HB 26-1411

HB 26-1411, which has been signed into law, changes Colorado's medical assistance program by limiting benefits for pregnant women and children based on income and immigration status. Starting in 2027, it caps dental services at $750 annually, restricts behavioral health services to fee-for-service only, removes coverage for certain collaborative care programs, and limits home- and community-based services for some low-income immigrant families unless they already receive these services by the end of 2026. Additionally, the bill sets a cap on enrollment for children in the state medical assistance program and eliminates the state's children’s basic health plan. These changes will affect eligibility and coverage for thousands of Colorado residents who rely on public healthcare programs.

Official Summary

Joint Budget Committee. The bill limits the benefits pregnant women and children with a certain family household income and citizen or immigration status are eligible for under the state medical assistance program and the medical assistance program.     Eligible pregnant women and children are subject to the following limitations on benefits: Beginning July 1, 2026, there is an annual cap on dental services in the amount of $750;Beginning January 1, 2027, behavioral health services offered must be provided on a fee-for-service basis only;Beginning January 1, 2027, services offered through the accountable care collaborative are no longer covered; andBeginning January 1, 2027, managed care services through the medical assistance program are no longer covered.     Beginning January 1, 2027, children under 19 years old whose family household income does not exceed 260% of the federal poverty line, adjusted for family size, and who are not eligible for the medical assistance program due to their immigration status, are not eligible for home- and community-based services, community first choice, long-term home health, private duty nursing, hospice care, and nursing home care unless those children already receive those services on or before December 31, 2026.      For the 2026-27 state fiscal year, the bill caps enrollment of children in the state medical assistance program at 25,000 children if certain conditions are met.     The bill repeals provisions requiring the department of health care policy and financing to develop an outreach and enrollment strategy for enrolling eligible groups into new coverage options.     The bill repeals the state children's basic health plan.     The bill makes and reduces an appropriation to the department of health care policy and financing.(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

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