This story was produced as part of the Colorado Capitol News Alliance. It first appeared at cpr.org.
The future of Colorado's Medicaid program is getting an in-depth look and that could lead to reforms. That’s the job of the Colorado Commission on Medicaid, which met on Monday.
Its arduous task? Come up with strategies to manage rising Medicaid costs and prepare for sweeping new federal policies.
Von Limbaugh, from Aurora, is the father of 24-year-old Andrew who has intellectual and developmental disabilities. He'd like to see lawmakers “cut through some of the bureaucracy so that it's easy to navigate, easy to understand and predictable. And then making sure that they're protecting people.”
“We'd like to see a system that's focused on the members, not the bureaucracy,” he told lawmakers.
“I hope that they will continue to hear real stories from real families. We're a diverse population,” said Michelle Limbaugh, Andrew’s mom.
Families want to be heard
Another parent, who also has a child who is enrolled in Medicaid, said she was glad lawmakers formed the 10-member commission and hoped its efforts would be the start of a dialogue.
“After two years of testifying, writing and attending meetings, the JBC (Joint Budget Committee) was starting to listen to the people of Colorado,” said Kathy Fieber of Littleton, the mother of 26-year-old Ben, who has Down syndrome and autism. “I am hoping what comes to light is the areas of wasteful spending, where staffing can be trimmed and accountability for the mismanagement.”
The agency that manages Medicaid, the Department of Healthcare Policy and Financing, has come under intense scrutiny, over the handling of its surging budget and controversies, like an overbilling mistake that cost Colorado tens of millions.
Big bite out of budget
About 1.3 million Coloradans get health care that's covered by the state's Medicaid program, called Health First Colorado. It has a roughly $20 billion budget, a third of state spending. But its budget has grown sharply, by double digits annually for the last several years.
“The legislature is trying to grapple with a budget for the state where we can't keep up with the needs of Coloradans and in particular Coloradans’ health care needs and those growing costs,” said Rep. Emily Sirota, a Democrat from Denver, who chairs the state’s powerful Joint Budget Committee.
She noted that the cost of health care is growing much faster than TABOR, the state law limiting revenues the state can keep and spend, allows.
She says Colorado’s social safety net is in distress.
That could describe the state’s budget as well, with a billion dollars in cuts this year just as major federal cuts, and new work requirements, start to unfold — part of H.R. 1, or the One Big Beautiful Bill.
“We have challenges coming from many different directions, but what we see is that those challenges are probably overlapping,” Sirota said, in an interview before the meeting.
Call for all parties
Sen. Barbara Kirkmeyer, a Republican who ran for governor and whose seat is in Weld and Larimer counties, said she’d like to hear from both the public and major groups involved with Medicaid, like hospitals, family caregivers, county governments and the disability communities.
“Why, in their opinion, had the cost grown so dramatically? And maybe there's more questions than that, but I think that would be helpful from the very beginning so that we can actually dig in early,” she said. “I'd rather hear what we're going to do to move forward from people who are involved in it, implementing it, boots on the ground.”
Other lawmakers on the panel said they’d like staff to find out how other states are handling their own tough Medicaid budgets, which ones are doing things right and where Colorado is unique.
Another advocate, Maureen Welch, the founder of Navigating Disabilities Colorado, sparked a back and forth when she told lawmakers she gets calls in her role as a consultant from families considering a move to Colorado. It has a reputation for being more generous with benefits than other states, she said.
“I think Colorado should look at that,” said Welch from Littleton. who is the parent of a 19-year-old son with intellectual and developmental disabilities. “We need to serve the people that are already in Colorado and make sure that we protect those services.”
Scope of the effort
As the discussion amongst the commission unfolded, they discussed what should be part of the scope of the effort. The work in front of the commission was described by one participant as “behemoth.”
“I think we're taking on just a gigantic amount of things,” said the chair Sen. Judy Amabile, a Democrat from Boulder and another member of the JBC. If its members can agree on a few key changes “that would be a huge success. If we can come up with just even a handful of things that make this system work better.”
The commission plans to have a report with detailed recommendations ready in December. Those will go to the new governor and is expected to be a key issue for the candidate who wins office in the fall.
