House adopts health-care supplemental after heated debate over uncompensated care and migrants

The Colorado House of Representatives on Feb. 12, 2025 adopted Senate Bill 93, a supplemental appropriation to the Department of Health Care Policy and Financing, after extended floor debate about uncompensated care and whether migrant arrivals were driving hospital costs.

The bill, moved on the floor by the majority leader, passed on third reading and final passage by a 43–22 margin. The tally was announced after members voted by the electronic machine: “With 43 I, 22 no, and 0 excuse, Senate Bill 93 is adopted.”

Supporters said the supplemental is a routine budget “true-up” to cover higher-than-expected utilization and enrollment in state health programs. Representative Yadira Sirota, a supporter, said, “This is a supplemental bill. We run supplementals to make adjustments mid year to the budget … We made projections and those projections have changed based on utilization.” Sirota told colleagues the largest increases were tied to Medicaid enrollment and higher per-person costs for medical and behavioral-health services.

Opponents framed the vote as a question of priorities and fiscal accountability and repeatedly linked uncompensated care to migration. Representative Justin DeGraaf said opponents were resisting what he called a recurring state burden created elsewhere: “My opposition to the supplemental is that this uncompensated care is largely driven by the migrant crisis that we have here in Colorado.” Representative DeGraaf and others quantified the strain in different ways during debate; DeGraaf cited $13,900,000 in uncompensated care while urging the House to address root causes rather than approve additional supplementals.

Several members raised concerns about rural hospitals and local capacity. Representative Erin Richardson (speaking in a separate bill debate) and others noted closures and service reductions in rural areas; Representative Melissa Johnson described calls from constituents facing multi-hour drives for maternity care and said rural hospital losses could impose large out-of-pocket costs on families.

Representative Troy Marshall pushed back on characterizations that the debate was about denying care. He asked colleagues on the floor, “Are you gonna demand before any treatment starts documentation and papers or are the physicians going to immediately try and help that child?” Marshall said denying emergency treatment is not what the debate is about and urged support for the supplemental to avoid destabilizing hospitals.

Other supporters framed the appropriation as consistent with policy choices the General Assembly has already made, such as expanding coverage for children. Sirota said programs like Cover All Coloradans and state reinsurance aim to reduce long-term uncompensated care by increasing access to preventive services.

The transcript shows a sustained, often partisan exchange on the floor that mixed budget technicalities with broader policy disagreements — including immigration, state budgeting choices and priorities for severance tax revenue. After debate concluded, the House proceeded to the recorded vote and adoption of the bill on third reading. The transcript does not record further steps after final passage in the House.