What was pitched as a modest expansion of Colorado’s safety net has quickly turned into a budget headache. Colorado’s Cover All Coloradans health program, created to extend Medicaid-style benefits to children and pregnant people regardless of immigration status, has ballooned in use and spending since it went live on Jan. 1, 2025. Instead of a low-profile, state-funded add-on, it has become a major pressure point as lawmakers in Denver stare down a large shortfall in the state budget this spring and openly talk about cutting benefits and capping services.
State fiscal analysts now say Cover All Coloradans will cost roughly $104.5 million in the fiscal year that began July 1, which is about 611% higher than the $14.7 million estimate used when the law passed. Enrollment surged, people used more care than projected, and the original fiscal note missed badly. Lawmakers are now scrambling to resize the program and rethink its funding structure, according to The Colorado Sun.
The Colorado Department of Health Care Policy and Financing says the program mirrors Health First Colorado and CHP+ benefits for newly eligible children and pregnant people and that it launched on Jan. 1, 2025. Department materials note that roughly 20,000 children and pregnant people had enrolled early on, and the agency emphasizes that children’s coverage under the program is paid entirely with state dollars while pregnant people’s care draws a federal match. In public updates, HCPF has urged communities and providers to use the department’s toolkits and Ambassador program to navigate enrollment and privacy concerns, per the Colorado Department of Health Care Policy and Financing.
Why Costs Ran Hot
Joint Budget Committee staff told lawmakers that the two biggest drivers were unexpectedly high enrollment and higher-than-forecast per-person costs, noting that Colorado initially relied on out-of-state data and academic studies to build its estimates. The staff paper points out that only 49 Cover All enrollees, all children, used long-term services and supports through Nov. 30, 2025, but warns that even a trickle of utilizers of long-term services and supports could grow the budget exponentially. Staff recommended legislative changes to limit the state’s exposure and adjust the program’s benefit structure, according to Joint Budget Committee staff…