By now, you are likely aware that the Budget Resolution Bill passed both chambers of Congress and has been signed into law by President Donald Trump. What has been termed the “Big Beautiful Bill” is officially the Congressional Budget Reconciliation Act for the fiscal year 2025 and authorizes federal tax collection and expenditures from 2026 to 2034.
One of the provisions of this new congressional budget that has received significant attention includes Medicaid cuts totaling over $1 trillion across the next 10 years. The intent appears to be to reduce the number of Americans participating in Medicaid coverage and shift some of the costs back to the states.
Colorado was already facing a challenging state budget situation; current estimates are that the budget shortfall for next year will be well over a billion dollars. The budget cannot bear any shift of costs from the federal government, which estimates put between $1 billion and $2.5 billion per year.
Currently, about a third of Colorado’s state budget goes to its portion of Medicaid costs and covers more than 22% of the state’s population. Of that, about 42% of Medicaid costs support long-term services and supports for children and adults with disabilities or chronic conditions and older adults with aging-related disabilities. It is unrealistic to think that Colorado can balance its budget (as is required in the Colorado Constitution) without impacting the lives of people with disabilities.
This is the challenge that will be faced by our elected legislators and state staff members as they try to minimize the impact on Colorado residents. The Colorado Legislature wrapped up its 2025 general session in May, but it is anticipated that they will return for a special session in the coming months to grapple with the impacts federal cuts will have to the state budget year that already started July 1.
It is likely something voters will have to grapple with in coming years as well. The Colorado Taxpayer’s Bill of Rights gives Colorado voters the power to approve or reject proposed tax increases, so we may well be asked to help support essential programs.
Regardless of how and who makes the decisions, there are difficult decisions to be made. Will Colorado change the eligibility for Medicaid programs, serving fewer people? Will the state reduce the benefits available through Medicaid? Will we reduce the rates paid to providers that already struggle to keep up with rising costs and sustain an adequate workforce? Will rural hospitals be able to survive as the costs of uninsured patients are shifted to medical providers?
Currently, we have more questions than answers. The Colorado Department of Health Care Policy and Financing, which manages the state Medicaid program, is maintaining a helpful webpage with updates on the situation. For the most current information, check out https://tinyurl.com/4375ewv9.
Cuts to Medicaid will affect all of us, especially in rural communities. Now is the time to come together with solutions to support the health and well-being of all Coloradans.
Tara Kiene is president/CEO of Community Connections.
