The result is an inability to find extra funds for many of our state’s pressing needs, including services for people with intellectual and developmental disabilities (I/DD). I/DD providers can’t raise tuition, can’t blend inadequate Medicaid rates with other sources of income, and can’t increase other sources of income (such as insurance payments) while limiting Medicaid clients to a manageable loss like other areas of health care.
There may be a way to pull ourselves, at least partially, out of the hole we have dug for ourselves. In Colorado, the Hospital Provider Fee (HPF) is a major budgetary factor that is currently triggering a TABOR refund while I/DD providers are facing rate cuts. The Hospital Provider Fee generates about $750 million revenue, which counts towards the State’s TABOR revenue limit.
If the HPF were statutorily changed into an enterprise, a number of cuts proposed by the Governor could be eliminated. Colorado has almost two dozen enterprises that finance and/or administer various programs, including unemployment insurance, our higher education system, the Colorado Lottery, corrections, and special districts providing essential services such as fire protection. Changing the HPF to an enterprise would not require a vote of the citizens of Colorado.
Instead, creating this new enterprise would require the legislature to introduce a bill this coming session (which is likely), similar to HB 15-1389: Create New Hospital Provider Fee Enterprise, which was introduced last year and received too little attention too late in the session. The state legislature, the Speaker of the House of Representatives, and the President of the Senate will all need to exercise the leadership necessary to get the presumptive bill to the floor for a vote this time. Governor Hickenlooper, who currently supports the concept, could exercise the influence and leadership necessary to move Colorado out of the shadows of this perpetual cycle of budgetary crisis.
This is not a permanent solution for the constitutional budget abuse, but it could by us a few years until our collective knowledge will allow us the necessary collaborative budget daylight we seek.
Then again, what do I know?