DON’T MISS: Gov. Jared Polis and a group of four top state lawmakers — Senate Minority Leader Paul Lundeen, R-Monument; Sen. Chris Hansen, D-Denver; House Speaker Julie McCluskie, D-Dillon; and House Minority Leader Mike Lynch, R-Wellington — will appear at a free, virtual Colorado Sun event Thursday ahead of the 2024 legislative session.
The event begins at 6 p.m.
When lawmakers in 2015 established an independent committee to review Colorado’s Medicaid provider rates, the goal was to ensure state officials were listening to health care providers and responding to their financial needs.
Every year since then, the committee of medical professionals has come up with a recommended dollar amount for each specialty. And every year, the Colorado Department of Health Care Policy and Financing has given lawmakers a smaller number: What the administration is willing to pay for.
That pattern continued this year, with Gov. Jared Polis’ administration proposing $11 million less for health care providers than the Medicaid Provider Rate Review Advisory Committee recommends.
And that’s just for the handful of specialties under review this cycle. All other Medicaid providers under the department’s purview would get just a 1% across-the-board bump at a cost of $29 million to the state’s general fund.
At a time of 5.2% annual inflation, that amounts to a de facto pay cut at a time of widespread staffing shortages in the industry.
“By not appropriately increasing people’s compensation to at least keep pace with inflation, we are guaranteeing that we’re going to have a major problem with providers,” Rep. Shannon Bird, the Democratic chair of the JBC, said at a briefing in December.
This year’s rate review covered a number of practices, including dental care, surgeries and maternity services. But one specialty accounted for nearly the entire difference between the department’s proposal and the committee’s recommendations: pediatric behavioral therapies for children with autism.
Autism treatment providers would receive nearly $11 million less under the department’s proposed budget than the advisory board recommends.
The proposal comes at a tenuous time for such therapies. Colorado has lost at least nine agencies that provide autism treatment over the past two years, with providers telling The Colorado Sun that the state’s low reimbursement rates are driving therapy providers out of Colorado.
Among them was the JumpStart Autism Center in Englewood, which closed in May after its founder said the practice was losing $5 an hour on its Medicaid clients, who made up 70% of its patients. That’s led to growing waitlists at the ones that remain.
The proposal left budget writers incensed.
“What it looks like is we are taking feedback, but we’re not actually utilizing that feedback,” Sen. Rachel Zenzinger, D-Arvada, told department leaders at a recent hearing. “It’s just a box that we’re checking to say ‘yes, we listened to stakeholders.’ ”
Added Sen. Barbara Kirkmeyer, R-Brighton: “I’m wondering why we even have the MPRRAC if you’re not going to follow their recommendations.”
Department officials pointed to budget constraints, saying the governor’s office gave them a target they had to meet.
“Our budget targets were very, very tight,” said Bettina Schneider, the chief financial officer for HCPF.
The committee’s recommendations, she added, were “not made under the burdens of balancing the budget.”
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MORE: It’s not clear that even the advisory committee’s recommendation would provide enough money to ensure widespread access to medical care.
JBC’s nonpartisan staff noted that for many specialties, the rate review relies on comparisons to other states.
But what if those states’ health care providers are underfunded as well? If so, the recommendation might not be as valuable as it appears.
“You’re just finding out that in weird, idiosyncratic, irrational ways, your rates are just as crappy as everyone else’s rates,” budget analyst Eric Kurtz told the JBC this month. “It’s not telling you whether the rates are necessarily adequate or not.”
Out of the 10 comparison states used in the committee’s review, all but one — Washington — faces a shortage of lower-wage health care workers over the next three years, according to a 2021 study from Mercer consulting. Half of them face nursing shortages.
Colorado is expected to grapple with larger shortages than most. The report estimates Colorado will fall 54,000 workers short of its staffing needs for lower-wage jobs like medical assistants, home health aides, and nursing assistants by 2026. Colorado’s projected to have the third-worst nursing shortage in the country, with a deficit of 10,000.
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YOU HEARD IT HERE
Scott was discussing the political implications on X, the social media site formerly known as Twitter.
“Those who believed she would make a run again have boxed themselves into a corner by endorsing one of the candidates opposing her,” Scott wrote in an apparent reference to Grand Junction attorney Jeff Hurd, a Republican running in the district. “I never endorsed candidates for many reasons but this is a new one.”
Scott brings up a good point.
A number of big-name Republicans — former Gov. Bill Owens and former U.S . Sen. Hank Brown, to name a few — rallied around Hurd when it appeared he was facing Boebert in the primary. But Boebert’s departure from the race likely guarantees other Republicans, who were wary of challenging the congresswoman, will jump into the race.
Some people who endorsed Hurd may even get in the race — we’re looking at you, Mesa County commissioners.
Some other potential candidates:
Former state Sen. Don Coram of Montrose, who ran against Boebert in 2022 and lost in the primary, told The Unaffiliated he’s not interested in running for Congress again.
STORY: Lauren Boebert will switch congressional districts to improve her chances of winning in 2024
ELECTION 2024
The big questions we have about Lauren Boebert’s decision
U.S. Rep. Lauren Boebert’s decision to switch congressional districts was a surprise to even her biggest supporters. When The Colorado Sun was trying to confirm the news Wednesday, many of the Republicans we spoke to were shocked and confused.
It’s easy to understand why. The congresswoman’s switch to the 4th Congressional District, in eastern Colorado, from the 3rd District, which is mostly in the western half of the state, poses more political questions than answers.
