When my son accidentally punctured his eardrum years ago, we rushed him to Mercy Hospital. The doctors’ offices were closed, and Durango didn’t have any urgent care clinics at the time. He was fine, but we felt lucky we had a doctor and services so close. Not everyone in the six counties of our district is so fortunate.
When it’s a matter of sickness and health, the consequences are real. Understandably so, almost nothing in recent years has been more at the forefront of politics than health care. Between the national discussion about the future of the Affordable Care Act and the Colorado conversation about our rural hospitals struggling to make ends meet, people are confused and concerned. People want to know how their family is going to get the services they need, and how they are going to afford it.
Here in Colorado, the hospital provider fee has been a key pillar to keeping our hospitals open and ensuring the health and safety of our residents. Hospitals pay the hospital provider fee based on their occupied beds and outpatient charges. The fee attracts matching funds from the federal government – doubling in the process. The money goes right back to the hospitals, helping them cover the costs of uninsured patients and uncompensated care.
The need for this extra federal money goes back, in part, to the 1980s, when an unfunded mandate was handed down to hospitals that required them to provide emergency care to everyone, even if they were uninsured. This policy has saved countless lives; it also placed an enormous burden on hospitals.
In addition to this emergency care, hospitals and health care providers in our state annually provide many services that are uncompensated or undercompensated. Between these reimbursement issues and the mandate on emergency care, many rural hospitals simply can’t make ends meet without the support from this fee.
The hospital provider fee, despite being a lifeline for the health of Colorado and our Southwest communities, finds itself in the center of a budgetary policy debate. There are two propositions on the table to ease our current budgetary mess. The first is to cut the fee revenue in order to help balance the state budget, preventing hundreds of millions of dollars in TABOR refunds at the same time as we’re having to cut funding from schools.
Considering the lean budgets of our rural hospitals, this is a not a good option and runs the risk of putting many of our local hospitals out of business entirely. A second option, which was discussed hotly in the 2016 session, is to make the fee into a state enterprise, which would formally set the pool of private and federal monies aside from the rest of the state budget. Separating the fee from the rest of the budget would allow it to work as it was originally intended, bolstering healthcare in our rural areas while relieving the budgetary pressure it’s currently creating.
In a time when there are few easy answers to the budgetary situation, restructuring this fee is a no-brainer; it’s an opportunity to find a solution that will avert dire cuts to hospitals and help ensure access to health care in rural areas of the state. We should take it.
Barbara McLachlan represents State House District 59. Reach her at barbara.mclachlan.house@state.co.us. .
