Consumer advocates are worried the answer is “no.”

Statehouse Republicans, on the other hand, think it’s asking for far too much.

Colorado exchange CEO is playing Goldilocks, saying the $125 million federal grant request she wants to send to Washington is just right.

Colorado is bumping up against a May 15 deadline to apply for its third and final federal grant to launch its insurance exchange, recently re-branded as .

The $125 million request, if granted, would push total federal funding for Colorado’s exchange over $185 million.

Consumer advocacy groups, including the broad coalition known as the , think the request should include more thanÌýthe current $10.5 million line item for a customer assistance network to help people buy policies in the exchange and figure out if they’re eligible for premium subsidies. Nationwide, funding for the online marketplace’s consumer assistance will vary widely between states.

If Colorado’s network is underfunded, “frustration and withdrawal from a few will lead to withdrawal from the enrollment process by many as word spreads about long wait times or impersonal or inadequate assistance ultimately leading toward bad press for the exchange,” in one of three the state’s received from consumer groups criticizing proposedÌýnavigator funding levels. Navigators are the people who will provide help toÌýindividuals seeking to buy insurance through the exchange.

“The long-term viability of the exchange strongly depends on its success in the first year when Coloradans initial experiences will shape their impressions of the exchange for years to come,” echoed a that includes AARP, Boulder County and safety net health care provider Denver Health.

Exchange CEO Fontneau responded that Connect for Health Colorado is budgeting more for navigators than the $10.5 million in the federal grant request. She expects an additional $4 million to $6.5 million will be channeled to the exchangeÌýfrom administrative fees assessed on each policy sold,Ìýabout $22 per year per policyholder. The exchange has also requested more than $2 million for the program from private foundations.

GOP Concerned About Tax Burden

Some Republicans have theÌýopposite concern: that Colorado is requesting too much federal money.

Colorado’s exchange, “should be funded through operating revenue, it’s not fair to put the burden on the federal taxpayer,” says , a physician-entrepreneur Republican lawmakers appointed to Colorado’s exchange board. He’s angry that Colorado increased its grant request after learning in January that the grant could be used to fund operations beyond 2014.

“What we were going to pay for ourselves we’re now asking the feds to pay for,” he said.

Fallon doesn’t have enough allies on the board to modify its very pro-White House bent, but his opposition to the pending grant request this week stirred the body’s most fiery debate yet.

Other board members, including the who serves in an ex-officio role, said the state should err on the side of asking for more money than it estimates it will need and return any unused funds.

But guessing the amount the state will need is difficult. If a relatively high number of people use the exchange immediately after it opens, a lot of revenueÌýwill be generatedÌýthat can be used for operations.ÌýBut if enrollment numbers are initially low, the state will need to lean on federal funding more to maintain the new infrastructure.

Fallon scoffed at suggestions that Colorado should ask for a high number and then pay back any unused federal funds.

“I believe your intentions are genuine,” he told a fellow board member, “but I’m cynical any government body will not spend” every dollar it has.

Fallon’s anger was echoed by Republican state lawmakers on a special exchange oversight board who reviewed the grant request Tuesday.

State Rep. said the size of the requestÌý“leaves me fairly speechless.”

“We were given to understand that we were running the leanest, most cost-effective exchange in the country,” Gardner said, “so it’s disappointing.”

Other members of the committee seemed incredulous that the exchange would need another nine-figure sum after Colorado’s legislature had only days earlier approved the $22 per policyholder per year fee, as well as agreeing to send it any remains from the state’s now-disbanding high risk insurance pool.

“If [the exchange] were a private concern I think you’d be looking for a job,” Republican Senator told exchange leaders Tuesday. He and other oversight committee members were under the impression that the exchange wasn’t planning to request additional funding beyond that in the measures approved by the state legislature. Democrats on the committee said they never heard that as those bills moved through the legislative process.

Republican Senator was angry that the committee’s sole meeting this legislative session came just one day before the session ended. And being asked to sign off on an 80-page federal grant request just days before its submission deadline clearly displeased her.

“The timing is horrible,” she said, “I’m almost without words.”

Republicans on the oversight committee are essentially powerless to thwart exchange board decisions this year. The state law that created the oversight committee allows its co-chairs to approve exchange board actions.ÌýThis year, with Democrats controlling the state House and Senate, that means both of those seats are held by Democrats.

And Democrats on the committee stood up to defend the grant request.

“We as Colorado taxpayers are paying” to fund exchanges nationwide, said Senator , “and if we choose not to use it, one of our neighboring states can apply for and receive those funds to set up their own exchanges, and then we’ll have an increasing cost for access to health care for our own residents.”

Colorado’s $125 million exchange grant request to Washington is still in draft form. The exchange board will hold a phone conference Friday to work out any details before submitting it in time to meet the May 15 deadline.

