Colorado Democrats fear deep health care consequences in federal spending bill
A view of the Colorado Capitol in Denver on June 6, 2023. (Quentin Young/Colorado Newsline)
Colorado Democrats and health care providers are warning of dire consequences for patients who rely on Medicaid for insurance coverage if the federal spending bill becomes law.
The bill passed the U.S. House of Representatives by one vote last week and now sits in the U.S. Senate, where it could be largely rewritten. It could take most of the summer to shepherd a final version of the bill to President Donald Trump's desk.
Colorado's four Republican House members voted for the bill and the four Democrats in the delegation voted against it. The bill enacts much of Trump's domestic policy agenda, including an extension of the 2017 tax cuts, and Republicans argue it targets waste and fraud in government spending.
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Some of the House-approved bill's most sweeping provisions are changes to Medicaid, the nation's health care program for low-income people that covers roughly 1 in 5 Americans. The changes include new work requirements for most people, more frequent eligibility checks and elimination of federal matching funds for some types of care, including gender-affirming care.
Those modifications would amount to about $700 billion in cuts over the next decade, according to the nonpartisan Congressional Budget Office.
It would also mean fewer people enrolled and more cost-sharing for states, which are in charge of administering Medicaid programs. Democrats wrote in a letter to the state's congressional delegation this week that Colorado's hospitals, clinics and other providers could lose up to $990 million in annual federal Medicaid funding.
'The intent is to have people dis-enroll to save money in the short run. Make no mistake about it,' Dr. Steve Federico, the chief of government and community affairs at Denver Health, said during a virtual press conference on Thursday with legislative leaders and health care providers. 'Ultimately, all health systems will see more patients who cannot afford to pay, thus seeing uncompensated care, which hurts all of us. These costs will stress health systems' ability to care for patients, to provide needed appointments or to buy necessary medications or supplies. Hospitals and communities across Colorado will be at risk of decreasing services, decreasing access, or closing their doors all together.'
When hospitals provide uncompensated care, some of the costs ultimately get shifted to people with private insurance through higher premiums.
Ultimately, all health systems will see more patients who cannot afford to pay, thus seeing uncompensated care, which hurts all of us.
– Dr. Steve Federico, chief of government and community affairs at Denver Health
Sen. Jeff Bridges, a Greenwood Village Democrat who chairs the Legislature's Joint Budget Committee, said an increase in administrative work could cost the state about $57 million and require thousands of new case managers. Lawmakers passed an ultra-tight budget this year that already required about $1 billion in cost-saving measures to absorb the cost of the state's Medicaid program.
'(Republicans in Congress) talk about waste in government. This is $57 million that will be spent on admin and not health care. And this isn't a huge problem — we're not seeing $57 million worth of health care provided to people who don't qualify,' he said.
Democratic lawmakers said the proposed Medicaid cuts could result in 11% to 18% of participants losing coverage.
That could include Veronica Montoya, a Denver resident who began relying on Medicaid after her chronic illnesses made it difficult to work. Her coverage has made it possible to get appropriate and effective care, she said.
'I'll be on this medicine for the rest of my life, God willing, because it has helped. But if I lose this medicine, I don't see a very good future,' she said. 'I think about what these proposed cuts would do to me and I wonder how a silencer is more important than something that keeps me able to still function and have a life.'
The bill includes the elimination of a customer tax on firearm silencers.
The Colorado Legislature, which completed its regular 2025 session earlier this month, might need to reconvene for a special session if deep Medicaid cuts go through in order to find a solution that keeps the program functioning. House Speaker Julie McCluskie, a Dillon Democrat, said Thursday no decisions on a special session had been made yet.
'Obviously there's a great deal of uncertainty at the moment. Whether or not a special session is in our future will depend on the impacts that ultimately are felt by the passage of the budget this year at the federal level,' she said. 'So no decisions or determinations have been made on what our response will be — whether that is something that comes in a special session or next legislative session.'
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