Colorado lawmakers limit health care enrollment for immigrant children, but raise cap on dental benefits as budget talks conclude 

After weeks of wrestling with how to rein in spending on a program providing health coverage to immigrants, Colorado lawmakers gave final approval Tuesday, April 28, to a proposal to limit enrollment and end certain benefits starting this year. 

Lawmakers in the House and Senate approved a plan put forward by the legislature’s Joint Budget Committee as part of the state’s overall budget package for the 2026-27 fiscal year, which begins July 1.

The vote comes after much back-and-forth between the two chambers and the budget committee over how to deal with skyrocketing costs for Cover All Coloradans, which provides similar coverage to Medicaid for low-income immigrant children and pregnant women, regardless of immigration status. The program, which went into effect in 2025, has cost the state more than six times its original estimate. 

“What we had was a program that was growing unsustainably,” said Rep. Kyle Brown, D-Louisville, one of six lawmakers who sit on the budget committee that crafts the state’s annual spending plan. “We took some measures, which I think are difficult but necessary for the short-term, to understand what’s going on with the program and make sure we are controlling costs.” 

The proposal, which now goes to Gov. Jared Polis along with the rest of the budget package for his signature, would cap enrollment for children 18 or younger at 25,000 per year. As of February, enrollment was around 28,000 people, about 20,000 of whom were children, according to the Colorado Department of Health Care Policy and Financing, which oversees the state’s Medicaid programs. 

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Lawmakers also voted to cap dental benefits and end long-term care services for new enrollees, which originally was projected to cut roughly $12.9 million from the program next fiscal year. 

The budget committee, however, decided to raise the dental cap of $750, which they initially proposed, to $1,100. The move was intended as a compromise after House Democrats pushed to preserve much of the program during budget debates.

House lawmakers had successfully passed an amendment to the budget committee’s plan that would have eliminated the enrollment and dental cap. Rep. Lorena Garcia, D-Adams County, who brought the amendment, said it would have helped “make the pain just a little bit less.” 

Those changes were reversed in the Senate, punting the issue back to the budget committee, which ultimately decided to keep the enrollment cap but raise the limit on dental benefits. The House and Senate then voted to repass the plan. 

“I’m glad that we were able to (in the budget committee) provide a little bit better benefit for folks in the dental benefits, because those are some of the most utilized benefits in Cover All Coloradans,” Brown said. 

The changes to Cover All Coloradans are among a plethora of spending cuts that lawmakers approved this year to close a roughly $1.5 billion shortfall in next fiscal year’s state budget. 

Part of the reason for the shortfall is due to revenue constraints under the Taxpayer’s Bill of Rights, or TABOR, a 1992 voter-approved amendment to the Colorado Constitution that limits state revenue growth to the rate of population growth plus inflation. 

The state is also spending more to deliver programs created by lawmakers, like Cover All Coloradans, which was originally projected to cost $14.7 million in its first full fiscal year. Instead, the program will end up costing the state over $104.5 million for the fiscal year that began on July 1 and runs through June 30, according to fiscal analysts. 

Funding for children in the program comes from state dollars, although the state uses some federal funding to cover pregnant women. 

The discrepancy is largely driven by more immigrants enrolling in the program than initially expected, as well as an underestimation of the cost of providing services to children.

“This is a population that is very hard to estimate,” the Colorado Department of Health Care Policy and Financing wrote in an emailed statement. “Subsequent to the passage of the legislation, we had the largest migration into the U.S. since the late 19th century.”

Republican critics have pointed to Cover All Coloradans as an example of spending that goes beyond the scope of what the legislature should be doing. 

“We can’t afford to keep overspending on programs that are not core to our government, core to what we are supposed to be doing as legislators here at the state Capitol,” Sen. Barbara Kirkmeyer, R-Brighton, one of two Republicans who sit on the budget committee, said in a recent interview. 

Kirkmeyer, who is also a candidate for Colorado governor this year, said the enrollment cap on Cover All Coloradans is a “good first step.” 

Immigrant advocates warn that the cuts to health care benefits will cost money down the road in the form of more emergency room visits and uncompensated care, further straining the state’s health system. 

“I think some of the cuts to various programs, including this one, will have long-term consequences,” said Alex Sanchez, president and CEO for the Western Slope-based immigrant advocacy group Voces Unidas. 

Brown said he hopes that if Colorado’s budget environment improves in future years, lawmakers can reverse cuts that were made to Cover All Coloradans. 

“I believe that health care is a right, not a privilege,” Brown said, adding, “especially when we’re talking about kids … they deserve to be able to go to the doctor, they deserve to be able to go to the hospital and not worry about whether they can pay for it.”