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Colorado Health Care at a Crossroads: Building a Path to Health Care for All

Colorado Health Care at a Crossroads: Building a Path to Health Care for All

Thursday, October 18th, 2007

http://www.progressivestates.org/dispatch

Events

Labor Holds Vigil for Health Care Victims in California:
The California Labor Federation AFL-CIO is holding a statewide 48-hour vigil for the "victims of health care." The vigil is sending the message to Governor Schwarzenegger, who recently vetoed a comprehensive health care reform bill, that the state needs real health care reform. Health care advocates are concerned that the Governor's own proposal does not go far enough to ensure affordability for all residents or require employers to make meaningful contributions to health care.

Valuing Families

BY Adam Thompson

Colorado Health Care at a Crossroads: Building a Path to Health Care for All

Colorado State Rep. Morgan Carroll opened a health care public forum on Tuesday night in Denver with

I am unapologetically biased towards the consumer perspective. We are not and should not be here to do what insurance companies or pharmaceutical companies want. They have had their way.  Now our day is here. 

The forum - Colorado Health Care at a Crossroads: Building a Path to Health Care for All - was attended by over 150 Coloradans, legislators and health care experts to highlight progressive priorities and values for health care reform in Colorado. 

It was sponsored by the Progressive States Network and also by the Colorado Progressive Coalition, ProgressNow, The Bell Policy Center, UHCAN, AFSCME, SEIU, the Center for Policy Alternatives and the Herndon Alliance. In addition to State Rep. Morgan Carroll, panelists included: Robin Baker, Senior Policy Analyst at The Bell Policy Center; Ella Hushagen, Health Policy Analyst with FamiliesUSA; John Arensmeyer, Founder and CEO of Small Business Majority; and Adam Thompson, Senior Health Policy Specialist with the Progressive States Network. 

Health Care Debate in Colorado


Colorado is in the throes of a focused, thorough and, at times, emotional debate about how best to guarantee all residents the care they need when they need it.  In 2006, State Representative Anne McGihon sponsored SB 208, a bill creating the Blue Ribbon Commission on Healthcare Reform, now known as the 208 Commission.  Since May, the Commission has been studying four different reform plans submitted by health care stakeholders.  The proposals range from a comprehensive single-payer type plan to less expansive and, frankly, detrimental individual mandates and limited-benefit-health plans. 

Recently, the 208 Commission itself developed and presented for study a fifth proposal.  The fifth proposal includes many features of the other four, including individual mandates, signaling the approach to reform it is likely to endorse in its final report to the legislature due in January. 

Several other states have commissions or task forces studying how best to achieve health care security for all residents, including Iowa, New Mexico, New York, and Kansas.  As we have discussed previously, commissions can be effective ways to bring stakeholders to the table to study reform options and iron out differences of opinion in order to move comprehensive health care reform. 

Progressive Values for Reform


The forum on Tuesday highlighted progressive priorities for reform by discussing elements of the five plans before the Commission and discussed some of the unique challenges facing reform in Colorado.  Issues and perspectives addressed by the panelists included:

  • Individual Mandates - Panelists referenced the inability of Massachusetts to ensure affordable options for all residents, causing the state to exempt tens of thousands of residents from the mandate.  Individual mandates are patently unfair absent meaningful and shared responsibility from all health care stakeholders - employers, insurance companies and providers. 

  • Limited-Benefit Plans with Low Annual Caps - Panelists stressed that these plans do not protect Coloradans with chronic diseases or who suffer a major medical event or diagnosis, like a heart attack or cancer. 

  • Affordability of Coverage- Panelists discussed the need for a mechanism to ensure affordability such as capping family expenditures to a percentage of income, perhaps on a sliding scale, and which reflects other real-world family costs like housing, transportation, food and the ability to accrue savings. 

  • Health Insurance Connectors - Panelists strongly asserted the need for robust oversight and regulation of insurance companies if reform pursues a public/private partnership offering health plans to residents.  Connector-like programs, which are designed to negotiate with insurance companies to bring more affordable options to market, need robust health insurance rate review and regulation to be successful.

