Fact Sheet on TABOR – Taxpayers’ Bill of Rights
October 27, 2006
The Taxpayers’ Bill of Rights is a state constitutional amendment that limits the growth of state and local revenues to a set formula – inflation plus population growth. It is named after the constitutional amendment enacted in Colorado in 1992. If expenditures rise more quickly than this formula allows, the state must cut expenses, which include reducing access to critical public services.
Colorado is the only state to have adopted TABOR. In 2006, approximately 16 states considered the proposal. Most were defeated, but it appears that citizens will vote on whether to adopt TABOR in Maine, Nebraska, and Oregon. In November of 2005, Colorado suspended TABOR for five years, in large part because of the outcry regarding cuts to social services.
TABOR is particularly problematic for health care and mental health care expenditures, which tend to rise more quickly than inflation. In Colorado, there were significant reductions in provider reimbursements, eligibility, and benefits and an increase in the uninsured as a percentage of the state’s population. The state’s dire financial situation also devastated the criminal justice system, leading to overwhelming case loads for probation officers and a marked decline in their ability to transition individuals back to the community.
Colorado was one of two states that did not respond to NAMI’s Grading the States survey. TABOR had forced numerous cuts to state employees in critical areas such as the state’s Division of Behavioral Health and Housing (DBHH). The agency cited significant staff reductions in the past few years as the reason that it did not have the time to respond and responded “data not available” when asked for information on evidence based services. The NAMI report concluded:
Those statements speak volumes about the degree to which Colorado’s state budget battles have hog-tied the state’s mental healthcare system, impairing initiative and hampering responsiveness and accountability to consumers and families.[i]
Mental Health Funding and Programs:
- Colorado’s per capita spending on mental health treatment is extremely low compared to its per capita income. Colorado ranks 33rd nationally, spending a mere $66.30 per capita on mental health treatment. In contrast, the state ranks 9th and has per capita income of $32,550.[ii]
- Between 2001 and 2004, Colorado eliminated important mental health and substance abuse programs, including:
- Early Intervention Program;
- Mental Health Treatment Program for Detained Youth;
- Early Childhood Mental Health Program;
- Community Mental Health Program for uninsured clients.[iii]
- Emergency department admission rates for Medicaid and uninsured clients with mental health and/or substance abuse grew 83% over three years.[iv]
- In FY 2004, the state helped approximately 14,000 fewer mental health consumers that it did three years before.[v]
- The state reduced the number of hospital beds at a time when they were cutting community services.
- Ft. Logan Mental Health Institute eliminated 16 residential beds, 27 adult unit beds and an after care program.
- Pueblo Mental Health cut 8 adolescent beds and 32 adult beds.[vi]
- In FY 2003-04, the state eliminated funding for mental health services in all state detention facilities, including a juvenile detention center.[vii]
Substance Abuse Funding and Programs:
- Between 2001 and 2004, the state cut General Fund appropriations for substance abuse prevention and treatment programs by more than 10%.[viii]
- Colorado ranks 49th in the country on per capita substance abuse and treatment spending. At the same time, Colorado ranks first in the nation for cocaine use and 4th for illegal drug use.[ix]
Medicaid Funding and Programs:
- The percentage of doctors in Colorado who will treat individuals with Medicaid has declined in response to reductions in reimbursement rates to health care providers. The percent of Colorado pediatricians who treat children enrolled in Medicaid declined dramatically from 41% in 2000 to 24% in 2003.[x]
- The proportion of low income individuals enrolled in Colorado’s Medicaid program is one of the lowest in the nation. Only five states have lower enrollment rates.[xi]
- In 2004, Colorado made significant Medicaid program cuts to private duty nursing, purchasing of medical equipment, and reimbursement rates for nursing homes.[xii]
- Since 2002, hospital reimbursement rates have declined and suffered cuts by almost 5%.[xiii]
Health Care Funding and Programs:
- Between 1992 and 2004, the percentage of uninsured children doubled in Colorado, even as it fell nationally. Colorado ranks last among the 50 states on this measure.[xiv]
- Due to the implementation of TABOR, Colorado’s rates of child immunization plummeted and the state went from 24th to 50th in the country on the share of children receiving their full vaccinations. Even after investing more funds, Colorado still ranked very low in 2004: 43rd in the nation on this measure. At one point in 2001-2002, funding was so low that the state suspended some of its vaccination requirements for school children because, unlike other states, Colorado could not afford to buy the vaccines.[xv]
The Judicial System Funding and Programs:
- Between 2003 and 2004, nearly 100 court employees were laid off and an additional 290 positions were not filled. The system is now understaffed by 17%, while the case load grows by roughly 7% per year.[xvi]
- Between 2003 and 2004, nearly 50 probation officers were laid off while case loads were increasingly substantially. Probation officers have a caseload of 217 adult offenders, which is well above the national average of 130. Due to these cuts, Colorado’s success in transitioning adult probationers back into the community has declined between 2002 and 2004. [xvii]
- Trial courts and clerk’s offices have reduced their hours when they are open to the public, leading to slow responses to inquiries, long wait lists for help, lack of support for judges and an increase in errors. Hearings that are required to take place within 2 days of filing are routinely taking 30 days.[xviii]
[i] Grading the States: A Report on American’s Health Care System for Serious Mental Illness, at 48.
[ii] Grading the States: A Report on American’s Health Care System for Serious Mental Illness, at 48.
[iii] The Bell Policy Center, TABOR Issue Brief: Mental Health (www.thebell.org).
[iv] Grading the States at 48-49.
[vi] The Bell Policy Center, TABOR Issue Brief: Mental Health (www.thebell.org).
[x] Center on Budget and Policy Priorities, “TABOR Is Hazardous for Health Care” (www.cbpp.org).
[xi] The Bell Policy Center, TABOR Issue Brief: Medicaid and Health
[xiv] Center on Budget and Policy Priorities, “TABOR is Hazardous for Health Care.”
[xv] Center on Budget and Policy Priorities, “TABOR is Hazardous for Health Care.”
[xvi] The Bell Policy Center, TABOR Issue Brief: Judicial Branch.