TAXATION WITHOUT REPRESENTATION: Latest on Obamacare in Colorado

The Colorado legislature has been unable to audit the Colorado health exchanges, yet, at the same time the health exchange can raise a tax on all health insurance plans—including those plans bought through an employer and outside the exchange.  We are quickly approaching a situation where the average Coloradan is getting taxed by an organization it cannot hold accountable.  On top of this, Coloradans cannot opt of health insurance without paying a penalty, meaning it’s impossible to avoid paying a tax despite having no voice or representation with the organization levying it.

As reported by Health News Colorado:

A $13 million tax on all Coloradans with health insurance would pay half the operating costs at the state health exchange next year and in 2016 under the newest financial projections.

The proposed tax would affect at least 875,000 people and includes Coloradans who get their insurance through their employers or outside the exchange. [the Peak emphasis]

Perhaps state Sen. Owen Hill said it best:

“Not only is this not fair. It really is against the law. We have a law here in Colorado that says you can’t increase taxes without a vote of the people,” said Sen. Owen Hill, R-Colorado Springs, who sits on the exchange’s legislative oversight committee.

How do they justify such an outrageous tax?  By vaguely saying all people are better off when people have insurance since emergency rooms will no longer have to pass the costs of treating the uninsured onto people with insurance.  Yet, this ignores the fact that most of the expansion of health insurance has been gained through Medicaid, and Medicaid is notorious for such a low reimbursement rate to doctors that doctors either limit the number of Medicaid patients they have, or refuse them outright, saying they lose money on every Medicaid patient they see.

On top of this, a Harvard study recently revealed people on Medicaid end up going to an ER 40% more than those without.  If Medicaid doesn’t pay enough to reimburse doctors, how are they going to cover ER expenses which are much higher?  And since ERs can’t refuse to treat Medicaid patients, who do you think will end up subsidizing their visits?  Yep, looks like we’re back in the same boat as before, if not worse off, and on top of that, we have a new tax that we have no say over.

It gets worse. Connect for Health Chief Financial Officer is expecting 20% of the 120,000 that allegedly enrolled to not pay, or opt of their insurance in the coming year.  Unfortunately for them, because of the bill liberal Sen. Udall passed (and would pass again) they’ll have no ability to find other insurance until November.


FACT CHECK: Executive Director of CDHCP Claims Medicaid Expansion Will Reduce ER Visits

A Denver Post story today details how Obamacare wasn’t so much about making private insurance affordable as expanding government-run healthcare:

In Denver, 2½ times as many people enrolled in the taxpayer-funded Medicaid program from October through the first quarter of 2014 as those who signed up for private insurance through the state exchange, state figures show. [the Peak emphasis]

State Sen. Kent Lambert argues this will end up as unfunded mandate by the Federal government, as Colorado in the future will have to come up for the funds to support this expansion of Medicaid.

It’s a huge burden on taxpayers,” Lambert said. “Colorado made a decision, the governor made a decision under Democratic leadership to expand the criteria for Medicaid to a much larger population, and the federal government also expanded Medicaid.” [the Peak emphasis]

The Hickenlooper administration believes this is false, as the expansion of Medicaid will result in fewer ER visits and more preventive care:

Susan Birch, executive director of the Colorado Department of Health Care Policy and Financing, said the Medicaid expansion will not impact the state budget but will help get costs under control.

Taxpayers are paying for these people in emergency rooms and jails,” she said. “It’s far cheaper to coordinate care and keep asthma under control, keep diabetes from resulting in amputation.” [the Peak emphasis]

In the immortal words of Lee Corso, “Not so fast my friend!”  According to a Harvard study reported on by The Washington Post back in January, the expansion of Medicaid actually does the opposite, it results in more ER visits:

As the health-care law expands Medicaid to cover millions more Americans, a new Harvard University study finds that enrollment in public program significantly increases enrollees’ use of emergency departments.