  • Budgetary Constraints - Major institutional barriers to reform in Colorado are its budgetary rules, which limit the public sector's ability to marshal financial and health care resources to achieve health care security for all residents.  First, Colorado cannot expand general fund appropriations more than 6 percent in any year.  Second, the 1992 voter-approved TABOR law sets draconian limits on how much the state can raise and spend each year.  However, in 2006, voters created a window-of-opportunity by enacting Referendum C, which waives for five years the spending limits imposed on state government by TABOR.  Increased funds allowed by Referendum C are to be used for education, health care and transportation.

Audience Feedback and a Call to Action

Questions and comments from the audience showed tremendous interest in a guaranteed or single-payer type health care reform, a sentiment also prevalent at one of the 208 Commission's public hearings.  Incidentally, the Lewin Group, which has studied the 4 original proposals and is currently examining the 5th, showed that the Colorado Health Services Single Payer program is so far the only proposal that would achieve coverage security for all Coloradans and would dramatically reduce health care spending more than any other proposal, by $1.4 billion. 

Audience members also asked what they can do to influence the outcome of the health care debate in Colorado, to which Rep. Carroll offered a call-to-action: 

We have the opportunity to do something right for all of us.  I can not emphasize enough how critical your voice is in this process.  You and your participation are the best check and balance we have to the wealthy special interests under the dome.

More Resources

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Strengthening Communities

BY J. Mijin Cha

A Sensible Approach to Immigrant Drivers' Licenses in New York

Moving to increase safety on its roads and open opportunity for new immigrants, New York state changed its driver license policy to allow all New Yorkers, regardless of immigration status, to apply for state driver's licenses. Allowing undocumented individuals to obtain driver's licenses will reduce the number of unlicensed drivers, improve traffic safety and save New York motorists an estimated $120 million per year in insurance premiums due to the decrease in unlicensed drivers. Plus, the policy will generate roughly $6 million in new license fees.

The amended policy aims to overturn a series of bad policies adopted by the NY Department of Motor Vehicles that resulted in approximately 300,000 immigrants facing suspension of their driver's licenses. As a consequence, hundreds of thousands of individuals were not able to legally drive to work, take their children to school or access medical care.

Increasing Public Safety and Security


Despite attacks on the policy by some anti-immigrant quarters, law enforcement officials across the state and country have come out in support of issuing identification that could bring millions of undocumented drivers out of the shadows into a regularized, licensed status.

A number of national security experts praised the New York measure for its new verification procedures. Under the policy, someone applying for a license without a Social Security number would need a valid foreign passport and the passport's authenticity would be verified through new scanners installed at all DMV offices with photo-comparison software being deployed to keep people from getting multiple licenses under different names. "The future New York license will be more robust than today's driver's licenses, and of much greater use in screening and investigations involving terrorism," said Susan Ginsburg, a former staff member of the 9/11 Commission who is now a senior fellow at the Migration Policy Institute and an adviser to the federal Department of Homeland Security.

Integrating Immigrants into the Community


As importantly, Governor Spitzer emphasized the use of licenses as a key to community inclusion: "As long as I am governor, we will not pretend that they (undocumented immigrants) do not exist, we will not cut them off from participating in our society, and we will not become part of a myth that is propagated at the federal level that they are not here." New York will join eight other states that do not require proof of legal status to obtain a driver license: Hawaii, Maine, Maryland, Michigan, New Mexico, Oregon, Utah, and Washington.

Avoiding a Two-Tiered System


While some have called for a "two-tier" licensing system, New York learned from Tennessee's failed experiment when beginning in 2004, Tennessee created a license system that provided special driving certificates to people without social security numbers. The certificates allowed the holder to drive but were not valid for identification purposes. A year after the policy was enacted, the National Immigration Law Center found that instead of providing a viable licensing system, the Tennessee law resulted in additional burdens for law enforcement agencies, increased the number of uninsured drivers, and led to increased discrimination against immigrants.

Instead, New York's plan is designed to actually work for both immigrants and law enforcement needs. As stated by Chung-Wha Hong, Executive Director of the New York Immigration Coalition, "the new policy is a win-win for immigrants and for all New Yorkers and a giant step forward for public safety."

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Research Roundup

With the vote on SCHIP today, there's a flurry of new reports and polls. 