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Last summer’s mass shooting at the movie theatre in Aurora, Colo., led Gov. John Hickenlooper to call for stricter gun control and in mental health care. Several significant gun bills passed, and a package of mental health reforms are moving forward, but there may not be enough support to win funding for 300 new in-patient psychiatric beds.

That would bring mentally ill and addicted homeless people to , a one-time mental hospital, then prison, that’s been shuttered for two years near the tiny town of . The patients would leave the streets of the cities where they live now and voluntarily come to Fort Lyon. And the town would welcome the jobs that reopening the facility would create.

Jack Simms, who’s been homeless in Colorado Springs for a decade, says this step is necessary.

“I see it, man. They need to open some beds somewhere, at a mental health facility or something. I can survive out here, [but] these mentally ill people, it’s rough. They just walk up and down the paths. They look like zombies,” says Simms, who says he struggles with depression and smokes pot to cope. “I’d be a guinea pig. I’d try it out.”

Kathleen Tomlin used to work as an administrative assistant at the old psychiatric hospital, a veterans’ facility. ÌýIt’s several miles past Las Animas’s one stoplight. Dozens of empty buildings surround an old parade ground, giving it the feel of an empty college campus.

“When I started, there were over 600 employees,” says Tomlin as she tours the building where she used to work. “That was in 1973.”

“This was a good place because it was soothing,” she adds, “It was relaxing. It wasn’t like a big city, metro area. [Patients] loved it and they would get attached. And some of them still see me and they say, ‘Oh, I miss Fort Lyon.’”

But the movement to de-institutionalize the mentally ill meant jobs dwindled at Fort Lyon, and businesses closed in Las Animas.

Tomlin says people here used to take pride in working at Fort Lyon and they would like to see the hospital and the jobs come back. She’s cautiously optimistic now that state lawmakers like , a Democrat from Fort Collins, are backing the governor’s push to reopen it.

“I can’t think of a better use for a historic campus, and also a place that is going to help improve the lives of many people,” Ginal said.

Hickenlooper’s idea is that the homeless mentally ill people who volunteer to come to Fort Lyon for treatment will get housing vouchers they can use to live elsewhere when they complete the program.

But not everyone thinks that this plan is going to do a lot of good.

“Having someone in transitional housing teaches people how to manage living in transitional housing,” says of the non-profit .Ìý “But then they have this huge hurdle, the re-entry problem.”

Tsemberis says that renting apartments for homeless, mentally ill people in the neighborhoods where they are, and getting them treatment there, works better than shipping them off someplace.

“You could skip all that transitional stuff, and go right to graduation from the street,” Tsemberis says. “Give the support services, and you wouldn’t have to go home by way of Fort Lyon.”

There’s value to that approach, says . He’s worked for years to get local housing and treatment programs funded.Ìý But he supports Fort Lyon reopening, because prior to theÌýgovernor’s proposal, nobody was talking about pouring millions of dollars into any help for people living on the streets.

“It’s not really a question of either-or: Should the state support community-based options or should they support Fort Lyon?” says Parvensky. “They really should be doing both, but historically they’ve been doing neither.”

The governor’s proposal faces a tough hearing at the state Senate appropriations committee on Friday. Opponents on that committee point out that there’s only funding for it for two years. But backers of the idea are optimistic they can find more money for future operations.

Still, opponents inside and outside the legislature say trying to combine economic development with helping the homeless won’t do either well. Colorado would be better off, they say, helping Las Animas find a new industry and spending money on housing and mental health services at the neighborhood level.

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Dr. Chris Colwell, an emergency department physician in Denver, says he sees gun-violence victims on a weekly basis. And when those cases are fatal, they are hard to forget.

“These are the injuries that the [patients] will come in, and they’ll look at me, and they’ll talk to me, and then they’ll die,” says Colwell, who’s been at Denver Health, the city’s biggest public hospital, for 20 years.

Colwell also treated casualties from two of the deadliest mass shootings in American history. He responded to the scene during the 1999 massacre at Columbine High School where 15 people died. He also treated victims of last July’s movie theater shooting in, where a dozen were killed and 58 wounded.

Often, Colwell will treat a shooting victim, and then treat the shooter after he or she has been caught by police. Colwell describes a case from a few months ago in which he treated a woman who later died — and then her husband, who fired the gun.

“They had had a fight. He had caught her in what he felt was cheating, and he had lost his temper,” he says. “He went and grabbed the pistol that he had for home defense at his bedside, and he made a snap decision.” Now, he adds, “his life will never be the same, and hers was gone.”

Colwell says it’s remarkable how often people who pull the trigger are surprised at the consequences of their actions. And he’s deeply disturbed by how easy guns are to get.

