Glossary

208 Commission: Officially known as The Blue Ribbon Commission for Health Care Reform, the Commission was created to study and establish health care reform models for expanding coverage, especially for the underinsured and uninsured, and to decrease health care costs for Colorado residents.

Cost-shifting: The practice employed by hospitals and doctors of charging paying patients - primarily those with private insurance - more to recover the cost of providing care to uninsured patients or those covered by such public programs as Medicaid and Medicare, where reimbursements don't cover the full cost of provide care.

Employer Mandate: also "Pay or Play" - A way to finance universal or expanded coverage in some health care reform proposals. Generally, this is the requirement that employers pay for all or part of the cost of basic health insurance benefits for their employees or pay a tax to a government fund to cover the uninsured.

ERISA: A federal act passed in 1974 that established standards and reporting/disclosure requirements for employer-funded pension and health benefit programs. Under ERISA, states can't regulate self-insured health plans offered by employers, giving employers latitude in the benefits they can offer employees.

Individual Mandate: A government-instituted requirement that individuals must have health insurance. Violators are typically assessed a financial penalty.

Long-term care: Range of medical and/or social services designed to help people who have disabilities or chronic care needs. Services may be short- or long-term and may be provided in a person's home, in the community, or in residential facility. Generally paid for privately or are covered by Medicaid.

Medicaid: Form of public assistance sponsored jointly by federal and state governments providing health coverage to low-income kids, parents, pregnant women, elders and people with disabilities. In Colorado, more than 380,000 receive coverage through the program, which was created by the Social Security Act of 1965.

Safety net: A largely nonprofit and public network of providers and institutions that provide low-cost or free medical care to medically needy, low-income, or uninsured people, including those covered by Medicaid and SCHIP. The health care safety net can include (but is not limited to) individual practitioners, hospitals and community and school-based clinics.

Self-insured or self-funded: Employers that set aside funds to pay for the health care costs of employees and their dependents. A self-insured/self-funded employer assumes complete financial responsibility for the health care costs of its enrolled employees and dependents based on the employer's benefit plan. Self-funded health insurance is not regulated by states' insurance commissioners but rather by federal ERISA legislation.

State Children's Health Insurance Program (SCHIP): A federal-state partnership run by the states in which the federal government pays $2 for every $1 Colorado spends to provide health coverage to low-income kids and other family members whose family income is too much to qualify for Medicaid. Colorado's program is called Child Health Plan Plus.

Single-payer system: A system where one entity - public (state agency) or private (an insurance company) - collects health insurance premiums and negotiates rates paid to providers for providing care under a defined benefit package for all covered individuals.

TABOR (Taxpayer's Bill of Rights): Constitutional amendment passed in 1992 by Colorado voters to restrain all levels of government (state, local, school and special districts, etc) by limiting how much revenue governments can collect. At the state level, spending can't grow by more than 6 percent a year, which makes creating or expanding programs difficult. TABOR requires that any state or local tax increase must be approved by voters of the affected level of government.

Uninsured: People who lack public or private health insurance coverage. About 785,200 Coloradans lack coverage in any given month, according to The Lewin Group, a health care consulting firm based in Falls Church, Va.

Sources: Colorado Health Institute, Business Health Forum, California HealthCare Foundation, Wellmark Blue Cross and Blue Shield