Blue Ribbon Commission numbers could be off by nearly 1 million
But spokesperson says, “numbers don’t matter.”
Face the State Staff Report
As a Colorado legislative commission considers revolutionary changes to the way health care coverage is delivered in the state, commissioners have at least one major dilemma. They don’t know how many uninsured people actually live in the state.
According to the Lewin Group, a national consulting firm hired by the legislature’s Blue Ribbon on Health Care Reform to provide such figures, the number of Colorado residents who didn’t have health insurance for at least a portion of the past year stood at 1.4 million. This compares to a previous Lewin-released figure of 562,800. The smaller figure reflects those the Lewin Group says went without insurance for at least a full year between 2005 and 2007.
These two figures, however, are off substantially when compared to the U.S. Census Bureau’s calculation of Colorado’s uninsured at 758,800. In a recent Rocky Mountain News report, the Lewin Group disputed the Census figures, saying they under-reported the number of Colorado residents receiving health care through publicly-funded Medicaid.
In the same Rocky report, commission spokeswoman Edie Sonn was dismissive of the need for accurate numbers. Telling reporter David Montero,” the numbers matter less than the impact and the cost shifts that result from that.”
According to recent news reports, if one of the five proposals currently being considered by the commission as the state's strategy for reducing the number of uninsured Colorado residents, taxpayers could face an annual bill of more than $1 billion.
Because of the huge cost of the proposals being considered, at least one of Sohn's fellow commissioners adamantly disagrees about the importance of numbers. According Linda Gorman, they are very important. "How can you put a dollar figure on insuring people when you don't know how many people you are talking about?"
Gorman agrees with the Lewin Group that the U.S. Census Bureau figures are flawed. Most notably, she says they are inaccurate because they include Colorado's medicaid-eligible residents as uninsured. "This is extremely misleading because when a medicaid-eligible person goes to the hospital to seek treatment, they are going to be signed up for medicaid and get treatment," she said. "These people should be considered insured for the purposes of our total numbers."
At a commission meeting earlier this year, the Lewin Group estimated that just 72 percent of medicaid-eligible individuals are signed up for such coverage.
The commission defines health care access based on insurance coverage. Gorman and other commissioners have pointed out, however, that coverage is frequently provided outside of a traditional insurance model. Free clinics, public hospitals, and private urgent care centers all frequently provide care without involving insurance companies.
Gorman also noted that the Lewin Group's figures do not include accurate estimates on the number of uninsured illegal immigrants seeking or receiving health care. According to the federal government's Health Benefits Stimulation Model estimates, up to 167,000 of Colorado's uninsured are non-citizens. The government does not provide an estimate on how many of these individuals are in the U.S. illegally. According to Gorman, this figure plays a significant role in budget planning, however, because the state cannot legally claim federal matching funds for non-emergency Medicaid health services provided to illegal aliens.
Described by Gorman as "a giant marketing machine," the commission is operating with a $1.6 million budget. "If the commission isn't going to be careful about (Colorado's uninsured) number, why should the public trust anything we say about uninsured costs?"
The commission is expected to release its final reform recommendations to state legislators in early 2008.