Office of Sen.

Mike Johnston
Colorado General Assembly | 200 E. Colfax Avenue | Denver, CO 80203 | 303.866.4864

FACT SHEET MEMORANDUM

SB 12-085 Reducing General Fund Expenditures Sen. Mitchell Staff Name: Gaby Corica & Quinn Girrens What the Bill Does: SB 12-085 seeks to return Colorados Medicaid and Childrens Basic Health Plan to its eligibility requirements and services to its 2006 level. In order to achieve this goal, this bill proposes to: Repeal eligibility for certain qualified aliens and their children, for certain children in foster care, for people in the Medicaid buy-in program, and for childless adults. Lower the income level for parents of children eligible for Medicaid from 100% to 60% of the federal poverty line. Eliminate 12 months of continuous eligibility for children. Replace advanced practice nurses services with nurse-midwife services. Repeal from the list of optional services eligible for reimbursement under Medicaid: o Over-the-counter medications o Out-patient substance abuse treatment o Cervical cancer immunization for females under the age of 20 o Screening, brief intervention, and referral to treatment for individuals at risk of substance abuse o Alternative therapies for people with spinal cord injuries. Eliminate presumptive eligibility for public medical assistance for children and for certain people eligible for long-term care. Lower the income level for eligibility under the childrens basic health plan from 250% (what it is currently) to 205% of the federal poverty line. Colorado Context: The number of Medicaid enrollees from 2006 to 2009 increased by less than 500,000, going from roughly 550,000 annual enrollees to less than 650,000 in 2009.1 Since 2006, the federal government has been contributing more than half of the states total Medicaid costs.2 In 2009, the federal government contributed just over $2 billion ($2,116,124,164.00) to Colorados Medicaid costs while the state contributed $1.4 billion.3 Up until 2009, Medicaid enrollment rates had remained around the same rate

Colorado Medicaid Statistics, http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/colorado.html, (last visited Jan. 27, 2012). 2 Id. 3 Id.

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For a complete list of fact sheets, visit www.mikejohnston.org/in-the-legislature.

with an annual enrollment count of about 550,000 each year. 4 In 2009, the enrollment number jumped up to just over 700,000 for the year.5 National Context: Most states across the country are making budgetary cuts in Medicaid enrollment and eligibility because of the recession. In Utah the legislature passed a bill requiring the Department of Health to apply for federal grants to help simplify the enrollment and renewal process for Medicaid. . . .6 Oregon has submitted waivers to the Centers for Medicare and Medicaid Services (CMS) to save an estimated $240 million in FY 2012 through the creation of Coordinated Care Organizations to manage physical, oral and mental health services, improve quality and reduce costs.7 Other than Colorado, South Carolina, Nebraska, South Dakota and Arizona are also reducing Medicaid payments to physicians.8 Along with Colorado, Connecticut, Florida, Nebraska, New Hampshire, North Carolina, Oregon, Pennsylvania, South Carolina, Texas, Virginia, and Washington are making cuts to hospitals.9 The payment cuts, which require federal approval, are part of a larger effort by states to reduce the cost of Medicaid, typically the largest- or second-largest expenditure after education. In some states, dental services and other optional benefits have gone under the knife.10 To help balance some of the costs, many states are requiring enrollees to sign up for private Medicaid managed care plans.11 States on average currently pay Medicaid providers about 72% of what Medicare pays.12 Similar to SB 12-085, Washington passed a bill that preserves the Basic Health Plan (BHP), but it reduces the programs funding and limits eligibility.13 Fiscal Impact: There is currently no Fiscal Note available for SB 12-085.

4 5

Id. Id. 6 Id. 7 Id. 8 Phil Galewitz, Medicaid payments go under the knife, USATODAY (July 5, 2011), http://www.usatoday.com/news/washington/2011-07-05-state-medicaid-reimbursements_n.htm. 9 Id. 10 Id. 11 Id. 12 Id. 13 Impact of HB 1086 on Health Care Authority and the Medical Purchasing Administration, STATE OF WASHINGTON HEALTH CARE AUTHORITY/MEDICAID PURCHASING ADMINISTRATION, http://hrsa.dshs.wa.gov/News/Budget/MedicaidBudgetImpactHB1086_31711.pdf; See http://hrsa.dshs.wa.gov/news/budget.htm (last visited Jan. 27, 2012).

DRAFT 1/29/2012 3:38 PM

For a complete list of fact sheets, visit www.mikejohnston.org/in-the-legislature.