“I see patients every day that are right on the edge of being unstable. … They describe problems with access to medications; problems with access to psychiatric care or substance abuse care; problems with access to homes or to shelter,” says Colwell. “But they don’t describe problems with access to guns.”

Dr. Katie Bakes, who has worked with Colwell in the emergency department for 10 years, also says it’s the gunshot victims that she can’t shake.

A few weeks ago she treated a three-year-old who’d been shot in the head. Her mother had shot each of her three children and then committed suicide. “Our patient was the only one who was ,” Bakes says.

Such experiences have made Bakes unequivocal in her opposition to guns.

“I hate guns. If I could snap my finger and get rid of all the guns I would. I think they’re evil,” Bakes says, “I don’t really care what the other side of the argument is. I just don’t want to see another 3-year-old come in and be shot in the head.”

Bakes and Colwell say gun injuries feel much more deliberate than any other kind of trauma they see.

“It’s so senseless,” Bakes says. “You know, it’s not an accident, somebody intentionally pulled the trigger for whatever reason.”

But not all physicians share this perspective.

Dr. Jack Cletcher, a retired orthopedic surgeon, has treated his share of gunshot victims, too, from the streets of Chicago, and, decades ago, he took care of wounded soldiers just off the plane from Vietnam. He can sympathize with Bakes and Colwell, but he doesn’t agree that laws need to change.

“This is the kind of emotional reaction that occurs with these horrible catastrophes that happen,” Cletcher says. “The gun is only the instrument. It’s not something that happens because the gun does it. There has to be somebody holding the gun to do it.”

Cletcher is opposed to most of the new gun restrictions lawmakers are talking about in and .

“I don’t think we need new laws, we just need to make the ones we have work better,” says Cletcher, who would rather see lawmakers focus on better treatment for the mentally ill, and keeping guns out of their hands.

Recently, leaders of the Colorado Medical Society went to Washington to for measures to help prevent gun violence. Strengthening mental health care was on their agenda, and they support President Barack Obama’s executive action for increased research into gun violence.

Dr. John Bender, the organization’s president-elect, showed Rep. Ed Perlmutter, D- Colo., the results of a recent survey of the medical society’s members in which about two-thirdsÌýwant to see gun regulations strengthened and about a third don’t.

No similar survey exists for doctors nationwide, but a majority of AMA delegates have tighter restrictions on guns. , but among those calling for stricter gun control laws are the and several groups of specialists, including theÌý , the and the .

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“He started complaining of his memory starting to slip,” the internist recalls. The patient would forget where he had put things, and struggle for simple words and phrases.

Dumont prescribed anti-depressants, and saw the man every eight weeks or so.

Like a lot of people in this small town 90 miles northwest of Denver, Dumont and his patient had been drawn there by the ruggedly beautiful mountains. They would often talk about one specific mountain called , which is a cherished part of Dumont’s life.

On their last visit, Dumont recalls he did ask his patient whether he was having any thoughts of hurting himself, and he got a convincing no.

“What in hindsight struck me about that visit is that he brought me a gift, which was a geological survey marker from the top of Longs Peak,” says Dumont. “The next that I had heard of him was from an emergency phone call from his wife about a month later. … She had to come in and talk to me [about] how to deal with the fact her husband had committed suicide.”

Dumont’s patient shot himself in the head with a rifle. Dumont was stunned, and guilt-ridden. He says he always asks his depressed patients about suicide, and whether they’ve thought about how they’d do it.Ìý But he regrets not asking this patient specifically whether he had any guns in the house.

Suicide prevention researcherÌý at the Harvard School of Public Health wants to make that question routine when doctors talk with patients.

Miller says that Dumont was doing everything he could to try to keep his patient from making a suicide attempt. “But what he didn’t do was the second step, which is to make it hard for him to die if he did make an attempt.”

That step is asking patients if they have access to guns, he says. If someone tries to commit suicide without using a gun, they probably .

“The likelihood of their dying is of an order of magnitude lower. Instead of there being a 90-plus percent chance of death, there’s a greater than 90 percent chance that they’ll live,” Miller says.

Miller cites oneÌý that found that nearly half of all suicide victims had seen a primary care doctor within a month of killing themselves. So it’s important for them to bring up suicide and possible means.

“We have to get people to stop thinking about these discussions as gun control in one way or another, but rather as a way of conveying useful information, so people make decisions that protect their family,” he says.

There are lots of reasons family doctors avoid bringing up guns with their patientsÌý— everything from not wanting to offend, to being too busy checking off all the screenings and questions about smoking, diet and exercise.

Not everybody wants gun advice from a medical professional. Edgar Antillon organized aÌý at the Colorado state capitol earlier this year. He says he would resent a doctor bringing it up.

“Tell me to stay healthy, tell me my baby has colic, but I don’t think it’s their job to tell me about gun safety.”

