Colorado Medicaid Mismanagement Raises Concerns

Whenever healthcare challenges arise, Colorado policymakers are quick to point fingers at Washington, D.C. Lately, they’ve blamed policies they disagree with and the potential expiration of COVID-era insurance tax credits for the barriers to Coloradans’ healthcare access. But the numbers tell a different story.

Under Governor Jared Polis and the Colorado Department of Health Care Policy and Financing (HCPF), the state’s Medicaid program has been plagued by mismanagement, red tape, and bureaucratic failures, with devastating results for patients and taxpayers. The potential effects of the combined federal proposals pale in comparison to the consequences of the state’s own redetermination crisis following the end of the COVID-19 pandemic.

When the COVID-19 public health emergency ended in 2023, states were required to reassess who qualified for Medicaid coverage. Most states took the time to do this carefully. Colorado didn’t, which began the redetermination disaster that the state is still trying to find its way out of.

HCPF has been busy not caring for patients but instead expanding its own budget and payroll. Since 2018, the agency’s budget has ballooned by 83 percent, and its full-time staff by 81 percent, even as it covers fewer Coloradans. The number of Medicaid patients per employee has dropped nearly in half.

Meanwhile, HCPF automatically disenrolled 41 percent of Medicaid recipients—more than 700,000 people—without even checking whether many were still eligible. That makes Colorado one of only three states (and the only blue state) that now has fewer Medicaid enrollees than before the pandemic. While reducing the number of government program beneficiaries can certainly be a good thing, it must be done the right way. 

This wasn’t about tightening eligibility. It unfortunately amounted to bureaucratic incompetence, and patients were often the last to know about it. Thousands of families only discovered they were uninsured when they sought care. The uninsured rate in Colorado has since jumped from 6.7 percent to 7.9 percent. Among children, it climbed 50 percent in a single year.

Colorado policymakers should focus on getting their own house in order before pointing blame at other policies. They need to fix what’s broken by streamlining enrollment, modernizing outdated systems, and ensuring that healthcare dollars actually follow the patient, not the bureaucracy.

It is time for accountability in Colorado state leadership. The results are clear: patients have fewer options, hospitals are struggling, and taxpayers are spending more for less. Meanwhile, HCPF continues to expand its bureaucracy and divert funds away from the very people it’s supposed to serve.

States should be accountable for managing access to care with the finite and valuable taxpayer dollars in their coffers. They should not be passing the buck to Congress when their own decisions make things worse.