Senate appropriations panel advances bill to end new Medicaid benefit for community health workers after hours of testimony

The Senate Committee on Appropriations advanced Senate Bill 25-229 after hearing roughly two dozen minutes of witness testimony and a round of floor questions from committee members. Senator Jerry Bridges moved the bill; amendment J001 was adopted before the roll call.

The measure would end a Medicaid reimbursement benefit for community health workers (CHWs), patient navigators and promotores that the Legislature enacted in 2023. Supporters of the benefit told the committee that the state had already invested in implementation and that repealing the benefit would forfeit federal matching dollars and undermine ongoing programs.

The witnesses who urged the committee to vote no included Andrea Dwire, who identified herself as with the Alliance of Colorado Community Health Workers, Patient Navigators, Promotores de Salud and as a public health practitioner at the University of Colorado School of Public Health. “Please oppose Senate Bill 25-229,” Dwire told the committee, saying Colorado programs were already using planning grants and other state funds in anticipation of the Medicaid benefit. She cited analyses she said showed returns on investment and savings when CHWs are reimbursed through Medicaid.

Mary Faltinski of Boulder County Public Health described concrete examples in which home-visiting CHWs helped families avoid emergency care and ensured follow-up appointments. “Medicaid reimbursement for community health workers has been part of a larger public health plan to shore up funding deficits for several years,” Faltinski said, asking the committee to reject the repeal.

Speakers from hospitals and statewide health organizations also opposed the repeal. Andrea Stoysavelovich, senior policy coordinator, Government Affairs, at Children’s Hospital Colorado, said the state has already spent implementation money and that losing the benefit would also risk federal match funds: “Elimination would not only mean the loss of the investment thus far, but also the federal funding,” she said.

Sarah Froelich, executive director of the Chronic Care Collaborative, summarized research and Colorado program experience supporting CHW involvement in chronic-disease prevention and management and asked senators to vote no. Kelly Herb Zager, representing rural providers, described a rural hospital that hired a community health worker in anticipation of the benefit and said the hospital’s program would be jeopardized if the benefit were repealed.

Committee members pressed sponsors for fiscal detail during floor questioning. Senator Cinthia Coker asked whether the state’s $3.4 million expenditure would bring $8.2 million in federal matching funds, a ratio the record showed as roughly 2.36 to 1 if the figures cited in committee comments are correct. Sponsor Senator Bridges responded that the fiscal note prepared for the 2023 bill did not include realized savings from the program and that the committee was not assuming savings in the current budget calculus.

Bridges framed the repeal as a difficult budget choice made because the program had not yet gone into effect and therefore had no enrolled beneficiaries relying on it. “This is eliminating a program that has not started,” Bridges said during questions. Several other senators said the decision was painful but necessary amid the committee’s broader work to address a structural budget gap.

Before the final roll call on the amended bill, the committee adopted an internal amendment marked J001. The roll call recorded in the transcript shows Senators Gonzales (aye), Kirkmeyer (aye), Coker (no), Liston (aye) and Pelton (aye); those five named votes in the record result in four recorded ayes and one recorded no from the explicitly named votes captured in the transcript. The committee chair recorded the bill as passing the committee.

Supporters of the CHW Medicaid benefit told the committee the state had begun implementing the program and that Medicaid reimbursement offers a sustainable funding path for community-based workers who help patients navigate care, address social needs and reduce higher-cost health care use. Opponents among the committee framed the vote as a necessary cut to balance the state’s budget in the near term.

The committee’s action advances the bill for additional steps in the legislative process; sponsors and witnesses said they may pursue amendments on the floor or consider ways to protect local programs already invested in CHW capacity.

Votes and formal actions recorded for this bill are in the committee record; the transcript identifies multiple witnesses who urged the committee to oppose the repeal and documents committee discussion about federal match, implementation costs and budget tradeoffs.

That debate ended with the committee adopting J001 and advancing the amended bill by recorded voice and roll call.

Ending: The committee’s vote clears the bill for later floor consideration and sets up a likely dialog on the Senate floor about preserving local programs, potential hold-harmless language and the value of federal matching funds as the Legislature finishes its budget work.