While Colorado cuts care for its most vulnerable, it continues funding undocumented children in a $96 million program

By Shaina Cole | Contributing Writer, Rocky Mountain Voice

“This is selfish.” That’s how Jon Caldara opened his April 1 column, writing not about politics, but about his son. He leads Denver’s Independence Institute and has long been a free-market voice in Colorado.

“My son, Chance, has Down syndrome,” Caldara shared. “This 21-year-old man cannot consistently count to five, can’t read and can’t write his own name. He needs constant supervision for choking risks. He still needs help toileting. And that’s just the start.”

Medicaid, Caldara wrote, “was designed for people like him, our most vulnerable. And I am grateful for it. This is the funding he requires to live.”

The Colorado legislature is in the process of cutting it — not because the state determined Chance and people like him don’t need it, but because it is running out of money. 

A significant reason it is running out of money is a program it created in 2022 to provide Medicaid-equivalent coverage to undocumented children. That program, Cover All Coloradans, was projected to cost $10 million this fiscal year. It is now projected to cost $96.3 million — with not a single dollar of federal matching funds attached to the children’s portion.

The families of Colorado’s most disabled citizens are asking a simple question: Why?

A Program That Blew Past Every Projection

Cover All Coloradans was created by HB 22-1289 and signed into law in 2022 by Governor Jared Polis. 

When the bill passed, Legislative Council Staff estimated it would cost $10,031,139 in General Funds for FY 2025-26, built on an enrollment assumption of approximately 1,311 children. 

The fiscal note acknowledged the estimate was likely conservative: “for children, little utilization data is available, resulting in what is likely a conservative estimate.” 

The legislature proceeded anyway.

Actual enrollment of children in FY 2025-26 is 20,470. That is a 1,461 percent enrollment over initial projections. The state is now projecting the children’s program will cost $96,265,223 in General Funds in FY 2026-27. Every dollar is state taxpayer money. The JBC Staff Figure Setting states it plainly: “The services are paid with the General Fund. There is no federal match.”

Caldara wrote, “Their ‘Cover All Coloradans’ program to give illegal immigrants Medicaid benefits wasn’t supposed to cost much. Just $14.7 million taken from folks like Chance. It’s now pushing $105 million. That’s a 611 percent miss.”

The disability cuts did not originate in the legislature. Governor Polis initiated them through executive orders issued in August and October 2025, directing a combined $616 million in reductions to HCPF as Colorado scrambled to close a budget hole created when Congress passed the federal “One Big Beautiful Bill Act.” 

The Long Bill now before the legislature converts those executive-ordered cuts into permanent law. 

When Polis announced the August cuts, he left Cover All Coloradans coverage untouched — reducing only $130,000 in outreach funding for the program. The disability cuts that followed were made by the same governor who signed Cover All Coloradans into law and who chose, at every step, not to reduce its enrollment.

Six Cuts. One Fiscal Year. All Landing on the Same People.

In the same budget year that Cover All Coloradans children will cost $96.3 million in state money, Colorado is imposing six simultaneous cuts on its disability community — compounding, concurrent, and all hitting the same population.

The DD waiver waitlist, already at 2,749 people waiting an average of seven years, is being extended further by cutting the rate at which new people enter the program by 50 percent. For every two people who leave, only one new person gets in. The JBC Staff Budget Briefing states plainly that “this proposal will increase the length of time and number of individuals on the waitlist” — projecting it toward 14 years, erasing a decade of progress. Year 1 General Fund savings: $3.2 million.

Children with disabilities who turn 18 have long been automatically placed into adult DD waiver services. That pathway is eliminated. They now go to the back of a 14-year waitlist, with a statutory exemption only for foster youth. Year 1 General Fund savings: $7.6 million.

Casey Barrett’s 15-year-old daughter Olivia cannot speak. She uses a wheelchair. She requires supplemental oxygen to breathe. Barrett is her caregiver around the clock — and the state pays him for that work. 

Under the new budget, those compensated hours are capped at 56 per week. For a child like Olivia, 56 hours does not come close to covering what her care actually requires. 

Barrett is not an outlier. Across Colorado, parents have left careers to provide full-time care for adult children with feeding tubes, oxygen machines, and seizure disorders. 

The cap hits all of them the same way. “The finances that we would need to just maintain would be gone,” Barrett said. Year 1 General Fund savings: $1.1 million.

Beyond those three cuts, the state is requiring disabled adults to contribute their own income toward residential care costs, slashing community outing hours for disabled children by half, and cutting family homemaker service hours from 10 to 5 per week.

Taken together, the six cuts save approximately $25.9 million in General Funds in Year 1. Cover All Coloradans children will cost $96.3 million in the same year. 

Every disability cut combined saves less than 28 cents for every dollar spent on the undocumented children’s program. The DD waiver and disability services draw approximately a matching federal dollar for every state dollar spent. Cover All Coloradans children draw nothing.

This is also happening as a separate federal audit found $77.8 million in confirmed improper Medicaid payments for autism therapy in Colorado — with an additional $207.4 million under question — a program the state gave a rate increase to, while the audit was already underway.

What HB 26-1411 Does — and Doesn’t Do

The bill’s conservative supporters hoped HB 26-1411 would impose meaningful limits on Cover All Coloradans. What Rep. Lorena Garcia’s floor amendment left them with on April 9, after second reading, was something narrower. 

The outreach mandate — HCPF’s standing directive to recruit eligible immigrants into new coverage options — is gone, cutting off state-funded promotion of a program already running nearly $70 million over its original projection. 

The bill also ends managed care and Accountable Care Collaborative access for participants beginning January 1, 2027, and bars undocumented children from long-term services and supports on the same date. It’s a start, but more limits were included in earlier versions of the bill.

What Rep. Garcia stripped out matters more. 

The original bill included a hard spending trigger. If enrollment crossed 25,000 children or quarterly costs exceeded their proportional share of the annual appropriation by five percent, new enrollment would freeze. That mechanism is gone. So is the $750 annual dental cap. Neither survived to the engrossed version.

In their place, the amendment added something entirely different: $6,178,751 in new General Fund dollars allocated directly to Cover All Coloradans children. 

The offset came from reducing daily payments to two private correctional facilities — Bent County and Crowley County — from $77.16 to $71.85 per inmate. The legislature found room in the prison contract budget to fund the same program the bill was supposed to rein in.

When the legislature needed $6 million to continue covering undocumented children, it found the money — by cutting private prison contracts. 

When Colorado’s most severely disabled citizens and the parents who provide their round-the-clock care faced $26 million in cuts, no equivalent offset was found. 

Lawmakers applied different budget strategies to the two populations.

“The State Will Still Find Plenty of Money for People Who Never Needed It”

Caldara writes that he will find a way to keep Chance housed and cared for. Other families will not.

“With half the money needed to hire caretakers, therapies, food, transportation, rent and supplies, families will be forced to forfeit their own children to an institution or group home. Basically, these cuts will force parents to give their vulnerable adult children to the state.”

“My son will lose half the help he needs to live. But don’t worry. The state will still find plenty of money for people who never needed it in the first place.”

Colorado now spends $1 in every $3 of its General Fund on Medicaid. As Caldara notes, since 2009 Colorado’s population grew roughly 20 percent while Medicaid enrollment grew 200 percent. Caldara argues it is “a policy choice,” not a demographic shift.

The disability community did not make that policy choice. They are paying for it.