Survey: Even Republican voters support changing the hospital provider fee – once they understand it

3 min. read
Denver Health on Bannock in Lincoln Park. (Kevin J. Beaty/Denverite)

Denver Health would lose million in the current state budget. (Kevin J. Beaty/Denverite)

Colorado hospitals stand to lose more than $500 million in the budget currently under consideration by the Colorado General Assembly. That hit could be eliminated if the legislature would move something called the hospital provider fee into an enterprise fund, but many Republicans have seen that effort as an end-run around TABOR.

Now here comes the Colorado Hospital Association, which very much supports the enterprise fund idea, with a survey from the Tarrance Group, a Republican polling firm, that finds support among Colorado voters, including Republicans, for changing the classification of the hospital provider fee.

The hospital provider fee is collected on patient revenue from hospitals and is matched by federal dollars before it's returned to hospitals. It's meant to increase reimbursement for Medicaid patients and pay for the care of people who don't have insurance.

For the last two years, the fee has contributed to putting Colorado's budget over the revenue cap created by the Taxpayer's Bill of Rights. To avoid hitting that cap and cutting other programs, the state has reduced the amount of money it collects from hospitals, left federal matching dollars on the table and reduced the amount of money it sends back to hospitals. Rural hospitals are particularly affected by this trade-off.

This year's budget, which passed the Colorado Senate last week and will be taken up by the House this week, reduces the fee by $264 million. With federal matching dollars, that's a total loss of $528 million to hospitals.

If the hospital provider fee were made an enterprise fund, a kind of stand-alone business operation, its revenues wouldn't count toward the TABOR limit. That would insulate the fee from the budget battle not just this year but in perpetuity.

The survey oversampled Republican voters in heavily Republican counties to make sure their views were represented. These are the folks that Republican state lawmakers will be accountable to if they vote for something seen as undermining TABOR. To do the survey, pollsters had to explain to voters what's going on with the budget and the arguments for and against moving the fee to an enterprise fund. So, hats off to everyone who stuck with the poll.

Overall, 64 percent of respondents supported the idea of an enterprise fund, compared to 28 percent opposed. Among likely Republican voters, 51 percent supported the idea, compared to 39 percent opposed. Voters also said they supported TABOR by a two-to-one margin.

A bill sponsored by state Sen. Jerry Sonnenberg, a Sterling Republican, and Senate Minority Leader Lucia Guzman, a Denver Democrat, would move the fee to an enterprise fund in exchange for reducing the overall revenue cap. (There's a bunch of other moving pieces involving funding for rural schools and roads too.) Democrats in the House have signaled that reduction in the revenue cap is not going to stay in the bill, so it will be interesting to see how far this gets and what the final form of the legislation looks like.

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