Source: Department of Health Care Policy and Financing
At a recent forum in Loveland, a senior advisor to Governor Jared Polis denied there was any possibility of job losses in the healthcare sector under the administration’s proposed public option. But this blanket assertion isn’t credible and ignores the pleas of doctors, nurses and other healthcare professionals from all across Colorado.
CLAIM: There will be no job losses under the Polis administration’s public option.
The potential for healthcare job losses under the public option, which would cut payments to doctors, nurses and other hospital professionals to finance a new state-controlled insurance plan, is a sensitive point for the Polis administration. At a recent forum held by the Northern Colorado Legislative Alliance, Department of Healthcare Policy and Financing Executive Director Kim Bimestefer said the following:
“It’s not done yet. You can’t say we’re going to lose jobs. It’s not going to happen. We’re going to be thoughtful about this. It’s not the intent. So get rid of the boogeyman. There is no boogeyman. There aren’t going to be job losses.”
But during the same event, Bimestefer was fact-checked in real-time. Margo Karsten, chief executive officer of Banner Health in Northern Colorado, told the forum that patient services and hospital jobs will be threatened by the public option:
“Knowing the state option is out there, I’m going to need to look at services … and absolutely it’s going to impact our employment.”
Before going into hospital administration, Karsten was a nurse, and her concerns about the public option are echoed by healthcare professionals all across the state.
Consider the following comments from healthcare professionals during the short public comment period that was allowed by the Polis administration on its draft public option report:
Joe Foecking, director of rehabilitation at UCHealth Memorial Hospital:
Health care providers will go elsewhere, hospitals will close, jobs will be lost and the overall health of Colorado will suffer. Please reconsider this reckless proposal.
Cassandra Williams, patient safety program manager for a non-profit hospital in Denver:
“I fear that a public option for healthcare coverage will jeopardize the already fragile healthcare ecosystem … If hospitals are no longer able to keep their doors open due to insufficient reimbursement, the loss of jobs and billions in economic activity is just the tip of the iceberg.”
Liz Concordia, President and CEO, UCHealth:
This proposal does not include a final actuarial analysis, so hospitals are left to themselves to determine how serious the implications might be. In the initial years, we expect substantial losses each year because of the government-mandated rate setting. If the commercial insurance market begins to collapse as we fear, these costs would multiply 10-fold. To mitigate these losses, we would expect to both reduce staff and cut services.
The Polis administration flatly denies any potential for job losses under the public option, despite clear statements from senior Polis administration officials about their desire for budget cuts and staffing reductions across the healthcare sector. For example:
“I honestly believe, in my heart of hearts, if we are going to drive true affordability across the system, we have to take money out of that system.”
“We have in some areas way too much access… An abundance of providers in healthcare doesn’t drive costs down, it often drives costs up.”
These comments, made at the very start of the public-option design process, are even more concerning in light of recent research into public-option proposals and their impact on healthcare quality and access.
National studies into the public option have warned of hundreds of billions of dollars of budget cuts across the hospital sector during the next 10 years, threatening more than 1,000 rural hospitals with closure because of government-mandated cuts to reimbursement rates. Here in Colorado, a coalition of business groups called the REMI Partnership found the same problem with a state version of the public option: By cutting payments to hospitals for treating patients, patient services and thousands of healthcare jobs will be put at risk.
The Polis administration’s response to these concerns, however, has been to avoid them. The final draft of the administration’s report on the public option did not say where reimbursement levels will be set – instead, they will be determined on “a hospital-by-hospital basis” at some point in the future.
By keeping these numbers off the table, the governor’s advisors may believe they are shielding themselves from criticism over job losses and service cuts in the healthcare sector – and quite possibly pushing off these tough decisions to state lawmakers when the legislature reconvenes in early 2020.
But the state’s healthcare professionals aren’t so easily fooled – and neither is the public.