DENVER — With a budget deficit looming over the State of Colorado next year, one program in particular is under the microscope: Medicaid.
A special session tackled some of the anticipated $1.2 billion budget shortfall, which was created in part by tax changes made in President Donald Trump's One Big Beautiful Act (H.R.1). As a result, Colorado will collect less revenue than expected when lawmakers approved the state budget in May.
Some of that $1.2 billion revenue loss was absorbed by the state education fund and the affordable housing fund. Around $300 million that the state had in surplus, which would have been refunded to taxpayers, will be used to help fill the gap.
During the special session, lawmakers cut corporate tax breaks by about $250 million. They left it to Gov. Jared Polis to make spending cuts and to determine how much to borrow from state reserves.
Just after the special session concluded, Polis announced a total of $250 million in cuts and redirected spending in order to balance the state budget.
The Department of Health Care Policy and Financing (HCPF), which administers Colorado's Medicaid program, makes up roughly one-third of the total General Fund appropriations for the next fiscal year. Polis called Medicaid the "fastest-growing part" of the budget when he presented his proposal to the Joint Budget Committee (JBC) last week.
The JBC is a group of Colorado lawmakers tasked with preparing budget recommendations for the General Assembly every year.
HCPF will see more than $79 million in cuts. About $38 million of that will come from freezing an increase in provider reimbursement rates that kicked in on July 1.
Then, an executive order from the end of October "initiated an additional $537 million in budget reductions to HCPF, most of which will begin this fiscal year to quickly realize savings to address the state’s current and future budget challenges," according to the department.
HCPF has proposed several changes within budget requests targeted at saving money and the sustainability of programs. Their proposal was guided by a certain framework created by the department that aims to "avoid draconian cuts."
However, families and providers who rallied on the steps of the Colorado State Capitol on Tuesday morning believe the proposed cuts to Medicaid would be devastating.
- Watch the full rally from Tuesday, organized by the Colorado Association for Behavior Analysis (COABA)
Those at the rally, which was organized by the Colorado Association for Behavior Analysis (COABA), claimed the potential cuts would hurt critical autism therapy services. According to COABA, Polis' plan would cut almost $10 million in Pediatric Behavioral Therapy (PBT), which includes Applied Behavior Analysis (ABA) services.
Ashley Brahl attended the rally with her son, Amos, who is 7 years old.
"He is the light of our family," Ashley said about Amos. "He has instilled empathy within us that we hope that every human learns over time, but it is now ingrained and embedded in our family and in my other children because of our daily lives — of how we navigate things with Amos' differences and challenges being part of the autism community.”
Amos lives with severe autism and is nonverbal. The family only recently was approved for coverage under Medicaid.
“It took me two years to get approved," Ashley explained. "I had been working on a special needs bed for him for two years as well, which we just got approved for Medicaid last month and received his bed last night. My husband and I haven't slept in the same bed in years, because we take turns sleeping with him. So, through Medicaid, we've been able to access this bed, which would be inaccessible to us."
In addition, Ashley said Medicaid allows her son to access resources like ABA services and dental cleanings.
“If we don't have access to this, we probably wouldn't be able to live in our same house, and we would have to remove a lot of the normalcies of our life, like being able to pay for our other children's sports programs," said Ashley.
Ashley fears cuts to Medicaid in Colorado will change how her family lives.
"I don't see how exactly we are going to be able to make it. We would have to reroute our whole life's plan," Ashley said. "This is a basic need, and my child needs it... We're trying to lay the bricks so that he has a foundation when we're gone, and if this necessity is removed from us, I don't know how we're going to achieve that.”
Prior to the rally, the JBC heard from the Medicaid Provider Rate Review Advisory Committee (MPRRAC), which is designed to offer recommendations regarding Medicaid provider rates. However, committee members said the insight from MPRRAC contradicted Polis' proposal.
"The frustrating part is the governor's budget request came in and said, 'Hey, we're just going to cut everybody across the board and cut provider rates,'" said State Sen. Barbara Kirkmeyer — R, District 23. “It's kind of like, why are we doing this now when the governor's request is something totally different? And so, it just puts us in a conundrum.”
Tuesday marked one of the first conversations expected within the JBC regarding provider rates.
"I am very concerned that we are going to lose providers, and wait lists will start coming back, and we will lose access to care. And it won't just be for those people who are on Medicaid — it ends up being for every Coloradoan that we lose access to care," Kirkmeyer said.
Near the end of September, COABA filed a lawsuit against Polis and HCPF, which argues pediatric autism therapy services are being singled out for reductions in coverage. The lawsuit claims state and federal laws are violated as a result, alleging mental health and autism-related services are being treated more restrictively than physical health services.
A spokesperson with Polis' office declined to comment on the pending litigation.
Related coverage:
- Gov. Polis presents budget to lawmakers, focuses on proposal that would cut Medicaid programs
- Polis announces spending cuts to balance state budget, with healthcare and higher ed the biggest targets
- Colorado lawmakers empower Gov. Polis to make deep spending cuts
- State lawmakers return to Colorado Capitol for special session to address massive budget gap
- Colorado Gov. Jared Polis announces special session, state hiring freeze to address $1.2B loss of revenue
- Colorado faces new $1.2 billion budget shortfall: 'No money to pay our bills'
- Colorado Republicans, Democrats disagree on how much progress was made during special session
