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News

Feb 10, 2017

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Legislative Update: Feb. 10, 2017

by | Feb 10, 2017

Legislative Updates

Medicaid issues warrant notice
Three bills that were recommended and developed by CCLP and the Colorado Cross-Disability Coalition (CCDC) will be considered by Colorado legislators next week. House Bills 1126 and 1143 are scheduled to be heard by the House Public Health Care & Human Services Committee, Feb. 14 at 1:30 p.m. at the State Capitol. A related measure, Senate Bill 121, is slated to be reviewed by the Senate Health & Human Services Committee’s on Feb. 16 at 1:30 p.m.

The bills, which received bipartisan sponsorship, are intended to address shortcomings in client correspondence and notifications when Medicaid benefits are about to be changed or terminated. An interim committee held three hearings about Medicaid correspondence last summer, which included testimony from CCLP, CCDC, and the Colorado Department of Health Care Policy and Financing.

Currently, Medicaid recipients are supposed to receive notice with information about how to appeal changes or termination of their benefits if they believe the action is unjustified. In practice, however, these notices are often vague and confusing. Most do not specify why benefits are being terminated or reduced, so Medicaid clients don’t always know whether they should challenge the decision. Furthermore, without proper notice, those who appeal may be unable to fully prepare their case.

Sponsored by Rep. Jessie Danielson, D-Wheat Ridge, and Sen. Larry Crowder, R-Alamosa, HB 1126 would ensure that an administrative law judge reviews the sufficiency of Medicaid termination notices at the beginning of an appeal hearing. The bill also requires the judge to inform the client of his or her option to receive an improved notice with the possibility of maintaining benefits, or proceed with their hearing.

Sponsored by Rep. Lois Landgraf, R-Fountain, and Sen. Crowder, HB 1143 would direct the state to audit communications with Medicaid clients. These audits would review the notices for legal sufficiency, clarity and accuracy. Audit findings, conclusions and recommendations will be presented to legislative committees, which can then consider whether the results warrant further reforms.

Finally, SB 121, sponsored by Sen. Kevin Lundberg, R-Berthoud and Sen. Crowder, requires the Colorado Department of Health Care Policy and Financing to engage in a process to improve Medicaid client communications – including client letters and notices – that addresses denial, reduction, suspension, or termination of Medicaid benefits.

Collectively, these proposals will help ensure that Medicaid clients do not lose access to health care due to the shortcomings in the current notification process.

Bill to Watch: SB 4
At first glance, Senate Bill 4 looks like a reasonable solution for Medicaid recipients who have problems accessing specialty health care services. Sponsored by Sen. Jack Tate, R-Centennial, the measure would allow non-Medicaid-enrolled health care providers to bill Medicaid patients directly for services. Unfortunately, that means that those who can least afford it will be on the hook for medical fees and – because of federal rules – for the cost of all referrals, orders or prescriptions that come out of visiting a non-Medicaid-enrolled provider.

Despite its intentions, we believe the legislation would result in decreased, not increased, access for Medicaid patients. By making it easier for providers to bypass Medicaid and treat patients from their community for cash, this bill would incentivize some providers to leave the Medicaid program, while shifting significant costs onto individuals. Losing even one Medicaid doctor in rural areas could be a disaster for patients. Worse, the legislation puts low-income families at a high risk of medical debt, with related risks of aggressive debt-collection practices, growing interest on debt, wage garnishment and medical bankruptcy.

Regardless of these serious concerns and opposition from CCLP and other advocacy organizations, the bill was approved by the Senate Health and Human Services Committee on Feb. 9. CCLP will continue to oppose the bill as it moves through the legislature.

On the Radar: SB 110
Finding quality, affordable child care remains one of the more daunting challenges for Colorado parents across the economic spectrum.

SB 110, sponsored by Sen. Larry Crowder, R-Alamosa, and Sen. John Kefalas, D-Fort Collins, increases the accessibility of legal child care by expanding the circumstances under which an individual can care for children from multiple families without obtaining a child care license.
CCLP supports the legislation because it would expand access to legal child care options for families – especially in “child care deserts” where affordable child care options are hard to find.

CCLP’s ‘Manic Monday’
Two bills developed by CCLP will be considered by the Senate State Veterans & Military Affairs Committee on Monday, Feb. 13.

Senate Bill 118, sponsored by Sen. Rhonda Fields, D-Aurora, would require private occupational schools to provide information about educational outcomes (such as completion rates, total costs, estimated debt load and average starting salaries), before students sign a contract. The legislation also calls for the state to develop a website to help students make informed decisions when investing in a secondary education. Learn more about the legislation in this analysis by CCLP’s Chaer Robert.

Senate Bill 98, sponsored by Sen. John Kefalas, D-Fort Collins, and Rep. Joann Ginal, D-Fort Collins, attempts to promote and incentivize the conversion of land-lease manufactured housing communities into resident-owned communities. Details about the bill can be found in this posting by CCLP’s Kristopher Grant.

– By Bob Mook

 

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Recent articles

CCLP testifies in support of TANF grant rule change

Apr 15, 2024

CCLP's Emeritus Advisor, Chaer Robert, provided written testimony in support of the CDHS rule on the COLA increase for TANF recipients. If the rule is adopted, the cost of living increase would go into effect on July 1, 2024.

