Hickenlooper vetoes childrens’ health insurance bill

Childrens’ advocates praise Guv’s decision
The Colorado Statesman

Gov. John Hickenlooper handed down his first full-bill veto Tuesday, striking down a measure that would have asked certain low-income parents to pay monthly premiums for their children’s health insurance.

Senate Bill 11-213 was part of the package of bills designed to balance the 2011-12 budget, but it would have cost the state more to implement than it would have gained.

The bill has been the subject of furious lobbying for the past several weeks from children’s advocacy and health organizations, including The Children’s Hospital, Colorado Children’s Campaign, Colorado Medical Society, Denver Health Medical Center and the Rocky Mountain Health Plan.

Currently, families enrolled in Children’s Basic Health Plan (CHP+) annually pay $25 per child or $35 for more than one child, although the fee is waived for pregnant women and families whose incomes are less than 150 percent of the federal poverty level.

Under SB 213, and according to the bill’s fiscal note, the current annual enrollment fee would apply to families with income of 150 to 205 percent of the FPL; those with incomes above 205 percent would pay the new monthly premium, which would be $20 per month for the first child and $10 per month for each additional child, up to a maximum of $50 per month per family. The FPL is currently $10,830 for an individual or $22,050 for a family of four.

Despite the veto, however, enrollment fees for CHP+ will go up; Hickenlooper said the Department of Health Care Policy and Financing will increase the annual enrollment fee through its rule-making process later this year, a change that he said would be “minimally disruptive, administratively efficient, effective and elegant, and supports the goal of ensuring that kids will have access to coverage.” And because the higher enrollment fees weren’t due to kick in until 2012, Hickenlooper said the plan he envisions would follow either the same timeline, or possibly an earlier one. He also pledged to work with the Joint Budget Committee on changes to the CHP+ program.

It makes sense for low-income families to contribute for their health care, Hickenlooper wrote in his veto message to the state Senate. “What is troubling about this legislation, however, is not the policy intent, but the practical and negative impact it will have on children in low-income families…We have determined that the bill poses adverse consequences on children’s access” to health care through the CHP+ program, he added. The fees required by SB 213 would result in a 1000 percent increase in the cost to enrollees whose family income falls within the 205 percent to 250 percent federal poverty level, and as a result, Hickenlooper wrote, HCPF estimated that about 20 percent of those already enrolled in CHP+, or about 2,500 children, would likely drop out of the program and become uninsured.

Chris Watney, president of the Colorado Children’s Campaign, called Hickenlooper’s veto “an important victory for the children who benefit from the CHP+ program and will go a long way in continuing Colorado’s recent successes in reducing the number of uninsured kids in the state.” As to Hickenlooper’s plan to ask HCPF to increase the annual enrollment fee, Watney said she agreed that “shared responsibility is an important value, and we look forward to working with the Department of Health Care Policy and Financing to find reasonable ways to ensure CHP+ eligible families at higher income brackets are appropriately contributing to the cost of their children’s health care.”

The bill faced a tough road through the Legislature; it got support from only seven of the Senate’s 20 Democrats in its final vote and needed strong backing from the Republican caucus to clear that chamber. The bill got even less support from Democrats in the House; the only one to vote for it was Rep. Mark Ferrandino, D-Denver, one of its JBC sponsors.

In addition to its lack of support from Democrats, SB 213 had financial problems; its final fiscal note showed that while the state would have collected $1.27 million in revenue in 2012-13, the state would lose nearly $6 million in the first full year of implementation through a combination of technology and staffing costs, the cost of efforts to collect premiums, and nearly $4 million in federal funds.

Several House Democrats applauded Hickenlooper’s action Tuesday. Rep. Jim Riesberg, D-Greeley, said that during committee hearings “we heard that this approach would not have saved the state money, but would simply be detrimental to working families and their children’s health. I am happy that the Governor vetoed this shortsighted measure. In these tough times, we must protect children of low-income working families.” Rep. John Kefalas, D-Fort Collins, added that, “I’m glad that the Governor did the right thing and protected children of working families from losing access to good, affordable healthcare.”

In a statement Tuesday, Elisabeth Arenales, director of the health care program for the Colorado Center on Law and Policy, said the “state badly needs more revenue to support vital services, including health care for our most vulnerable residents. But this proposal was looking for revenue in exactly the wrong place — families already teetering on the edge of economic security. Senate Bill 11-213 would have pushed these families farther away from long-term security.”

The veto produced the strongest criticism to date from Republican lawmakers of the governor, of whom they had mostly been quite supportive. They touted the bill as a first step toward entitlement reform, and reacted accordingly to the veto. Sen. Greg Brophy, R-Wray, said in a Tweet that Hickenlooper’s veto was a “huge mistake. We need entitlement reform. This was [a] 1st minor step.”

“I am extremely disappointed that Governor Hickenlooper broke from the budget framework that we agreed to by vetoing Senate Bill 213,” said Speaker of the House Frank McNulty, R-Highlands Ranch. “Republicans and Democrats in both the House and Senate took an important step on welfare reform and the governor took a step back. That said, welfare reform is now in his court. We must ease the burden on working families and small businesses who are paying for these government programs.”

JBC member Rep. Jon Becker, R-Fort Morgan, said SB 213 was a “fair way to ensure that we continue to offer these programs while asking that those who participate do so in a responsible way and make a modest contribution to the system. I look forward to working with the governor to look for opportunities to make government programs more accountable and to continue to introduce more personal responsibility into our critical safety net programs.”

Becker’s JBC colleague, Sen. Kent Lambert, R-Colorado Springs, also expressed disappointment in the veto but said he was encouraged by Hickenlooper’s promise to raise the annual enrollment fee through rulemaking. “The Governor’s pledge to pursue this reform by administrative action is a positive step,” Lambert said Tuesday.

“This bill was the only structural reform of expenditures in the state’s $5 billion CHP and Medicaid programs,” Lambert said, adding that Republicans would continue to challenge the state’s health agencies to work with the Legislature on “realistic reform.”

Hickenlooper’s only previous veto had been on footnotes in the 2011 Long Appropriations Bill. Those vetoes were later overturned by the General Assembly.