The joint state and federal health care program for the poor got its first hearing this week in the state legislature, and no one testified against it.

(Photo: Megan Verlee/CPR News)
Opponents of expanding Medicaid in Colorado appear to have thrown in the towel.  The bill to add more than a hundred thousand Coloradans to the joint state and federal health care program for the poor got its first hearing in the state legislature yesterday, and no one testified against it.

Reporter Eric Whitney: Viewed through one lens, yesterday’s vote on the Medicaid bill by the Senate Health and Human Services committee was just that, one vote by one committee.

Senate Staff Dave De Novellis: Senator Aguilar?

Senator Irene Aguilar: Aye

De Novellis: Madame Chair?

Senator Linda Newell: Aye

De Novellis: Five-two

Newell: Congratulations, passes 5-2, you are on your way to appropriations.

Reporter: . A vote like than can be just the start of a long battle.

But for the Medicaid bill yesterday’s vote signaled an end to more than three years of fighting by Colorado Republicans.

They fought Medicaid expansion as part of the Affordable Care Act in Congress in 2009. When it passed, the state’s Republican Attorney General joined the lawsuit against it at the U-S Supreme Court. When the court upheld the law, but made it’s mandate to expand Medicaid optional for states, Republicans tried to win enough votes in the statehouse to say no to President Obama’s plan.

And that led to this small but significant moment yesterday, when Linda Newell, vice chair of the Senate Health and Human Services committee asked:

Newell: Is there anyone else in the audience who wishes to testify? Seeing none, testimony phase is over…. 

Reporter: That was the sound of no one stepping up to testify against the Democrats’ bill, a quiet admission that President Obama’s party stands united behind Medicaid expansion in Colorado, and the bill is all but guaranteed to be signed by Governor John Hickenlooper.

It even got one Republican vote in the committee. Senator Larry Crowder from the San Luis Valley was an aye even though the bill would have advanced if he’d voted with fellow party members Ellen Roberts and Kevin Lundberg.

Lundberg, from Larimer County, put up the most spirited fight against Medicaid expansion. He chided supporters of the bill who say Colorado should pass it because it will send nearly $100 million a year in federal money to the state to help pay for healthcare for people with low incomes.

Senator Kevin Lundberg: Doesn’t that logic really put us in the same category as Congress and the administration in their irresponsible spending spree? 

Reporter: Democrats say the government can afford to provide health benefits to more low income people. Senator Irene Aguliar, who’s sponsoring the Medicaid expansion bill, says that if taxpayers leave millions of Americans uninsured, they end up paying in other ways.

Aguilar: People will at some point need health care, and we know that if we provide it early we can save money. We can either do this proactively and give people the opportunity to maintain their health and maintain their ability to work and contribute to our economy, or we can do it reactively and continue to have the costs shifted onto those with insurance, the way it’s happening now.

Reporter: Representatives of Colorado’s business community echoed Aguilar’s points that reducing the number of people without insurance will be good for Colorado’s economy. Hospital representatives said more people on Medicaid will reduce the number of unpaid bills they’re stuck with, which means they’ll be able to keep costs down.

But Senator Lundberg said he’s worried that if Medicaid is easier to get, people will stop buying private insurance, and that could be bad for hospitals, because Medicaid doesn’t pay them as well as private insurance.

Lundberg: Can the hospitals stay in business if Medicaid rates were the only thing they were living off of?

Reporter: Russ Johnson, who runs the hospital in Alamosa, took that question. He says 25% of the population he serves is currently uninsured.

Russ Johnson, CEO San Luis Valley Regional Medical Center: There’s no question that the erosion of commercial insurance into Medicaid provides some risk, but it is a risk I would welcome, compared to the risk of a quarter of my community having no insurance.

Reporter: One of the last businesspeople to testify was Mark Reece with the Colorado Association of Health Plans. 

Mark Reece, Associate Director, Colorado Association of Health Plans: On behalf of Anthem Blue Cross and Blue Shield, Cigna, Colorado Access….

Reporter: He says the health insurance companies he represents all think Medicaid should be expanded, and support the bill.

Reece:  We ask for your support of senate bill 200. 

Reporter: The testimony from Reece’s and other business leaders clearly didn’t please Senator Lundberg.

Lundberg: I’m quite disappointed that big business likes this, and particularly health underwriters. Obamacare was designed to shut the private sector down, but unfortunately it appears the organized sector of the industry is just going along. I wish there was some leadership that would step up and say, let’s find free market solutions. 

Reporter: No leaders proposing free market solutions, or any other alternatives to the bill to expand Medicaid stepped up at its first hearing yesterday. They’ll have several other opportunities to do so as the bill moves through the legislature, but with Democrats holding a solid majority in both the House and Senate, it appears all but a foregone conclusion that Governor Hickenlooper will sign the bill, and that more than a hundred thousand Coloradans who can’t get Medicaid now, will be able to in 2014.