A Preview of the 2012 Colorado Legislative Session

1. A Preview of the 2012 Colorado Legislative Session January 4, 2012 CO AHEC, Central CO AHEC and CHI Conversation Series

2. A Challenging Year for Health Policy in 2012 Competing spending priorities Supreme Court ruling on the federal health reform law (ACA) Divided legislature and 2012 elections

3. Budget Challenges

4. Decreased Revenues and Appropriations Colorado General Fund Operating Appropriations FY2003-04 to FY2012-13 (Projected) (Projected) Source: Joint Budget Committee Appropriations Reports and the Governor's State Budget Request for FY2012-2013

5. Medicaid’s Increasing Share of State Budget Colorado General Fund Operating Appropriations, FY2003-04 to FY2012-13, As Percent of Total ARRA funding (Projected) (Projected) Source: Joint Budget Committee Appropriations Reports and the Governor's State Budget Request for FY2012-13

6. Medicaid Caseload Growth Source: HCPF Budget Request for FY2012-13,American Community Survey and Colorado Department of Labor and Employment

7. Medicaid Options Reducing eligibility Reducing benefits Reducing payments to providers Payment and delivery reform

8. Emerging Health Policy Themes for 2012

9. Departmental Efficiencies and Alignment • Hickenlooper administration initiatives to make delivery of services more effective and efficient: • Redesign and align long-term care services and supports under one agency (HCPF) • New Office of Early Childhood and Youth Development in Department of Human Services to consolidate early intervention

10. Program cost savings and improvements (1) Administration payment reform proposals

11. Program cost savings and improvements (2) Expected legislation

12. Health Care Workforce: A focus on quality Require the Colorado Department of Regulatory Agencies (DORA) to collect health care workforce information. Continue the Colorado Professional Review Act and extend to advanced practice nurses and physician assistants.

13. Healthier Communities • Prohibit sale of foods with trans-fatty acids in schools • Limit youth access to dissolvable tobacco products • Allow local governments to tax tobacco products without losing their local share of state tobacco tax

14. Implementing Health Reform • One of the 3 largest small group plans in the state • One of the 3 largest State employee health plans • One of the 3 largest federal health plan options • The largest HMO plan offered in state commercial market States are to choose essential health benefits for individual and small group insurance plans from one of 4 benchmark plans currently offered in state:

15. The Supreme Court and the ACA U.S. Supreme Court will hear arguments on the constitutionality of ACA in March. Decisions include: • Can legal claims can be made before tax goes into effect in 2014? Is the individual mandate constitutional? Severability: are other parts of law void without the mandate? Can states be required to expand Medicaid?

16. General Assembly: 2012 Key Dates Legislation Jan 27 Feb 1 May 9 Jan 11 May 3 Budget Process Nov 1 April 19 March 26 Feb 1

17. Summary No easy solutions We’re likely to see many more proposals and extended budget negotiations. However . . . Unlikely to see new programs or spending Continued efforts to improve efficiencies of current programs Groundwork for discussion of Colorado’s structural budget constraints

18. Ongoing Colorado Debate Concern about increasing public and private health care expenditures will focus debate on: What are the most essential health services? And . . . 2. What is the most cost-effective way to deliver them?

19. CHI Resources Legislative Opportunities and Trends Report 2012 Colorado Medicaid: Options for Cost Containment Long-term Services and Supports in Colorado Legislation in Review: Advancing Health in Uncertain Times Legislative Opportunities and Trends Report 2011

20. Click to change chapter title Allison Summerton • 720.382.7092 • summertona@coloradohealthinstitute.org