Changes to the state’s Medicaid and child health care programs
Re: “The right Rx for Medicaid?” Aug. 31 news story.
In the past two months, the Health and Human Services committees of the Colorado Senate and Colorado House reviewed an application by the Colorado Department of Health Care Policy and Financing to restructure our state’s Medicaid and Child Health Plan (CHP). This ambitious proposal – a part of the federal Health Insurance Flexibility and Accountability (HIFA) waiver process – would have made sweeping changes to the structure of our state’s most important safety net programs.
Although our final vote did not approve the application moving forward, the goals were admirable. They addressed rising health care costs and increased demand for services by combining Colorado’s Medicaid and CHP programs. Efforts to streamline eligibility, introduce year-round enrollment and reduce the overall costs necessary to operate all receive our full support. These are real solutions worth pursuing, but in a different form.
Our state’s health programs are 40 years old, occupy the second-largest line item in our budget, and serve more than 300,000 people. It is our responsibility as stewards of public health and safety to ensure these programs are operating at their greatest efficiency, both in structure and in finance.
While the proposal was based on laudable goals, the price of implementing these reforms was simply too high. If approved by the federal government, the HIFA waiver would have placed a cap on the amount of federal dollars entering Colorado. Federal funding caps shift the risk of higher health care costs onto states. States can either try to absorb additional costs or make further changes in the program to limit costs.
The number of uninsured residents in Colorado has grown steadily in recent years. Rising health care costs, recession and unemployment are contributing factors to this problem. If, in the next five years, our state were to reach this federal cap, we would be forced to either come up with state funding and forgo the federal match or make the difficult decision of which services to cut.
Additionally, the HIFA waiver process is unique in that it allows major changes to our programs without approval of the full legislature. Typically legislators have had time to review proposals and thoroughly debate their merit. Every county in Colorado is affected by changes to our state Medicaid program, and we believe that input is both necessary and appropriate from all 100 members of the Colorado legislature.
Any true solutions to this problem will be bipartisan. The right solution will lead to a healthier community, and implement a sound fiscal strategy for Colorado.
Rep. Anne McGihon, D-Denver
Sen. Brandon Shaffer, D-Longmont
Sen. Shawn Mitchell, R-Broomfield
Rep. Debbie Stafford, R-Aurora
Confirmation of Supreme Court nominee
If John Roberts is approved as the new chief justice of the Supreme Court, he will wield enormous influence over the country for possibly 30 years. The administration’s refusal to fully open all documents generated by Roberts in his very political rise to prominence leaves his legal thinking a cipher now incumbent upon the Senate to uncover.
The Senate should be interested in his views on the power of the executive branch versus that of the legislative. Also, what exactly are his views on the rights of the individual versus the power of the government? And what standing does concern for the environment have against the power of corporations and the almighty dollar? Or of minorities against a tyranny of the majority?
How, precisely, does he view the separation of church and state? As a Catholic, does he believe in the infallibility of the Pope? How will his religious beliefs influence his rulings from the court? Does he still believe Roe vs. Wade was “wrongly decided”?
If Roberts is evasive in his answers to these questions, his confirmation should be denied. The future of America is in the Senate’s hands.
Robert Porath, Boulder
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