Republican Senator Defends Support of Hospital Fee Bill Revamp

Republican Senator Defends Support of Hospital Fee Bill Revamp

Republican Senator Larry Crowder is a fifth generation Coloradan and represents a geographically large rural area of the state. Fifteen of the 16 counties in his district are considered poverty stricken. He was the sole Republican in the State Senate to support Medicaid expansion. Now he is the sole supporter in the Senate of a House Bill that would bring an end to the present hospital provider fee funding system and replace it with a system of funding that would be exempt from the TABOR limits. In an interview with Catherine Strode, Senator Crowder says his support of the bill is uncomplicated. He supports it he says because, put simply, it meets the health care needs of his constituents.

“We as Republicans are independent thinkers.”

Why are you co-sponsoring House Bill 1420, the Colorado Healthcare Affordability and Sustainability Enterprise (CHASE)?
“In my district, I have nine hospitals; six of them are critical access hospitals. Out of the nine hospitals, four of them were talking about shutting their doors due to lack of funding. The Medicaid expansion helped them. Medicaid pays 52 cents on the dollar, and the Hospital Provider Fee kicks it up to 74 cents. There is additional benefit for critical access hospitals. This is a reimbursement to the hospitals for the services they provide. What I see, on this particular issue, is we’re going to reimburse less to the hospitals. You have to look at this through the eyes of a rural legislator. In rural Colorado, if you’re in the southeast corner, you’re already 70 miles from the nearest hospital. If some of our hospitals see closure, we’re looking at several hours to get to the nearest hospital. It creates a serious issue for me. We have to have that staple of basic care in the hospitals throughout my district.”

How is this bill a financial boon to the rural hospitals?
“It is attempting to protect the Hospital Provider Fee. It creates the Enterprise Fund that would keep intact the situation we have now. The state government has withdrawn 73 million dollars from it to balance the budget. What this bill does, is, put that back. We are mandated to balance the budget annually and we have had somewhat of a downturn. The oil and gas severance revenues are down. What I’m saying is, ‘Let’s put the 73 million back into it and figure out different ways to balance the budget.’ We may not have a TABOR refund this year, but let’s say things get better and there’s more money coming into the state next year. As we go along, there will be less and less money for that matching grant. As long as the federal government keeps it up, we ought to utilize it. But the reality is, there’s roughly 73 million dollars taken right off the top this year.”

By supporting this bill are you going against the philosophy of TABOR?
“I am a believer in TABOR. In my opinion it does not threaten TABOR. If you look at the entities that are already on the enterprise since TABOR was established, you see this would fit very well. It will not affect TABOR. I would put this Hospital Provider Fee at the very top of the list. It ensures we can have reliable health care in rural Colorado. Nothing on the Enterprise Fund that we have now equates to health care. We think we deserve the same amenities you have in the metro area. It is a situation of quality for all citizens of the state of Colorado. That’s how I’ve approached it. I will continue to approach it in this manner. I think TABOR would very well be guarded. I think it would be maintained as it was meant to be. Now that there’s been some work on the budget and we realize there is no refund this year on TABOR, I believe this is the time to enact the Hospital Provider Fee into an enterprise so we can go on.”

How do feel about breaking ranks with your Republican colleagues over this issue?
“I’m a pretty firm believer in this philosophy: once a bill is introduced, it becomes a people’s bill. If there’s a definite benefit to the people of the state who we serve, it doesn’t matter to me who brings a bill up. I have to make those decisions that are in the best interest of my district. People can read all the stuff they want into it, but it’s really not any more complicated than that. We also set state policy. I get that. We don’t know if there are going to be other ‘R’s’ on this; I can’t tell you where we are on the senate side because I don’t know. My job is to represent everyone in the district. I represent with the values I hold as a Republican. As long as those values of the people are protected, I’m okay. We as Republicans are independent thinkers. It’s not a contentious situation with my caucus because we are independents in our thinking. We realize every area is somewhat different than the next Senator’s area.”