CBA Health Law Section: Ballot Impacts for Health Care

Transcription

1 CBA Health Law Section: Ballot Impacts for Health Care KATHERINE MULREADY VICE PRESIDENT OF LEGISLATIVE POLICY & CHIEF STRATEGY OFFICER OCTOBER 2016

2 Disclosure: CHA Voter Guide CHA Board of Trustees has taken the following positions on 2016 ballot initiatives: Amendment T Amendment U

3 ColoradoCare

4 Understanding the Arguments Promises universal coverage and cost savings More people with coverage More covered benefits No deductibles, limited co-pays Reduced overhead costs Bulk purchasing of goods and services Opponents are skeptical that more will cost less Limited administrative savings High costs to manage bureaucracy Untested and unaccountable state-run system Risky and unsustainable financing

5 Why CHA Opposes Amendment 69 Shifting to a health care payment and delivery system that would be almost entirely dependent on a single government entity would undermine existing health care resources, threaten the sustainability of Colorado hospitals and health systems, and impede providers ability to advance the health of communities. ColoradoCare is a strategy to pay for health care, it will not lower health care costs nor improve quality of care. Uprooting our current health care system and diminishing the progress Colorado has made in health reform on the assumption that ColoradoCare will be better is a risk Colorado cannot take. Source: CHA Position Paper, January 2016

6 1 It will control $38 billion in health spending, including $25 billion in new taxes. $36 BILLION $38 BILLION $39 BILLION $27 BILLION $28 BILLION $31 BILLION Annual Revenue Source: Fortune 500 Listing, 2015

7 2 No experience is required for board members, and accountability is limited.

8 3 We will still have to deal with multiple payers of health care. Source: Colorado Health Institute, 2016

9 4 We risk paying more for less coverage: benefits aren t guaranteed, nor is access to care when you need it.

10 5 $38 billion won t be enough maybe sooner than you think. ColoradoCare will have to cut benefits, cut provider payments, or increase taxes again. Annual Shortfall Estimates, by 2027 A Worst Case: $14B Deficit Best Case: $2B Deficit B C

11 6 It s only a refinancing mechanism. It doesn t address underlying cost problems in our health care system. Source: OECD Data 2013, Mercatus Center, George Mason University

12 7 We won t be able to attract the best and brightest businesses and health care professionals.

13 8 It will have a lot of control over decisions currently made by patients and their doctors.

14 9 It will jeopardize gains Colorado has made in health care reform. Colorado Blue Ribbon Commission for Health Care Reform

15 10 What if it doesn t work?

16 If Amendment 69 Were To Pass Litigation Pre-Implementation vs. Post-Implementation Implementation Appointment of Interim Board Implementing Legislation Section 1332 Waiver Authority Establishment of Election System

17 Amendment 72: Tobacco Tax

18 Amendment 72: Tobacco Tax Proposed $1.75 increase in existing $0.84 tax to fund health-related causes Resulting tax would be $2.59, jumping Colorado s state rank from 38 th to 11 th Will generate roughly $315 million annually for health-related investments CHA actively supports the Campaign for a Healthy Colorado because: We are committed to ensuring access to physical and mental health care across Colorado, and particularly in rural and underserved areas We are committed to evidence-based efforts to reduce health care costs for all Coloradans We are committed to treating individuals with tobacco-related chronic illness and using medical innovations to save lives Opponents are concerned about: Where dollars will go and fact that tobacco tax is built into the constitution

19 The Cost of Tobacco Use & Projected Benefit of Amendment 71 $1.89B Annual statewide health costs from smoking it is the leading cause of preventable death 20,800 Fewer premature deaths $1.27B smoking-caused productivity losses 6,100 Fewer pregnancies and births impacted by smoking $1.44B Long-term health care cost savings 5,100 Coloradans die from a smoking-related illness each year. 71,900 Youth prevented from becoming smokers and adults who quit $707 Annual health costs to every Colorado household from tobacco use Source: Campaign for Tobacco-Free Kids

20 Annual Funding Estimates $32M to provide access to care in rural and underserved areas $34M to improve youth mental health services $92M for medical research for cancer and tobacco-related diseases $48M to support medical and mental health care for Colorado veterans $54M for tobacco education and cessation programs $51M to modernize care incentivize health care providers to work in rural and underserved areas

21 Amendment 70: Minimum Wage

22 Increases minimum wage from $8.31 to $12 per hour by 2020, and create annual wage adjustments Colorado ranks 19 th among states and U.S. territories 15 states/territories have index adjustments for minimum wage Supporters say: At roughly $300 weekly take-home pay, Colorado s existing minimum wage does not allow individuals to meet a basic standard of living and many minimum wage earners are dependent on public benefits. Opponents say: Increasing the minimum wage will hurt low wage earners and small businesses who simply cannot afford to increase wage costs.

23 Health Industry Impacts

24 Proposition 106: End of Life Options

25 Allows terminally ill individuals to obtain and self-administer medication to end their life Terminally ill adults with capacity to make informed decision, verified by two physicians Similar to statutes in California, Oregon, Vermont, Washington Supporters say: Expands options for terminally ill individuals, while providing safeguards against abuse and legal protections for providers Opponents say: Would normalize assisted suicide and protections for individuals are insufficient, which may lead to abuse

26 Procedural Safeguards Patient qualifications Medication request procedures Physician specifications Legal Safeguards Tampering: Class 2 Felony Insurance, Wills, Contracts, Claims: No impact; insurer cannot exclude

27 Questions? For more information, visit or contact Katherine Mulready at