  • The Kaiser Family Roundation and Harvard's School of Public Health found in a poll of 1527 adults that 70% of the public supports an expansion of SCHIP, with even more Republicans supporting the expansion than opposing it. Two-thirds of the public oppose having the federal government limit eligibility for the program.

  • Voices for Illinois Children examines family coverage in that state, which has taken such strong leadership on health coverage for children and their parents. Illinois is one of eleven states that received a waiver to cover parents of children on SCHIP and has successfully used the program to extend coverage to 290,000 low-income parents, a program that would be ended if the Bush administration gets its way and eliminates all SCHIP coverage for parents.

  • The Urban Institute finds that out-of-pocket expenses for health care amount to 4%-5% of income for Medicaid and SCHIP recipients, while families on employer-provided health plans are as high as 12.9% for families below 150% of the federal poverty level.

Good news sometimes gets lost by the media. The Economic Policy Institute highlights the fact that since 1990, black children have seen their math scores increase from 188 to 222 on the National Assessment of Educational Progress tests, closing much of the gap with white children, who increased their scores as well but not as by as much. In fact, black children in 2007 scored as well as white children had back in 1990.

A survey conducted on behalf of the AFL-CIO finds that nearly half of homeowners with adjustable rate mortgages (ARMs) don't know how their ARMs adjust or reset, or how much their monthly payments will increase when they do. 41% of homeowners whose ARMs have reset say they are worried about making the new higher payments over the next few years. In response to the poll, the AFL-CIO has launched a "Save My Home Hotline" to provide information to union members to help them avoid foreclosure. 77% of those polled say government should do more to regulate the mortgage industry.

A new report by MapLight.org, California Healthcare - Dollars and Politics, finds that on five of seven key health care bills, California legislators' votes correlated directly with the source of their campaign contributions. For examples, on a key bill requiring health insurers to seek regulatory approval before selling new plans, the industry gave an average of $13,951 to state Senators voting no and only $478 to Senators voting yes.

The National Women's Law Center just released an update of its comprehensive report on women's health in the fifty states - Making the Grade on Women's Health: A National and State-by-State Report Card. The report ranks each state on 27 health status indicators, such as receiving regular mammograms, and finds that "states are failing to meet minimum standards when it comes to women's health." According to the report, the best state for women's health is Vermont and the worst state is Mississippi.


Please email us leads on good research at research@progressivestates.org

Resources

Colorado Health Care at a Crossroads: Building a Path to Health Care for All

The Bell Policy Center - Health Blog and Health Savings Accounts and High Deductible Health Plans

Small Business Majority - Small Business for Affordable Health Care

Families USA - Premiums Versus Paychecks: a Growing Burden for Colorado's Workers

Blue Ribbon Commission for Healthcare Reform

Colorado Progressive Coalition - Health Justice Organizing, September Newsletter

A Sensible Approach to Immigrant Drivers' Licenses in New York

New York Coalition for Immigrants' Right to Driver's Licenses - Equal Access for All Communities

National Immigration Law Center - The Tennessee "Driving Certificate" Not a Model Policy

National Immigration Law Center - Driver's Licenses for All Immigrants: Quotes from Law Enforcement

The Urban Institute - Undocumented Immigrants: Myths and Reality

New York Immigration Coalition - New Driver's License Policy is a Win for All New Yorkers

Frequently Asked Questions Regarding New Driver's License Program

Eye on the Right

Health care is big business, and apparently keeping unions out of health care is too. A whole host of companies now cater to business owners trying to keep unions out of their workplace. These companies sell seminars, web tools, and videos that aim to bring about employer-employee communications "without the presence of a third party." That translates to keeping unions out.

If you already thought the deck was stacked against employees trying to unionize, consider these additional face cards held up the sleeves.


Got a lead for Eye on the Right? Sent it to eyeontheright@progressivestates.org.

Masthead

The Stateside Dispatch is written and edited by:

Nathan Newman, Policy Director
J. Mijin Cha, Policy Specialist
Adam Thompson, Policy Specialist
John Bacino, Communications Associate

Please shoot us an email at dispatch@progressivestates.org if you have feedback, tips, suggestions, criticisms, or nominations for any of our sidebar features.

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