SB 25-228

Senate Bill 25-228, titled "Enterprise Disability Buy-in Premiums," changes how premiums for Medicaid buy-in programs are managed in Colorado. Instead of having separate funds for adults and children with disabilities, the bill consolidates these into a single fund called the Healthcare Affordability and Sustainability Medicaid Buy-In Cash Fund within CHASE (Colorado Health Access Sustainability Enterprise). This new system will help manage costs more efficiently by centralizing funding and creating a board to oversee the program. The bill has been signed into law, meaning it is now in effect and will impact how premiums are collected and used for medical assistance programs starting from 2025 onwards.

Official Summary

Under current law, there are 2 programs available to low-income individuals to buy in to the state medical assistance program: One for adults with disabilities and one for children with disabilities (medicaid buy-in programs). Individuals who participate in either program pay a premium based on their family income. The premiums are credited to the medicaid buy-in cash fund. The premiums credited to the medicaid buy-in cash fund are used to offset the costs of providing the medicaid buy-in programs. The costs of providing the medicaid buy-in programs are also offset by the money in the healthcare affordability and sustainability fee cash fund in the Colorado healthcare affordability and sustainability enterprise (CHASE) within the department of health care policy and financing (HCPF). The act repeals the existing medicaid buy-in cash fund and creates the healthcare affordability and sustainability medicaid buy-in cash fund (buy-in cash fund) within CHASE and directs that individuals who participate in the existing medicaid buy-in programs pay their premiums into the buy-in cash fund. The act creates a medicaid buy-in enterprise support board within CHASE to support the existing enterprise with the implementation of the medicaid buy-in program, including consulting with HCPF and the state medical services board on the amount of the premiums for and other components of the medicaid buy-in programs. Because CHASE is an enterprise for purposes of the Taxpayer's Act of Rights, its revenue does not count against the state fiscal year spending limit. For the 2025-26 state fiscal year, $6,660,761 is appropriated from the buy-in cash fund to HCPF for medical and long-term care services for medicaid-eligible individuals. The act also decreases in a corresponding amount an appropriation to HCPF from the existing Medicaid buy-in cash fund and adjusts similar appropriations to HCPF for the 2024-25 state fiscal year. (Note: This summary applies to this bill as enacted.)

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