There’s no doubt the health care system in this country is broken. In Colorado alone, more than 700,000 people are uninsured, and their ranks are growing. But the cost of serving them in hospital emergency rooms and public clinics is also soaring. So what’s a state to do?
Colorado has decided to place a bigger burden on recipients of its health program for the working poor, raising copays and fees for other medical services effective Feb. 1. It’s a painful step that reflects the harsh reality of rising medical costs.
Many of those eligible for the Colorado Indigent Care Program are single adults, some disabled, who don’t qualify for Medicaid, the program for low-income children and elderly. They make between $3,829 and $17,705 a year. Families of four with incomes up to $35,700 also qualify for the program.
Simply put, more money is needed to cover rising costs for doctors and other care providers who see CICP patients. Copays for the program have not been raised since 1999. Last year alone, medical costs rose 8.2 percent.
We worry that doctors, hospitals and clinics will stop serving CICP patients if the program falls too far behind the costs of care. Denver Health Medical Center, one of the state’s largest providers, says it lost $180 million in 2004-05 serving 31,000 CICP clients.
The program was created by the legislature in 1983 to cover citizens who aren’t eligible for anything else. It funnels money to 45 hospitals and 96 clinics that in turn serve the working poor on a sliding fee scale. Funding comes from both the state and federal governments.
A person now charged a $10 copayment for various services will be charged $15. For specialty care, individuals will be charged an additional $25 fee. For emergency outpatient care, fees for some will rise 200 percent. These increases might not seem onerous, but we don’t doubt they will be a burden for many individuals.
“We don’t want to harm the client, but we don’t want to lose access and providers either,” said Rhonda Bentz of the Department of Health Care Policy and Financing. But Lorez Meinhold, executive director of the Consumer Health Initiative, points to studies that show when copays are raised, some people are priced out of care altogether.
It is an issue that lawmakers need to address. “I feel for hospitals and clinics. They are having to meet their bottom line,” said attorney Elizabeth Arenales of the Law and Policy Center. “But we need to engage in a larger debate. Shifting costs to people accessing services isn’t the solution.”
