Health Care for Poorest Coloradans is at Risk as Medicaid Costs Dominate Budget Debate in Legislature
The Denver Post | By Nick Coltrain and Seth Klamann
In October, a group of Medicaid providers warned Colorado lawmakers that they were in trouble.
One after another, the providers — from hospitals, mental health clinics and community health centers — described a budgetary collision that’s played out for more than a year: Hundreds of thousands of Coloradans lost Medicaid coverage after the pandemic ebbed, resulting in less money for the clinics’ already-thin operations. Though those patients’ health insurance disappeared, they still needed care — but it’s no longer been reimbursed by the state.
The results, the providers said, have been layoffs, hiring freezes, reduced hours and anxious number crunching.
“This is very serious,” said Devra Fregin, the executive director of Clinica Colorado, whose clinics treat low-income patients. “Something needs to change, or we’re not going to be able to serve our state to the best of our ability.”
The providers’ pleas found a legislature — and a Medicaid system — at a crossroads. As clinics ask for help, lawmakers convening this week for the 2025 legislative session are bracing to cut hundreds of millions of dollars from the state budget.
Legislators have said they’re loath to cut Medicaid and further strain a sagging system. But the program takes up roughly a third of the state’s general fund budget, and K-12 schools — which lawmakers recently celebrated funding fully after decades of exploiting legal loopholes — account for another third.
That reality may force legislators to spread the pain to the most critical parts of the budget. It also may spark a deeper examination of Medicaid, the safety-net system that provides coverage for roughly a quarter of the state’s residents. On Monday, budget-writers are set to hold a daylong hearing combing through the spending of the Department of Health Care Policy and Financing, which manages Medicaid.
Citing that coming hearing, department officials declined an interview request last week. In emailed responses to written questions, executive director Kim Bimestefer said HCPF was “very concerned about state budget constraints and the impact on Medicaid over the short and long term. Despite some recent fluctuation, medical inflation continues to outpace growth in other goods and services.”
She said the agency also planned to discuss potential cuts during the Monday meeting with lawmakers.
The fiscal debate is set to dominate the legislature, which meets for four months beginning Wednesday, as lawmakers jockey for sparse funding for new programs — while also fighting to protect their priorities in a budget that must be balanced.
“I don’t want to cut Medicaid, and I don’t think there’s huge political appetite to cut Medicaid,” said Sen.-elect Judy Amabile, a Boulder Democrat who sits on the Joint Budget Committee and previously served in the House. “I think there’s political appetite to try to fix what is going wrong.”…
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