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Colorado’s Uninsured Rate. The Department of Health Care Policy and Financing (HCPF) is pleased that the 2025 Colorado Health Access Survey (CHAS) shows that the state’s uninsured rate is 5.9%, even lower than prepandemic levels of about 6.5%. The recently released CHAS shows that since the end of the Public Health Emergency, the percentage of the total population enrolled in Medicaid decreased as expected, while the percentages of people covered by their employers and the individual marketplace increased.
This 5.9% result is the product of extraordinary collaboration in a united effort to get Coloradans disenrolling from Medicaid connected to other coverages to achieve our shared goal of Keeping Coloradans Covered through the end of the public health emergency. We celebrate this outstanding achievement with gratitude and appreciation to all who engaged - care providers, consumer advocates, insurance carriers, county and other eligibility partners, Connect for Health Colorado, vendor partners, sister agencies, and so many more.
HCPF’s Proposed Fiscal Year 2026-2027 Budget. On October 31, the Governor released his budget for fiscal year (FY) 2026-27. It reflects the most fiscally constrained environment Colorado has faced in recent memory. State revenues continue to be challenged by the Taxpayer’s Bill of Rights (TABOR) limits, the end of federal stimulus funds, and the ongoing impacts of H.R. 1, which reduces federal matching funds for Medicaid and creates new administrative requirements.
HCPF represents about one-third of the state’s General Fund. We are grateful for our allocation in the Governor’s FY 2026–27 proposed budget of $20.6 billion total funds, including $5.99 billion General Fund for Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+). HCPF’s proposed annual budget represents an increase of $2.3 billion in total funds, $413 million increase in General Fund and 32% of available state General Fund. Approximately 96% of this funding goes directly to providers who deliver care to our members. The budget also includes reductions of $537 million in total funds, including $217 million General Fund. That means the FY 2026-27 budget of $20.6 billion total fund, including $5.99 billion General Fund, is net of the $537 million total fund and $217 million General Fund reductions. HCPF’s budget recognizes the need for Colorado to balance its budget in light of the state’s budget deficit fueled by our Medicaid cost trends, TABOR revenue limits, revenue reductions due to H.R. 1 that resulted in the August Special Session, and future H.R. 1 federal funding reductions like the Provider Tax. We will continue to work with stakeholders to leverage the Medicaid Sustainability Framework as we navigate this difficult chapter.
Given the fiscal challenges Colorado faces, on October 31 as part of the budget release, the Governor issued Executive Order D25 020 to make additional FY 2025-26 reductions, which include $13.5 million in new HCPF general fund reductions, $41.7 million total fund reductions. All reductions included in the Executive Order D25 014, signed August 28, 2025, remain in effect. HCPF is requesting all Executive Order reductions be extended into FY 2026-27. These measures target outlier trends, promote program integrity, and preserve member coverage while minimizing service impacts. We expect additional reductions to be released in January 2026 through the supplemental and budget amendment processes, impacting both FY 2025-26 and FY 2026-27. The January reductions will further slow unsustainable Medicaid trends and help achieve a longer-term goal of bringing Medicaid cost trends more in line with TABOR. We deeply appreciate your collaboration and shared commitment to sustainability.
While these reductions are difficult, they are part of a broader effort to stabilize Medicaid cost trends and maintain access to care. Medicaid cost trends remain elevated, outpacing revenue growth and driving the need for cost management. Our ongoing work with a third-party consultant to benchmark Colorado’s Medicaid program against other states will provide valuable insights to refine cost management strategies, reimbursement methodologies, and policy approaches. Findings expected this winter will help inform both our FY 2026–27 and FY 2027–28 budget planning.
HCPF submitted the Rural Health Transformation Program (RHTP) application to the Centers for Medicare and Medicaid Services (CMS) on November 4. The RHTP is designed to transform the existing rural health care infrastructure and build sustainable health care systems that expand access, enhance quality of care, and improve outcomes for members. This federally funded opportunity will provide grants totaling $50 billion from Federal Fiscal Year (FFY) 2026 through FFY 2030, with $10 billion available each year. Half of the funding will be evenly distributed to all states with approved applications, totaling an estimated $100 million per state per year. The other half will be awarded to approved states based on individual state scored metrics and applications that reflect the greatest potential for, and scale of impact, on the health of rural communities. CMS is expected to announce awardees by December 31, 2025. For more information and to sign up for the RHTP newsletter, please visit our website. HCPF and the Colorado Rural Health Center will be hosting a joint webinar on December 2 from 10 to 11:30 a.m. to provide an overview of the RHTP application and walk through the next steps in the program process. Please register here.
In addition to the RHTP, HCPF continues to prepare to meet the requirements of H.R. 1 mandates, including Work Requirements, six-month eligibility redeterminations, federal funding clawback risks, and more. These H.R. 1 federal mandates will create administrative burden for members, county partners and Medical Assistance sites, while requiring new technology investments to build the necessary administrative systems while increasing eligibility processing staff to handle the workload. The loss of coverage due to H.R. 1 will also impact members, care providers, and our economy. We will be working with members, providers and stakeholders to mitigate those negative impacts in the coming months. We thank you in advance for your partnership on this important, collaborative work.
How You Can Engage. We will continue to engage with stakeholders throughout the month to gather feedback on all this important work.
To submit a question or comment related to H.R. 1, please use our online form. You can also email us at hcpf_HR1@state.co.us. We are deeply grateful for your partnership and support.
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