Colorado’s EMS savings promise: Too soon to celebrate

By Cory Gaines | Commentary, Colorado Accountability Project

I thought the headline of the KUNC article below was quite provocative. The title is, in full, “Ambulance services would get funding boost while saving Colorado millions under new bill.”

Bit too certain, I thought. Not so much the first part, but the latter bit: “…while saving Colorado millions.”

First, to the bill. The KUNC article is linked first below, with the bill underneath it. Screenshots 1a and 1b are the summary of what the bill does from its fiscal note.

Skipping a lot of detail the bill allows EMS workers to do more treatments “in place”, where and when they are called out or encounter someone needing medical attention in lieu of scooping everyone up and taking them to the ER regardless of the reason for the call. Additionally, it lets EMS bill Medicaid for this service, something they’re not allowed to do now.

This expansion of both practice and billing is justified by how much money our state will save: fewer people will go to the ER, and paramedics are cheaper than docs and nurses.

But what justifies the claim KUNC makes in their headline, that it will save millions?

Returning to the bill’s fiscal note, you will see their estimate of the bill’s fiscal impact on the state starting on page 3 and continuing forward. There is much more detail, but I took a screenshot of Table 2A (attached as screenshot 2) so you could get an overview.

The reason for my skepticism about both KUNC’s and the Legislative Council Staff’s claims about the savings this bill will produce stem from the fact that I have a memory longer than that of a goldfish’s.

Time and again (wolves, the impact of HR1, the Big Beautiful Bill, etc.) we’ve seen forecasts by the LCS go wrong. Things haven’t quite worked out the way they wanted and/or changing circumstances have changed the numbers. See also screenshot 3 (from the bill’s fiscal note) about potential costs that were not included in these estimates.

I’m not saying that the bill can’t or won’t save money. I am saying it’s too early for claims about it. Nonetheless, it seems as though legislators of both parties have gotten on board with the concept. Screenshot 4 shows the vote breakdown for the Colorado House (the only place where there had been votes taken when this was written).

62 “AYES” and 3 “OTHERS” doesn’t happen without broad support.

I’ll leave with you with an important question.

What do you suppose will happen with any savings in public money produced by this bill? Figure you’ll get that back in refunds or via TABOR?

Ah, I kid. We know it’ll get spent elsewhere. Perhaps another one of those costly HCPF oopsies.

**Boy if there’s one thing our state needs it’s more things to bill to Medicaid!

https://www.kunc.org/politics/2026-03-04/ambulance-services-could-get-funding-boost-while-saving-the-state-millions-under-new-bill

https://leg.colorado.gov/bills/HB26-1069

When the bill comes due on pregnancy and childhood medical care for illegal immigrants

Per a recent Colorado Sun** article (liked first below), a 2022 bill (linked second below) which extended Medicaid coverage to pregnant “people” and their offspring regardless of immigration status, will cost the state a lot more than originally predicted.

Quoting the Sun article with link left intact:

“Providing health care to children and pregnant people who would qualify for Medicaid if not for their immigration status will cost Colorado more than six times what was projected this year. Because of higher-than-forecast enrollment, the state is expecting that the Cover All Coloradans program will cost the state $104.5 million in the fiscal year that began July 1. When Democratic state lawmakers passed a bill in 2022 launching the health insurance safety net initiative, nonpartisan fiscal analysts estimated the price tag would be $14.7 million for 2025-26.”

Yeah, I guess that when you offer free stuff to those here illegally compounded with turning your state into a safe haven for those here illegally, you end up with cost overruns for a publicly-funded health care program for those here illegally.

People respond to incentives.

Not that the Democrats who pushed this seem to have a sense of the likely consequences of their actions, and/or any remorse for what their choices have done to the state budget.

READ THE FULL COMMENTARY AT COLORADO ACCOUNTABILITY PROJECT

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