The research, published Thursday in the journal Science, showed a 40 percent increase in emergency department visits among those low-income adults in Oregon who gained Medicaid coverage in 2008 through a state lottery. [the Peak emphasis]

Not only will Colorado be on the hook to the tune of over $70 million next year to cover the Medicaid patients, according to the Joint Budget Committee, but we can now expect emergency rooms to be even more crowded.  The worst of both worlds.

Peak Fact Check Verdict™: You’re full of it.


DEATH BY NUMBERS: Bad News After Bad News on Obamacare Buries Udall

Remember that iconic scene in “Cool Hand Luke” when Paul Newman has to dig a ditch in the prison yard just to fill it back in? Just a complete exercise in futility.  We’re guessing Senator Mark Udall and President Obama have, and that it tickled them so much they decided to model their trillion-dollar Obamacare after it.

In a new Forbes article this week it was revealed a full 89% of enrollees in the Obamacare exchanges had been previously insured.  A law meant to expand insurance is really a funhouse of mirrors, where Udall and Obama cut 335,000 Coloradans’ health insurance, and then declare the law a success when those same people turn around and sign up for more costly health plans on the Obamacare exchanges.

In further humiliating news, it was revealed yesterday during House testimony that legislative analysts are expecting more people in Colorado to pay a health care fine then have to sign-up for the can’t-keep-my-doctor plans of Obamacare:

The legislative analysis guessed that about 254,700 adults in Colorado would pay federal fines next year for not getting coverage. That’s more than the 249,000 Coloradans projected to enroll in either Medicaid or a private health insurance plan. [the Peak emphasis]

Let’s keep the numbers rolling.  Ed Sealover over at the Denver Business Journal reports even though over a 100,000 people have been added to Medicaid doesn’t mean they’ll get to see a doctor anytime soon.

Adams, Denver and Arapahoe counties have the third-, fourth- and fifth-worst ratios of Medicaid enrollees to doctors who accept the lower-reimbursement insurance, all with less than one primary-care physician taking the insurance for every 2,400 enrollees.

And those numbers are likely to be exacerbated further as more people sign up for Medicaid. [the Peak emphasis]

The problem with Medicaid is the reimbursement rate is so low that most doctors usually lose money on each Medicaid patient they see.   When Medicaid patients don’t have access to doctors they end up going to ERs, increasing the number of people who use an ER by almost 40%!  Wasn’t Obamacare supposed to do away with the traffic jam that happens in ERs?

Meanwhile only 23% of the young healthy ones needed to sign up to keep premiums from rising have signed up.  #ThanksSenUdall


AILING: Colorado’s Exchange Signs Up Just 4% of Goal

UPDATE: The Associated Press reported that Connect for Health Colorado’s enrollee goal is 136,000 by the end of March 2014, and revised sign-ups in October to 3,700.  So, make that just 2.7% of goal.  Heckuvajob, guys.

Last week, we reported that Colorado’s Obamacare exchange had signed up just 3,400 enrollees compared to 34,000 Medicaid enrollees.  That’s one enrollee in the exchange for every ten in Medicaid, for you mathematicians at home.  This week, healthcare number crunchers, Avalere Health, published estimates on participation in the state level exchanges based on a proprietary formula its consultants devised.  According to Avalere’s estimates published in the Washington Post, Colorado’s sign-ups represent just four percent of its 2014 goal.

The national program’s disastrous launch is well documented, with much of the blame for low enrollment numbers placed squarely on its technical failures.  But according to Connect for Health’s “Metrics” webpage, the Colorado exchange website is working well over 99% of the time. The metrics page showed that the site had 364,000 unique visitors.  If even just 20% of its visitors had signed up, Colorado would have already made its 2014 numbers.  So, what’s the problem?

Could it be (gasp) that Coloradans think the healthcare exchange options are BS because they have higher deductibles, higher premiums, and fewer care options?  Is Colorado proving to be a harbinger state once again?   Once the national site is fixed, will Americans actually sign up for the national exchange or will they sit on the sidelines like Coloradans?  Fortunately for the Obama administration, the technical issues have dominated the conversation.  The fundamental debate begins the day the Obamacare website is functional.  Although, who knows when that will happen.


