Foes target Colorado’s new hospital fee

Less than two years ago, the Colorado hospital fee passed with much fanfare and to the great relief of the state’s hospitals.

The fee is expected to bring in more than $800 million for Medicaid to provide insurance for the state’s poor and indigent. It would allow thousands of children to be seen by doctors rather than go to the emergency room, or not be seen at all.

One of 24 states that have similar hospital fees, the money is matched by federal dollars, allowing as many as 200,000 people in the state to be covered through Medicaid.

But that money is now in jeopardy. A bill was introduced on the first day of the legislature to repeal the hospital fee. It’s not a surprise to those in the industry, those who are gearing up to stop the bill from passing.

“We knew it was coming,” said DeDe DePercin, executive director of the Colorado Consumer Health Initiative, the group that help craft the original bill. “So we’re prepared.”

DePercin expects to testify before the committees considering the bill, assuming the legislation gets consideration. She believes that the opposition from the Colorado Hospital Association, the Colorado Medical Society and her office will keep it from being heard on the floor.

The opposition is being led by the Independence Institute, a Libertarian think tank. For these foes, part of the reason behind the proposed repeal is that receiving the federal money could jeopardize Colorado’s fight against the federal health care reform bill. Some have speculated that Colorado would have to implement “Obamacare” because it was receiving federal money for Medicaid through the bill.

Republicans were skeptical of the fee from the start, saying hospitals will pass it along to paying patients. But hospital authorities claim the additional money will reduce cost shifting by bringing an infusion of federal cash to the Medicaid program.

Fees are imposed on inpatient and outpatient services, but only general acute care hospitals – those such as Memorial Health System and Penrose-St. Francis Health Services – pay the fee. Hospitals like Memorial who see high numbers of Medicaid and indigent patients pay a discounted fee.

The state barely had time to get the law passed and get the fee schedule approved by the federal government before the move to repeal it got under way.

The repeal, should it pass, won’t affect the state’s budget, because the money comes from hospitals and the federal government. It will only serve to reduce the number of people who are covered under Medicaid. Low-income patients will be left with few options other than defaulting on their hospital bills.

DePercin said the push for the repeal is a symbolic gesture meant to mimic the Republican moves at the federal level to repeal last year’s health care reforms.

The U.S. House of Representatives voted in January to overturn parts of the health care reform law. But the move is seen as largely devoid of meaning, since it has little chance of passing in the Senate, and no chance of escaping President Obama’s veto pen.

Another General Assembly bill will allow small-business owners to reimburse workers for health insurance – even when they don’t provide insurance through the company. Currently prohibited by state law, the move is seen as a way small businesses can comply with reform without being penalized.

Vaccine more effective in preventing shingles

Receiving the herpes zoster vaccine reduces the risk of developing shingles by 55 percent, according to a Kaiser Permanente study of more than 300,000 people.

The study appears in the current issue of the Journal of the American Medical Association.

More than 1 million people get shingles – a virus associated with chicken pox – every year in the United States. The number would be reduced by “tens of thousands” if more adults took advantage of the vaccination.

The study looked at outcomes of the herpes zoster vaccine in men and women aged 60 and older, those most at risk for shingles. Researchers found a reduced risk in all groups, both healthy people and those with chronic conditions like diabetes or heart disease.

The study is different than the clinical trial, which found it less effective for people older than 75. The newer study found no age difference in the efficacy of the vaccination.

The Centers for Disease Control and Prevention recommend patients of all ages receive the vaccination. The herpes zoster vaccine was licensed in 2006, but uptake in the United States remains low: about 10 percent in 2009 among adults 60 years and older.

“Our study shows the vaccine has the potential to prevent tens of thousands of cases of shingles, a painful, lingering disease,” said study lead author Hung Fu Tseng, a research scientist with the Kaiser Permanente Department of Research and Evaluation in “We suggest clinicians follow the CDC’s recommendations to talk to their patients about the option of vaccination against this serious condition.”

Shingles is a painful condition that can last months or years. Shingles is caused by the dormant chickenpox virus, which stays in the body after a person has recovered from chickenpox. The virus can  damage to the nerve system.

Amy Gillentine can be reached at 719-329-5205 or at amy.gillentine@csbj.com. Friend her on Facebook.