NARAL Pro-Choice Colorado : Political Updates

Health care reform took center stage at the legislature this year, with the long-awaited recommendations of the Blue Ribbon Commission on Health Care Reform released in January. As a result, the Colorado House and Senate considered more than 660 bills, many of which addressed aspects of Colorado’s health care system – from insurance regulations to the scope of services that advanced practice nurse practitioners can provide. While NARAL Pro-Choice Colorado monitored all legislation that could impact accessibility and affordability of reproductive health care in the state, six bills – SB 03, SB 95, SB 125, SB 182, HB 1173 and HB 1203 – occupied the organization’s focus in 2008.

SB 03 (Boyd, Riesberg), Expanding the Medicaid Family Planning Pilot Program: Signed into law by Gov. Bill Ritter Jr. in March, SB 03 removes the statutorily defined income-eligibility limit for Coloradans to receive preventive family planning services through Medicaid. Under the new law, Colorado's Department of Health Care Policy and Financing will be able to determine new income-eligibility limits by demonstrating budget neutrality; the limits will be applicable pending review & acceptance of a federal waiver submitted to the Centers for Medicare & Medicaid Services. Services covered include birth control counseling and products; screenings for breast, cervical and other cancers; pap smears; and other care aimed at preventing unintended pregnancy and increasing the time between pregnancies.

Senate Bill 192 (Ward and Williams, Rice and McGihon), Regulating Targeted Residential Picketing: Pending action by the governor, SB 192 prohibits picketing that targets a specific residence unless protestors are mobile, traverse a specified distance adjacent to the targeted residence, do not carry signs in excess of six square feet, and do not park a truck or van with related signage within prohibited distances of the targeted residence. Although not actively engaged on this bill, NARAL Pro-Choice Colorado supports efforts to protect the privacy of health care providers and staff who frequently are harassed by anti-choice picketers at their homes.

HB 1203, HB 1173, SB 182: Concerning Changes in Hospital Ownership: This trio of bills was introduced in part to provide clarification in situations of potential changes in hospital ownership and was spurred by the pending buyout of two health care facilities by the Catholic Sisters of Charity of Leavenworth, Kansas. Signed by the governor, HB 1203 (M. Carroll, Boyd) clarifies that in reviewing transfers of ownership, the Colorado attorney general may consider a reduction in the availability or accessibility of health care services. Previously, "material change" had not been defined, allowing the attorney general to disregard potential loss of health care services in the communities served by the hospital.

House Bill 1173 (McGihon, Shaffer), which deals with regulation of charitable organizations, originally included language that would have required review of a change in a charitable organization’s use of donor funds – such as when a hospital operated by a non-profit organization changed ownership and the non-profit used its assets for purposes other than health care provision. That language was stricken from the bill that was signed into law. Senate Bill SB 182 (Boyd, McGihon) was defeated in committee; the bill would have allowed the state Department of Public Health & Environment to review plans by hospitals to discontinue “essential health services” before discontinuation occurred and would have required the Department to define “essential health services.” NARAL actively supported all three bills because the bills would have an impact on access to abortion, birth control, treatment for ectopic pregnancies, and other reproductive health services administered by local hospitals.

Senate Bill 95 (Schultheis, Lundberg), Mandated Delay in Health Care: Defeated in committee by just one vote, SB 95 would have required doctors to refer out ultrasounds and to receive written notification from women at least 24 hours prior to receiving an abortion that they had received information about the availability of ultrasounds and had decided to view or refuse to view the ultrasounds. This bill would have put additional burdens on a woman who seeks an abortion, in some cases subjecting a woman who travels great distances to delays that necessitate more complicated procedures because the pregnancy has advanced to a later stage.

Senate Bill 125 (Harvey, Stephens), Preventing Responsible Sex Education & Reproductive Health Care: Also defeated in committee, SB 125 would have made it a misdemeanor to distribute materials to anyone under 18 if the materials could be considered obscene. As written, the bill left open for interpretation whether depictions of human anatomy or instruction on the use of contraceptives for educational purposes or in the provision of health care could have constituted a violation of the law - subjecting comprehensive sex ed and health care providers to investigation and possible charges.

Recommendations from the Blue Ribbon Commission for Comprehensive Health Care spurred the introduction of a flurry of legislation aimed at promoting health care coverage for all Coloradans. NARAL Pro-Choice Colorado monitored legislation introduced as a result of those recommendations to ensure such policy changes were consistent with the organization’s work of ensuring all Colorado women and their families maintain access to the full range of reproductive health care services to prevent unintended pregnancy, bear health children, or access safe, legal abortion. Below are some of the bills NARAL Pro-Choice Colorado monitored related to comprehensive health care reform.

A trio of bills that were signed into law (HB 1094 (Gagliardi, Hagedorn), HB 1061 (Roberts, Hagedorn), and HB 1060 (Gagliardi, Hagedorn)) changed statutes regulating the scope of medical care that can be provided by advanced practice nurse practitioners. Collectively, the bills increase the total number of providers available to low-income Coloradans. Also signed by the governor, SB 90 (Hagedorn, McGihon) allows for prescription drugs to be delivered via mail-order under the State Medical Assistance Program.

House Bill 1032 (signed into law) seeks to ensure that generic and non-patented medications remain available to Colorado Medicaid recipients following the enactment of the Federal Deficit Reduction Act of 2005 (DRA). Finally, SB 99 (Sandoval, Stafford), which is pending action by the governor, ensures that individuals in foster care do not lose health insurance when they turn 18 by making them eligible for Medicaid through age 21.