PeakFeed: Obamacare’s Massive Medicaid Expansion in CO

Is Obamacare enabling private healthcare insurance or just a massive expansion of Medicaid? Republican strategist Karl Rove shows its the latter.  Rove appeared yesterday on Fox News to discuss warnings that Obamacare signups would be woefully low.

He cautioned that those evaluating the numbers should look at the difference in numbers between those who are enrolled in Medicaid vs. those who are enrolled in Obamacare.  The former put no money into the pot and the latter do. As an example, he highlighted that 34,000 of Colorado’s enrollees have been filtered to Medicaid and just 3,400 have enrolled in Obamacare.

Nationally, Team Obamacare predicted that there would be seven million in Medicaid and 11 million in the exchanges, according to Rove.  If that’s the case, their ratio is a little off.  Did Colorado budget for all of these new Medicaid enrollees?  Just asking….


GRIDLOCK ON HICK’S WATCH: Return To Budgeting Business As Usual In State Budget Debate

UPDATE: Was Republican opposition to the budget busting long bill “sour grapes”? Oh contraire mon frere. Per a press release from Senate Republicans:

Denver- Today, Senate Democrats passed Senate Bill 213 on a party line vote, asking voters to approve a one billion dollar tax increase without reforms that improve student achievement.

“Just one week after Senate Democrats approved a historic budget that increases government spending at three times the rate of inflation, the voters will be faced with a one billion dollar tax increase,” said Assistant Senate Minority Leader Mark Scheffel (R-Parker) and member of the Senate Education Committee. “We need a student centered system that emphasizes improving student outcomes and instilling teacher accountability instead of perpetuating the present system that merely asks for more money without solving the problem.”

This year’s budget is set to be the first in a number of years not receiving a bipartisan blessing. Governor Hickenlooper and legislative Democrats’ left-wing agenda outside the budget process has no doubt poisoned the bipartisan well, but it doesn’t mean there aren’t clear reasons to oppose this year’s budget.

Sorry, Singleton, “sour grapes” are not the reason Republicans are opposing this year’s spending monstrosity.

It’s unfortunate for Governor Hickenlooper, as he has loved to trot out the line about Colorado’s bipartisan budget process. Here’s how Hickenlooper characterized last year’s bipartisan budget:

“The budget provides a comprehensive and thoughtful allocation of taxpayer dollars,” Hickenlooper said at the signing ceremony. “The support that both parties in both houses gave to the budget demonstrates that we’re trying to find the right compromise.”

Does the lack of support from one party then demonstrate the lack of compromise in this year’s budget, Governor?

Aside from political reasons, here’s five reasons why Republicans will and should oppose this year’s budget:



NO “MAGIC WAND”? Despite Hickenhoover’s Claims, Medicaid Waivers Given To Other States To Cut Costs

We had high hopes for Tim Hoover. After helping lead the way on ending the mainstream media honeymoon for Governor Hickenlooper, with tough articles on his wasteful spending and inability to make decisions, Hoover has suddenly swallowed Hick's talking points on Medicaid reform.

In Hoover's coverage of the Medicaid debate, his pieces increasingly read more like Op-Eds than real reporting.

Well Hickenhoover, we have a few examples you might want to dig into to better inform your (normally solid) reporting. 

Governor Hickenlooper keeps using the phrase "there is no magic wand," and the press dutifully reports it without analysis, as if that alleviates the need to look into the option of a federal Mediaid waiver.

Despite Hick's protestations that a waiver is not possible, reality provides a stark contrast. 

A year ago Democrat Governor of Washington state, Christine Gregoire, had a Medicaid waiver approved by the federal government. 

That waiver essentially converted Medicaid into a block grant program, or capped federal matching funds, that will allow Washington state to better manage the ballooning costs to state government. 

A similar waiver was also approved for Rhode Island in 2009. According to a report by the Common Sense Policy Roundtable on Medicaid reform, since the implementation of the waiver, projected Medicaid spending declined from $3.8 billion to $2.7 billion. 