Some of the biggest ones:
“I look forward to welcoming Lauren to the 4th District and representing her in Congress,” former state Sen. Jerry Sonnenberg of Sterling, one of the Republicans running in the 4th District primary, told The Colorado Sun. “I’ve lived, worked and raised my family here and I’m blessed to have always called eastern Colorado home. The 4th District is my home, and I’m going to continue to work hard to represent the principled conservative values of everyone who lives here just as I have always done.”
Former state Sen. Ted Harvey of Castle Rock was less diplomatic, telling Colorado Community Media that Boebert’s decision is “a vain effort to cling to power.”
“This desperate stunt by Boebert may not only jeopardize the Republican Party’s ability to retain (the 3rd District), but if she were to win the primary, could place (the 4th District) at risk as well,” he said.
Conservative talk radio host Deborah Flora, who lives in Douglas County and ran unsuccessfully for U.S. Senate in 2022, said in a text message that her “focus remains earning the support of the voters and serving the people, not my own political ambition.”
“This district is where I live and where I have fought for years on the values and issues,” she added.
MORE: Democrats have made something of an industry out of opposing Boebert in the 3rd District, forming federal political action committees and political nonprofits to try to block her from seeking reelection. It’s unclear whether those groups plan to continue their efforts as she runs in the far more Republican 4th District.
Rocky Mountain values, the liberal nonprofit that doesn’t disclose its donors, is top of mind. It planned to spend $2 million to defeat Boebert in 2024.
There’s also the Colorado Turnout Project and American Muckrakers PAC, two federal super PACs that have been focused on ousting Boebert.
“Every single voter in the 4th district needs to know that Boebert abandoned her constituents when the going got tough,” the Colorado Turnout Project said in a fundraising email sent Thursday.
ADDENDUM: The 3rd District and 4th District are similar in how expansive and rural they are. But, demographically speaking, they are very different.
The median household income in the 3rd District was $67,000, with 38% of households earning less than $50,000, according to 2022 census statistics. The median household income in the 4th District was $108,000, thanks to much of the district’s population being in Douglas County, a conservative, and wealthy, suburb of Denver.
The poverty rate in the 4th District in 2022 was 5.7%, compared with 12.3% in the 3rd District.
OIL AND GAS
Poll tests proposed 2024 ballot measure that would ban fracking in Colorado
A poll recently sent to Colorado voters asked about a potential 2024 ballot measure that would phase out fracking permits in the state and block them altogether by Dec. 31, 2030.
The measure, according to the survey, would let existing fracking operations continue and require the state “to explore transition strategies for impacted oil and gas workers.”
The language is identical to that of Initiative 46, which was filed with the state’s Title Board in May by Paul Culnan, whom the environmental nonprofit 350 Colorado describes as a super volunteer, and Patricia Nelson, who is the Colorado Fossil Fuel Just Transition Advocate for Green Latinos, another environmental nonprofit. They are being represented by Tierney Lawrence Stiles LLC, an election and political law firm that traditionally works for Democratic candidates and causes.
The title for the measure was set a few weeks later and the Colorado Supreme Court in September upheld the language following a legal challenge. The proponents of the initiative have until March to request a petition format from the Colorado Secretary of State’s Office before they could start collecting signatures to try to make the ballot.
Participants were presented with the following statements and then asked if it would make them more or less likely to vote for the proposed measure. A sampling of those statements:
It was unclear who was behind the poll, which was circulated in mid-December, but it appears to be proponents of the measure.
The oil and gas industry is pursuing its own 2024 ballot measures, all of which are one step ahead in the process. Two initiatives, 85 and 86, approved for signature gathering would prohibit state and local governments in Colorado from “adopting a law, ordinance, rule, resolution, or code that prohibits or discriminates against the connection or reconnection of an energy source for cooking, hot water systems, generators, cooling systems, or heating systems based on the type of energy to be delivered to an individual consumer.”
A third measure, Initiative 77, approved for signature gathering would require that economic impact statement summaries precede questions on the ballot.
The industry has eyed similar versions of the measures in years past but didn’t move forward. For 2024, oil and gas interests have injected millions of dollars into Protect Colorado, an issue committee, to back the initiatives.
Remember when: Gov. Jared Polis hoped to end the state’s oil and gas policy wars in 2019 when he signed Senate Bill 181, which launched a major regulatory overhaul. It was clear then those were big aspirations —and now the 2024 ballot is shaping up to be a battlefield.
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THE POLITICAL TICKER
ELECTION 2024: Several candidates recently filed to run for the state House. Antonio Soto, director of Colorado’s Minority Business Office, is running to represent House District 4 in northwestern Denver. Soto is the second Democratic primary challenger to state Rep. Tim Hernández, who was appointed to the seat in August. Democrat Jonathan Dooley filed to run for the open House District 18 seat in western El Paso County, which is being vacated by state Rep. Marc Snyder of Manitou Springs. Ephram Glass, a utility consultant, filed to run in the GOP primary against state Rep. Brandi Bradley in House District 39 based in Littleton. Former Montezuma County Commissioner Larry Don Suckla, a Republican, has filed to run in the open House District 58 in southwestern Colorado where former state Rep. Kathleen Curry, a Democrat, is also running. The district is currently represented by term-limited Republican Rep. Marc Catlin.
CONGRESS: A bill sponsored by U.S. Rep. Joe Neguse to expand mental health care for military families was included in a defense spending bill signed last week, the Lafayette Democrat’s office said in a news release Thursday. It was among more than 50 bills incorporated into the measure.
THE ASSOCIATED PRESS: Trump transformed the Supreme Court. Now the justices could decide his political and legal future
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COLORADO POLITICS
The 10 most-read political stories this year from The Colorado Sun
Here were the 10 most-read political stories published this year by The Colorado Sun:
THE BIGGER PICTURE
Corrections & Clarifications
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