Boulder County commissioners warn about effects of proposed federal health care overhaul

March 23--Cuts being considered in Congress to Medicaid, the government-funded heath care program, would jeopardize the availability of health-care coverage for thousands of Boulder County residents now enrolled in that program, the county commissioners warned this week.

"In Boulder County, Medicaid is the cornerstone of our safety net" for low-income residents, Commissioners Deb Gardner, Elise Jones and Cindy Domenico said in a letter to the county's congressional delegation.

"Although Boulder County is considered affluent, many of our residents are not and have been living without health coverage," the three Democratic commissioners wrote to U.S Reps Jared Polis, D-Boulder, and Ken Buck, R-Windsor, and U.S Sens. Michael Bennet, D-Denver, and Cory Gardner, R-Yuma, in a letter sent on Monday.

When Medicaid was expanded in October 2013 under the federal Patient Protection and Affordable Care Act and more people became eligible for its coverage, 28,708 Boulder County residents were enrolled in Medicaid and a related Child Health Plan Plus program, county officials said

As of last month, 60,257 Boulder County individuals were covered by Medicaid and CHP+, officials said, a 110 percent increase.

Meanwhile, the number of county residents without any insurance coverage dropped since the implementation of the Affordable Care Act -- nicknamed "Obamacare" because it was pushed and signed into law by President Barack Obama seven years ago, on March 23, 2010.

The percentage of uninsured Boulder County residents fell from nearly 12 percent to 5 percent after the Affordable Care Act took effect, county officials said.

The U.S. House of Representatives is considering and had planned to vote sometime today or tonight on what's being called the American Health Care Act, a measure that would repeal or replace major parts of the 7-year-old Affordable Care Act.

Boulder County's commissioners said in their letter to the congressional delegation that they have "strong concerns with the proposed Affordable Health Care Act" and expressed their desire "for a health care pan that supports a strong, healthy Colorado into the future."

If Congress cuts federal funding for Medicaid in the way laid out in the Republican bill currently under consideration, Colorado would have to spend between $700 million and $1 billion to offset that reduction, the commissioners said.

They said that's unlikely to be possible, because of budget growth and tax restrictions in the Taxpayer's Bill of Rights section of the Colorado Constitution.

Individuals experiencing homelessness or serious mental health issues, people who are incarcerated or recently incarcerated, as well as veterans, victims of domestic violence, families living in poverty and "families on the verge of self-sufficiency" rely on Medicaid for health coverage, the commissioners said.

"Access to health care for these individuals keeps costs down in other systems -- county jails, mental heath crisis centers, emergency rooms and schools," the commissioners said.

They said the proposed Medicaid cuts in the federal law being debated now "will cause a ripple effect through numerous systems, shifting costs and clients into programs that are incapable of absorbing increased demands."

Boulder County commissioners objected that the proposed law would also disproportionately increase conventional private insurance premiums for older Coloradans.

Currently, they said, insurance carriers can charge older individuals only three times ore than they charge younger people, but under the proposed American Heath Care Act, premium costs would increase to as much as five times what's paid by younger individuals.

"The result will be more seniors moving to long-term care more quickly, which will become more costly to Medicare, Medicaid and the health system as a whole," the commissioners wrote.

The commissioners said that "the drastic changes proposed in the American Health Care Act will harm Coloradans and our economy" and "cut thousands of Coloradans off of health insurance."

The commissioners asked the federal lawmakers to consider a number of changes to the American Health Care Act, including keeping the Affordable Care Act's Medicaid expansion intact and fully funding the federal match for that program.

Other Boulder County suggestions:

--Providing federal funding for the systems to which the American Health Care Act would shift costs, including jails, schools and mental health systems.

--Adjust the tax credits and subsidies in the proposed law "to address the needs of the aging population and low- and middle-income people in Colorado who currently rely on subsidies to afford heath insurance."

--Preserve federal funding for prevention and early-intervention programs that reduce costs within the health care system.

John Fryar: 303-684-5211, [email protected] or twitter.com/jfryartc

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