Opinion | Emily Tracy: 1918 to 2009 to 2020: What have we learned?
Western and Rural Colorado Health Care Coalition member
Rediscovering the history of the flu pandemic in 1918 raises many concerns we are living through today. How rigid should our shutdown be? How much testing and contact tracing do we need? Does public health or the economy take precedence? COVID-19, like the Spanish flu, is an unprecedented health emergency for the country, the state and our local communities, with implications for Colorado’s budget impacting local residents, patients and health care providers.
As a member of the Western and Rural Colorado Health Care Coalition, I have worked for a year and a half pushing for grassroots changes to our health care systems. We have seen some significant results through educating, testifying, lobbying and advocating. Now the virus threatens to wipe out those hard-fought improvements.
We are fortunate in Summit County to have Peak Health Alliance, which has enabled many local residents to gain access to the health care system. But at the same time, we still see some residents who delay seeking health care because they do not have adequate insurance. Delaying access to care in the time of COVID-19 can have serious, even deadly, consequences.
One coalition member remembers during the 2009 Great Recession the anguish in the Colorado Legislature’s Joint Budget Committee as huge across-the-board cuts were made to almost every program that the state managed or funded, cuts retained for years to come. No program was exempt, and any new legislation that required even a dollar of spending would not see the light of day for years.
The Joint Budget Committee now faces a $3.3 billion shortfall, well beyond what we saw from the Great Recession in any one year. We are concerned the biggest potential hit will be to Medicaid when Coloradans need health care access the most.
With more than 420,000 Coloradans having already lost their jobs — and likely their health coverage, too — this increase in unemployment will create new and unprecedented need for Colorado’s Medicaid program.
Medicaid is particularly important for rural citizens, with unemployment rates that are generally higher and less employer-sponsored health insurance coverage because of the costs. While Summit County’s Medicaid enrollment is generally less than 15% of the population, other counties in western Colorado often have much higher rates with counties like Mesa and Montrose running close to 30%. Rural health care providers, hospitals and clinics treat a higher percentage of Medicaid patients. Any cuts to Medicaid will have a huge impact on our rural communities.
State lawmakers should not cut Medicaid or defund a health care system in the middle of the greatest pandemic since 1918, much less cut education, older adult services and other vital services. But just like the 2009 recession, there are limited options.
There is, however, one option to temporarily increase state revenue to address this emergency through Colorado’s TABOR amendment. Under TABOR, the Colorado General Assembly can pass a temporary emergency tax reform measure. This could be used to provide emergency relief to 95% of Coloradans through slightly lower income taxes while asking households with yearly incomes above $250,000 to pay a little more. This would not only help Coloradans struggling during this health emergency by giving them a tax break but would raise revenue to avoid some of the most damaging cuts to programs and services.
Two-thirds of the General Assembly needs to vote to declare the public health emergency and pass this temporary emergency reform that would expire on Nov. 30. We cannot wait for Washington to decide whether they will provide financial relief to states as we have but a few weeks to pass our state budget.
Now is the time to use this TABOR mechanism to address this health emergency. The roughly $600 million this would raise in addition to using state reserves would help minimize the damage we will otherwise see from this emergency in rural Colorado. Without this measure, we will see deep cuts to or even closures of rural schools, colleges, hospitals, health clinics and the list goes on. These cuts will put rural Coloradans lives in jeopardy and prolong the economic calamity we face from COVID-19. Our lawmakers cannot and should not let that happen. We can endure some pain in the short run but cannot sacrifice our long-term sustainability.
Emily Tracy lives in Breckenridge and is a member of Western and Rural Colorado Health Care Coalition. She was a candidate for the Colorado Senate in 2012 and 2016.
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