CCLP’s legislative watch for April 5, 2024

Apr 5, 2024

For the 2024 legislative session, CCLP is keeping its eye on bills focused on expanding access to justice, removing administrative burden, preserving affordable communities, advocating for progressive tax and wage policies, and reducing health care costs.

HEALTH:
HEALTH FIRST COLORADO (MEDICAID)

To maintain health and well-being, people of all ages need access to quality health care that improves outcomes and reduces costs for the community. Health First Colorado, the state's Medicaid program, is public health insurance for low-income Coloradans who qualify. The program is funded jointly by a federal-state partnership and is administered by the Colorado Department of Health Care Policy & Financing.

Benefits of the program include behavioral health, dental services, emergency care, family planning services, hospitalization, laboratory services, maternity care, newborn care, outpatient care, prescription drugs, preventive and wellness services, primary care and rehabilitative services.

In tandem with the Affordable Care Act, Colorado expanded Medicaid eligibility in 2013 - providing hundreds of thousands of adults with incomes less than 133% FPL with health insurance for the first time increasing the health and economic well-being of these Coloradans. Most of the money for newly eligible Medicaid clients has been covered by the federal government, which will gradually decrease its contribution to 90% by 2020.

Other populations eligible for Medicaid include children, who qualify with income up to 142% FPL, pregnant women with household income under 195% FPL, and adults with dependent children with household income under 68% FPL.

Some analyses indicate that Colorado's investment in Medicaid will pay off in the long run by reducing spending on programs for the uninsured.

FOOD SECURITY:
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)

Hunger, though often invisible, affects everyone. It impacts people's physical, mental and emotional health and can be a culprit of obesity, depression, acute and chronic illnesses and other preventable medical conditions. Hunger also hinders education and productivity, not only stunting a child's overall well-being and academic achievement, but consuming an adult's ability to be a focused, industrious member of society. Even those who have never worried about having enough food experience the ripple effects of hunger, which seeps into our communities and erodes our state's economy.

Community resources like the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, exist to ensure that families and individuals can purchase groceries, with the average benefit being about $1.40 per meal, per person.

Funding for SNAP comes from the USDA, but the administrative costs are split between local, state, and federal governments. Yet, the lack of investment in a strong, effective SNAP program impedes Colorado's progress in becoming the healthiest state in the nation and providing a better, brighter future for all. Indeed, Colorado ranks 44th in the nation for access to SNAP and lost out on more than $261 million in grocery sales due to a large access gap in SNAP enrollment.

See the Food Assistance (SNAP) Benefit Calculator to get an estimate of your eligibility for food benefits.

FOOD SECURITY:
SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC)

Every child deserves the nutritional resources needed to get a healthy start on life both inside and outside the mother's womb. In particular, good nutrition and health care is critical for establishing a strong foundation that could affect a child's future physical and mental health, academic achievement and economic productivity. Likewise, the inability to access good nutrition and health care endangers the very integrity of that foundation.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides federal grants to states for supplemental foods, health care referrals, and nutrition information for low-income pregnant, breastfeeding and non-breastfeeding postpartum women and to infants and children up to age five who are found to be at nutritional risk.

Research has shown that WIC has played an important role in improving birth outcomes and containing health care costs, resulting in longer pregnancies, fewer infant deaths, a greater likelihood of receiving prenatal care, improved infant-feeding practices, and immunization rates

Financial Security:
Colorado Works

In building a foundation for self-sufficiency, some Colorado families need some extra tools to ensure they can weather challenging financial circumstances and obtain basic resources to help them and their communities reach their potential.

Colorado Works is Colorado's Temporary Assistance for Needy Families (TANF) program and provides public assistance to families in need. The Colorado Works program is designed to assist participants in becoming self-sufficient by strengthening the economic and social stability of families. The program provides monthly cash assistance and support services to eligible Colorado families.

The program is primarily funded by a federal block grant to the state. Counties also contribute about 20% of the cost.

EARLY LEARNING:
COLORADO CHILD CARE ASSISTANCE PROGRAM (CCCAP)

Child care is a must for working families. Along with ensuring that parents can work or obtain job skills training to improve their families' economic security, studies show that quality child care improves children's academic performance, career development and health outcomes.

Yet despite these proven benefits, low-income families often struggle with the cost of child care. Colorado ranks among the top 10 most expensive states in the country for center-based child care. For families with an infant, full-time enrollment at a child care center cost an average of $15,140 a year-or about three-quarters of the total income of a family of three living at the Federal Poverty Level (FPL).

The Colorado Child Care Assistance Program (CCCAP) provides child care assistance to parents who are working, searching for employment or participating in training, and parents who are enrolled in the Colorado Works Program and need child care services to support their efforts toward self-sufficiency. Most of the money for CCCAP comes from the federal Child Care and Development Fund. Each county can set their own income eligibility limit as long as it is at or above 165% of the federal poverty level and does not exceed 85% of area median income.

Unfortunately, while the need is growing, only an estimated one-quarter of all eligible children in the state are served by CCCAP. Low reimbursement rates have also resulted in fewer providers willing to accept CCCAP subsidies.