A constant fight between legislative Republicans and Democrats in Colorado is over how entitlement programs are paid for and how much they will ultimately cost. Republicans have remained skeptical of rosy predictions of costs, while Democrats have generally been in favor of passing additional entitlement spending, regardless of the fiscal impact.
One of the biggest fights in 2009 was over the Democrats' bill, HB 1293 (PDF), to increase the coverage pool for Medicaid, the federal health insurance program for the poor. The bill was the by-product of Representative Riesberg (D-Greeley), who is now Governor Hickenlooper's Insurance Commissioner, and Joint Budget Committee (JBC) member, Representative Ferrandino (D-Denver).
The additional Medicaid spending in the bill was purportedly paid for with a hospital user fee (read: tax). Despite an attempt by Republicans to request that the fee was transparently labeled as such for patients on their bills, the Democrats controlled both chambers and insisted the fee not be disclosed.
Then-state Representative Cory Gardner insisted transparency be a part of the bill, as the money comes from somewhere and patients have a right to know where that somewhere is. It doesn't come from the Tooth Fairy he said to guffaws from the House floor.
Gardner then referred to the bill as a "legislative colonoscopy" for taxpayers and with news that the program is basically broke already, his description seems exceedingly apt.
Not only did Democrats refuse to make the fee transparent, but they bollixed up the math on the program, leaving the program desperately underfunded only two years later.
The Denver Post's Tim Hoover reports:
Two years after lawmakers expanded Medicaid to cover poor adults without children, the state is vastly scaling back the program because the number of people eligible for coverage is nearly three times as high as first projected and the cost of insuring them is almost nine times original estimates. [Peak emphasis]
The new coverage followed the 2009 passage of major health care legislation that allowed the state to impose a fee on hospitals while drawing down matching federal money to expand Medicaid coverage.
House Bill 1293 was estimated to generate about $1.2 billion for Medicaid programs when fully phased in, and the measure called for expanding eligibility levels. A new eligibility class was created for adults without dependent children and whose income was up to 100 percent of the federal poverty level, or $10,890 per year for an individual.
With the program's financial structure in such an unholy mess it's instructive to look back at what proponents of the legislation said about it back when it was being debated.
As Representative Ferrandino sits on the JBC, and thus has significant influence on budgetary decisions, let's see what he had to say:
Representative Ferrandino: What this (HB 1293) is, is an innovative solution that helps us, um, cover over 100,000 more people without actually costing the state very much dollars. A little start up dollars, but after that, uh, we are able to use fees from the hospitals and match them with the feds and bring in about $1.2 billion to, ah, increase reimbursement rates to hospitals and also to increase coverage for the people of Colorado. [Peak emphasis]
"Very much dollars"? Excuse his rotten English for a second, and compare that to the fact that the program is very much financially broken only two years later. Care to correct the record, Monsure Ferrandino?
"100,000 more people"? Despite getting his facts wrong — it was estimated in 2009 that slightly less than 50,000 would be added to Medicaid's rolls — Ferrandino's fuzzy math was closer to reality. Under the bill's language, 143,000 people are eligible now. What did Ferrandino know back in 2009 that he wasn't sharing with others?
Now that the program has become one more example of actual entitlement spending being wholly different from rosy predictions put out before the passage of the entitlement, the lead cheerleader has some 'splainin to do.
Representative Ferrandino — if you'd like to write a mea culpa on your fuzzy math we'll gladly publish it on these pages. You can email it to [email protected]