But Dumont has spent a lot of time second-guessing himself, and he hopes small efforts on his part might reduce the odds that another patient would take his own life.

“I have a lower threshold for asking follow-up questions, asking the same thing a different way,” he says. “Or if I have any inkling, starting to push a little bit further, and say, ‘Well, so you’re not really thinking about it, but have you ever thought about how you would go about it if you were going to?’ And I have a lower threshold for asking about a weapon in the home as well.”

Dumont says he thinks more physicians would talk with their patients about guns if they got information about the health risks associated with them. Medical journals andÌý regularly issue advice on preventing everything from obesity to car accidents to workplace injuries. But there’s been a ban on federally-funded gun safety research until President Barack Obama restored it with an .

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But a consumer focus group in Colorado suggests people are going to want something more like TurboTax.

Like paying taxes, buying insurance is a complicated proposition, rife with jargon and high stakes: Errors can cost big money and run afoul of the law.

And like doing taxes, buying a policy on the exchange means interfacing with state and federal government agencies, too.

Jargon is a big issue for consumers, who want to be able to hover a mouse over confusing terms to get a quick explanation of something they need to know, a popular feature of the tax software.

The insight comes fromÌý by three Colorado nonprofits. The groups found 414 people in eight urban and rural locations to help the state’s exchange board understand what people are going to need to shop on the exchange.ÌýParticipants were volunteers, not scientifically selected, but organizers said their demographics roughly match those of anticipated exchange users.

The feedback tells exchange planners that they have a high mountain to climb. Consumers said they know very little about insurance and will need a lot of customer support to use the exchange.

Few participants said they would be comfortable choosing a policy on their own. Many worry they don’t understand health insurance jargon well enough to buy a policy online or that a website won’t have the information they need to make a good choice. About one in five are concerned the exchange won’t offer enough “human support.”

“That was a significant, issue,” said , who helped analyze the responses. “Make sure we have enough people available. That includes the call center, assisters and navigators, so that people both are and feel like they’re getting … competent assistance.”

A Colorado exchange call center is already in the works. The exchange board is also considering opening storefronts or other venues where people can get help face to face. The board has to balance demand for customer service with a desire to keep costs down and policies affordable.

Of the 414 people surveyed, 80 said they’d feel comfortable turning to exchange staff for support, and 16 said they would not.

In contrast, 162 said they would specifically not trust an insurance agent or broker, and only 47 said they would.

The trustworthy source of advice named by most people, 138, was doctors, nurses and health facility staff, versus 52 people saying they would not trust them. Colorado’s exchange board includes a physician, who has said he doesn’t think doctors in general know enough about health insurance policies to give goodÌýadvice to consumers.

More than half in the discussion group were under 30 years old. When asked “who helps you choose a health plan now?” 215 said “parents,” and 105 said a family member. Only 17 said they turned to the Internet for help picking a health plan now, fewer than named brokers/agents (22), employers (45) or “myself/nobody” (44).

Colorado is still studying how many navigators and call center lines it will need. ÌýIt sounds like a lot to state . He said that for the state to meet its goal of enrolling enough people in its first six months for the exchange to be self-sustaining, “that’s 800 people a day, seven days a week, for six months.”

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The bad news: ÌýThe state’s computer system is not compatible with most of the computer systems doctors use, so many practices don’t update the central database because it’s just too much extra work, according to , a researcher at the University of Colorado. That means doctors and researchers, who try to keep childhood immunizations on track, can’t rely on the database to make sure a vaccine isn’t missed or given twice.

This is just one small example of the digital disconnect that’s holding health care back, says , a policy analyst with the RAND Corporation. He says the ability for doctors to easily share information is the exception in America, not the rule.

Kellermann in this month’s Health Affairs, reflecting on a that said information technology could save America $81 billion a year by making health care more efficient. He found actual savings scant in 2012 and learned that many doctors complain electronic records make them less efficient.

The result is that the health care industry isn’t benefiting from the computer networks that have transformed industries such as manufacturing, retail and banking.

Kellerman points out that bank customers can “go to any ATM in the country — and in many cases in other countries” to withdraw money or transfer funds among accounts. “You can’t do that with health information technology today,” he says.

Dr. Farzad Mostashari, the , rejects the comparison. “People talk about the ATM,” he says, but “that’s seven data elements, and they charge you two-buck-fifty for shipping those seven data fields over. We’re talking thousands of data fields around things that are life and death.”

Mostashari’s office is charged with leading American medicine’s digital transformation, and it is responsible for distributing $27 billion in federal stimulus funds to providers who demonstrate they are meaningfully using health IT systems.Ìý According to a , while 72 percent of office-based physicians are using some sort of electronic system in their practice, only 40 percent of practices meet the definition of a “basic” system.