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.
Lawmakers Move To Rein In Spending
Last week, the JBC voted to end long-term care benefits for children under Cover All Coloradans beginning July 1 and to cap dental benefits at $750 per year. Supporters say the trims are needed to keep the program sustainable, while opponents argue the changes will leave vulnerable kids and families with serious gaps in care. Republicans, including Sen. Barbara Kirkmeyer, pushed to scrap Cover All entirely, while Democrats like Sen. Jeff Bridges urged a more measured approach and House Speaker Julie McCluskie pointed to unanticipated impacts when the program was enacted. The policy changes and the partisan tug-of-war were detailed in reporting by The Colorado Sun.
Federal Dollars And The Math
One reason legislators are eyeing cuts is where the money comes from. Colorado funds children's coverage under Cover All entirely out of the General Fund, while pregnant people's care still qualifies for a federal match, so trimming children's benefits has an immediate and direct impact on the state budget. HCPF and the governor's budget materials have warned that pending federal policy shifts and changes in match rates could complicate long-term cost projections and make the program even harder to budget for. The department's Cover All Coloradans pages include FAQs, toolkits and outreach guidance for communities and providers working through those rules; see the Colorado Department of Health Care Policy and Financing for resources.
The program's future now moves from staff memos to a full-blown legislative fight. The Joint Budget Committee's proposed changes will go to the full legislature as lawmakers finish drafting the FY 2026-27 budget in the coming weeks, and any permanent rewrites will require votes in both chambers. Whatever they decide will shape how Colorado balances immigrant-inclusive coverage with competing priorities in schools, health care and social services. Joint Budget Committee staff note that lawmakers face a tight calendar to act before the fiscal year that begins July 1, and their analysis is available from Joint Budget Committee staff.
