Last summer, the General Assembly convened a special session to make quick fixes to an $800 million budget shortfall. Lawmakers put Band-Aids on the problem, which is back again in the current legislative session.

A sizeable part of that fiscal crisis stems from health-care costs, particularly Medicaid — the result of legislative social engineering, not expanded Medicaid rolls.

A new report from the nonpartisan Common Sense Institute makes that clear. It found that spending by Colorado’s Department of Health Care Policy and Financing surged by 101% in the past decade — from $8 billion in 2015 to $16 billion in 2025.

That’s well above overall state budget growth, which was “only” 64%.

The biggest culprit is Medicaid spending — and 182 health care bills passed since just 2019, by CSI’s count, that have cost the state an estimated $858 million per year. That’s alongside a near-equivalent amount in federal matching funds.

That’s theoretically enough to cover the entire shortfall.

Between 2018 and 2024, enrollment increased by 7.6%. Those numbers dramatically inflated during the pandemic, dipping back down to 2015 levels between 2023 and 2025.

Yet since 2018, the health department’s full time employment jumped 72%. Administrative spending doubled.

CSI concluded the department could otherwise have held spending down to $10.8 billion last year. That’s more than 2015 but a lot less than what was actually spent thanks to “expansive policy and other nonessential spending” that surpassed “the combined growth rates of Medicaid enrollment, medical inflation, and obesity.”

The bottom line, per CSI: “HCPF is spending more than is strictly necessary to deliver its services.” 

Why? Lawmakers, determined to tinker with health care policy, have driven up compliance and administrative costs that have nothing to do with quality of care.

Those 182 bills have their costs, yet the legislature has audaciously blamed fiscal limits under the Taxpayer’s Bill of Rights. As The Gazette reports, the state’s “Medicaid Sustainability Framework” argued that the program’s growth consistently outpaced revenue growth allowed under TABOR, generating budgetary pressures.

CSI’s report exposes that conclusion as incorrect. This isn’t about TABOR. It’s about Medicaid as a centerpiece of poor state budgeting.

Given a doubling in Medicaid spending, is it any wonder Colorado has experienced massive Medicaid fraud?

As The Gazette reported, Medicaid dramatically loosened the state’s reimbursement structure, resulting in $25 million in unusual billings over a four-month period two years ago, as enrollment was peaking. Numerous new providers suddenly got in on the action. Dozens of them were suspended, and a new law was passed.

Prosecutors recently charged two transportation providers for defrauding Medicaid’s non-emergent medical transportation program of millions of dollars. Allegations include billing rides given to family and friends, for impossibly long distances — or that never even happened.

In 2021, an advisory panel claimed Medicaid was underpaying transportation companies. It recommended substantial rate hikes based on a faulty analysis.

Changes to the state’s formula, based on that analysis, enabled providers to charge much higher reimbursement rates for non-emergent transportation, ultimately costing $300 million annually.

But Medicaid fraud is just a symptom of a fiscal disease. The legislature keeps treating Colorado’s budget woes as an emergency requiring emergency fixes. In reality, they’re self-inflicted wounds.

Until lawmakers start treating health care as a fiscal responsibility and not a vehicle for expansive social policy, legislative Band-Aids will keep coming.