Colorado General Assembly establishes new Medicaid buy-in fund and support board

On April 23, 2025, the Colorado State Legislature introduced Senate Bill 228, a significant legislative measure aimed at enhancing access to medical assistance for low-income individuals, particularly those with disabilities. This bill seeks to streamline the Medicaid buy-in programs for adults and children with disabilities by establishing a new funding structure that promises to improve the sustainability and affordability of healthcare services in the state.

The primary purpose of Senate Bill 228 is to repeal the existing Medicaid buy-in cash fund and replace it with the Healthcare Affordability and Sustainability Medicaid Buy-In Cash Fund. This new fund will receive premiums paid by participants in the Medicaid buy-in programs, which are based on family income. The bill also establishes a Medicaid Buy-In Enterprise Support Board within the Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) to oversee the implementation of these programs and consult on premium amounts and other essential components.

One of the key provisions of the bill is its alignment with the Taxpayer's Bill of Rights (TABOR), allowing CHASE's revenue to remain exempt from state fiscal year spending limits. This aspect has sparked discussions among lawmakers regarding fiscal responsibility and the long-term implications for state budgets. Proponents argue that the new structure will provide a more reliable funding source for healthcare services, while critics express concerns about the potential for increased premiums and the sustainability of the program in the long run.

The bill has garnered attention for its potential economic and social implications. By improving access to healthcare for low-income individuals with disabilities, it aims to reduce health disparities and promote better health outcomes within these vulnerable populations. Experts suggest that this could lead to decreased reliance on emergency services and lower overall healthcare costs for the state.

As the legislative process unfolds, stakeholders are closely monitoring the bill's progress. Advocates for disability rights and healthcare access are hopeful that Senate Bill 228 will pave the way for more inclusive healthcare solutions in Colorado. The next steps will involve further discussions and potential amendments as lawmakers weigh the benefits and challenges of this significant healthcare initiative.