In Colorado in the last ten years Medicaid spending has more than doubled from $2.3 billion in '00-01 to $4.9 billion '10-11.

With Medicaid spending growing out-of-control, other budget items, mostly education, are getting axed. 

The bill requesting a Medicaid waiver is being sponsored by state Senator Greg Brophy (R-Wray), who told the Peak: "Either we reform Medicaid or we continue to cut funding for education. This isn't a philosophical argument; it's the recognition of a math problem."

On education cuts, Hickenlooper has said he is "not happy" and "[doesn't] see a way to get around it."

Well, Governor, a Medicaid waiver would be one way. 

Senate Minority Leader Bill Cadman has said Medicaid spending is a "tumor" on the state budget. 

As Medicaid waivers in other states have proven to turn that tumor from malignant to benign, why is the press and Governor Hickenlooper so seemingly opposed to exploring that option?


(FINALLY!) RED TAPE LIBERALS LOATHE: Hick Streamlines Medicaid, Welfare Application Process

Governor Hickenlooper made many a promise on the campaign trail to reduce red tape and bureaucratic headaches. The thing is…no one thought his first attempt to make red tape reform would be to make it easier to access government entitlements that are already making the state broke.

Yesterday, Hick announced the reform of the process to apply for a variety of government programs, making getting government assistance a much easier proposition and thereby expanding the enrollment in those programs. The Colorado Department of Human Services (DHS) thinks the potential exists to double the number of people on Medicaid, the budgetary item that is already responsible for virtually all of the increased spending in Hickenlooper's proposed budget for next year. 

The new state House Minority Leader, Rep. Mark Ferrandino (D-Denver) laughably lauded the reform as improving "efficiency in government." Per the Pueblo Chieftain:

The governor has said since he took office that he wants to see efficiency in government, and that's exactly what this is. It's not expanding eligibility, it's just a better way of reaching people who are eligible for and entitled to these benefits.

Good thing Hickenlooper was not expanding eligibility, as a bill supported by Ferrandino did in 2009. Despite Ferrandino's statement prior to the legislation’s passage that the Medicaid expansion wouldn't "cost the state very much dollars," the bill ended up expanding into a pool three times the amount of people originally estimated at NINE TIMES THE COST estimates.  

Ferrandino, unlike us and most of Colorado, seems to share Hickenlooper's warped view of the phrase "efficiency in government." In a time of economic malaise such as this, we generally assume that means making it easier to start businesses or cutting out redundant bureaucratic positions, not spending more tax dollars we don't have, quicker. 

Hick did, after all, promise to reduce regulations for businesses across Colorado. He backed off pushing that big bill last year, as Hick likes to "avoid the big fights." Much easier to increase government spending, especially when he doesn't need the Legislature's approval. 

Not that it won't affect the state government budget. It will. 

As Colorado must balance its budget every year and voters overwhelmingly rejected raising taxes when they shot down Prop 103 nearly 2:1, there is simply not enough resources to offer everybody a full plate of government entitlement programs.

There's not — not if you care about the kids. If more people start joining entitlement programs that means less money for roads and education. The budget pie doesn't expand if you add more people to the government social program rolls, it just means less pie for everything else. 

We thought Prop 103 supporter Mark Ferrandino cared about the kids. Guess he and Hick don't. 


CHICKENLOOPER NARRATIVE TAKES GRIP: Stapleton & Gessler Call Out Governor For Dodging Governance

Secretary of State Scott Gessler and Treasurer Walker Stapleton are the latest prominent conservatives to offer a stinging rebuke of Governor John Hickenlooper's hands-off, hide-out, tuck-duck-and-cover approach to governing the state of Colorado. Stapleton and Gessler both gave a thumbs down to Hickenlooper's approach in speeches before the Centennial Institute at Colorado Christian University last week.

Stapleton, having never held elected office before, found the approach particularly frustrating. Per the Colorado Statesman's Ernest Luning:

“It’s dawned on me, after spending my entire life in the private sector, that politics is a strange business,” said Stapleton, cracking a bemused smile. The reason, Stapleton said, is that “the less you do, the more popular you are. Think about how backwards that is.”  

