victory for women.”
“More than ever before, women’s health was a decisive issue in this election. Americans today voted to ensure that women will have access to affordable health care and be able to make their own medical decisions,” Cowart said.
“This election sends a powerful and unmistakable message to members of Congress that the American people do not want politicians to meddle in our personal medical decisions. The voters of Colorado reemphasized this message by turning the House to a pro-choice majority. This election season, many candidates voiced that women’s health was a non-issue. Tonight proved them wrong. Future politicians should see this election as proof that attacking women’s health should be done at your own peril.”