Issues to watch in the 2018 Colorado General Assembly
by Susan Koontz, JD, General Counsel, Senior Director of Government Relations
Featured in the January/February 2018 Colorado Medicine.
The Second Regular Session of the 71st Colorado General Assembly convened on Wednesday, Jan. 10, 2018, and will run through May. The Colorado Medical Political Action Committee (COMPAC) has already begun working to address issues sure to arise this legislative session including engaging legislators in the interim and working through the lobby team to maintain open communications.
For the benefit of Colorado physicians, all elements of the CMS public affairs program will be engaged, including professional direct advocacy, message development and communications, legal research and bill drafting, policy development and research, witness preparation, and member updates and calls to action.
Jerry Johnson of Johnson Consulting, a longtime and decorated lobbyist for CMS, gives his analysis of what to expect in 2018. “The 2018 General Assembly will be focused on the opioid crisis, the budget, divergent views about how to fix PERA [Colorado Public Employees’ Retirement Association] and highway funding, with each side positioning its approach to best serve the reelection of its members and respond to the needs of their constituents. Now that Congress has passed the tax bill and nothing is forcing the hand of states in the short-term, coupled with 2018 being an election year, it is highly unlikely that a new coverage scheme will emerge or be politically viable if it does.”
Though the individual mandate of the Affordable Care Act was repealed by Congress’s tax bill, Gov. John Hickenlooper strongly supports Medicaid expansion, the sale of subsidized health insurance tied to a consumer mandate to purchase such insurance, and preservation of employer-sponsored health insurance, and it is almost certain that his administration will not transition to a different coverage scheme during the remainder of his term in 2018, Johnson said.
“Because CMS actively supported both the Medicaid expansion and legislation that created Connect for Health Colorado, the state’s health insurance exchange, the governor might be open to strategies to further close the coverage gap, though any tax bill in the 2018 legislature would be dead on arrival in the state Senate.”
The economic pressures on physicians to control costs, coupled with the continued realignment of payment models in both public and private sectors, have generated significant partitioning of medical practice settings and placed further limits on practice choices that assure economic security and viability. The political uncertainties and interdependence of federal and state health care financing, and sharp differences among leaders and influencers regarding those policy options, will continue to exacerbate the business relationships between payers, physicians and other providers, as well as hospitals and medical staffs. Market responses will likely be antagonistic or predatory more than collaborative.
The stakes are clear for the 2018 election cycle: Partisan control of the executive and legislative branches of state government and the Office of the Attorney General. “Led by COMPAC, CMS and component societies, physicians are already heavily engaged in the process of interviewing candidates for open seats and developing relationships that will pay dividends however control of the Executive and Legislative Branches emerges,” Johnson says.
Physicians can stand up and make a difference. Stay involved during the session by joining COMPAC with a contribution at www.cms.org/contribute, volunteering to interview your local candidates for election, or testifying in support of bills as needed. Email email@example.com or call 720-858-6322 to express your interest in testifying. Watch for emails from COMPAC calling physicians to action on bills as they arise.
Issues to watch in 2018
Opioid crisis: More than 63,600 lives were lost to drug overdose in 2016, the most lethal year yet of the drug overdose epidemic, according to a new report from the National Center for Health Statistics. This already high-profile issue has been on the radar of top advocacy groups and elected officials for years and at least six bills will be introduced this session stemming from the work of an interim legislative committee.
“I am incredibly proud of the bipartisan work we have done through this interim committee to lay a foundation for addressing this epidemic, and begin to close the gaps people face in our system to move towards treatment and recovery. I look forward to continuing to work with the providers who are on the front lines and appreciate your involvement and feedback through this process.”
- Rep. Brittany Pettersen, chair of the Opioid and Other Substance Use Disorders Interim Study Committee
Budget: Colorado’s economy continues to be among the best in the nation and will continue to grow at a moderate pace through 2019. Gov. Hickenlooper submitted his FY 2018-19 budget request on Nov. 1, 2017. The key components of the request are full funding for K-12 education for inflation and enrollment, an increased appropriation for Medicaid and a salary increase for direct care staff, increased funding for corrections, and an increase in the state’s reserve.
Medical liability: The legislature may see another attempt at tort reform from insurance carriers through the elimination of “phantom damages,” or the difference between the medical expenses paid versus billed.
Scope of practice: The chiropractors’ association is interested in supporting legislation to allow chiropractors to be considered treating physicians for workers’ compensation cases.