It’s not like other professions, Stapleton continued, where more ambition and accomplishments usually lead to higher stature. “In politics, as long as you can sit comfortably on the sidelines when it comes to controversial issues, you’re popular. And we have a governor who’s incredibly adept at sitting on the sidelines on consequential issues facing our state.” [Peak emphasis]

This line of criticism might be familiar to our readers, as we have been highlighting Hickenlooper's hiding for some time on these pages. From the $3 billion tax hike known as Prop 103 to Congressional redistricting, Hick has refused to even let the voters of Colorado know where he stands, let alone wade into issues that cry out for some executive leadership. 

That's led not just conservatives but liberals to complain that the Governor is being greedy with his political capital. Liberals seem to believe Hick isn't "paying his fair share" of the burden when it comes to passing liberal legislation. 

Some high profile legislators, like State Senator Greg Brophy (R-Wray), have even penned Peak columns criticizing the Governor for his weak-kneed ways.

Only two days after Brophy hit Hick for hiding on dealing with the Occupy Denver squatters, Hick and Denver Mayor Michael Han(d)cock sent in the riot police to clear the camp. Which is to say, wake up Republicans. Hickenlooper is not immune to legitimate criticism. If he's wrong, it's your duty to say so.

Like, for example, Hick's BS excuse on why he couldn't tackle the budgetary behemoth that threatens to single-handedly kill the state's spending future — Medicaid. He claimed it was illegal to curtail Medicaid spending, despite fellow Democrat New York Governor Andrew Cuomo having tackled that entitlement only a few months back. We called the Medicaid cops on Cuomo, but they told us Hickenlooper has no idea what he is talking about. It was just another excuse to avoid a tough issue. 

Remember, as Hick let slip to Washington Post conservative commentator George Will, because Colorado is a such a politically balanced state, Hick believes he gets to "avoid the big fights."

Hick doesn't get to "avoid the big fights," he has just been allowed to by too few Republicans willing to call the Governor out.

Maybe, just maybe, Republicans in Colorado have grown weary of giving our weak but popular Governor a free pass. If they stay at it, maybe the Governor will actually be forced to, you know, do something. And if he doesn't, who knows, maybe his popularity will bear the consequences.


SOMEBODY CALL THE MEDICAID COPS: New York Governor Andrew Cuomo Broke The Law Says Hickenlooper

John Hickenlooper and Andrew Cuomo both fancy themselves Presidential material. Cuomo, because of the exaltation he has won from progressives nationally for his aggressive push for gay marriage in New York. Hickenlooper, because he managed to get just over 50 percent of the vote against Tom Tancredo and Dan Maes. (Yawn.)  

But Hickenlooper and Cuomo have at least one big thing as a difference…Cuomo has been among the Democrat Governors who has tackled Medicaid reform.  

Hickenlooper? He thinks Cuomo and the other Democrat and Republican Governors who have reformed Medicaid are law-breakers…petty criminals, who don't follow the law.

From the AP's Ivan Moreno:

Hickenlooper insisted that Medicaid waivers are not possible and that the new federal health care law prevents states from restricting eligibility.  

"We can't cut Medicaid. It's against the law," he said after the hearing. [Peak emphasis]

…Under Hickenlooper's budget, Medicaid next year would account for $185.6 million out of the $227.1 million increase in the general fund.

Really, Governor Hickenlooper? We thought you were a brewpub owner, not a lawyer.

Is it really illegal to reduce the growth in Medicaid spending?

Here's some of what Cuomo did in New York, according to Reuters:

New York's fiscal 2012 budget cuts more than $1.2 billion from state aid to local school districts and reduces spending on the state's Medicaid program by $2.8 billion.  

The budget sets an annual cap of $15 billion on Medicaid spending and ties future spending increases to a national index. Similarly, future education spending will be linked to personal income growth.

Somebody call the Medicaid cops. Hickenlooper says Cuomo broke the law.

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