Medicaid Is Eating Colorado’s Budget. Stop Blaming TABOR And Start Cutting Bloat.

The Colorado Sun’s Jesse Paul and John Ingold tackle the elephant in Colorado’s budget: Medicaid. Their long read details how the state’s price tag to run the program has surged well beyond the TABOR growth cap, creating billion-dollar gaps that crowd out everything else. Lawmakers are staring at another shortfall and a likely third if nothing changes.

Since 2018–19, the TABOR cap rose 39 percent while Colorado’s Medicaid costs jumped about 86 percent, or $2.6 billion, with recent years ballooning far faster than the cap. That mismatch is why the squeeze feels relentless: when Medicaid grows faster than TABOR, the legislature must trim Medicaid offerings or cut other programs.

The Bullet Point Brief

• Cost drivers are piling up: general medical inflation, post-pandemic utilization, and expensive cohorts like seniors and people with disabilities who are a small share of enrollees but a huge share of spending.
• Specialty drugs are a budget torpedo. They are roughly 2 percent of prescriptions yet around half of Medicaid drug spend; behavioral health and autism therapies have soared as well.
• State policy choices added costs: higher provider rates and coverage expansions, from postpartum coverage extensions to immigrant children and pregnant women, plus new benefits and copay eliminations.
• The ACA expansion is mostly federally funded in Colorado via the hospital provider fee, so trimming it does little for the state general fund even as feds cover 90 percent.
• Polis’ budget proposes holding growth below current projections with caps, dental limits, and service trims, and even wants to tether Medicaid growth to TABOR long term. Advocates and some legislators are pushing back.

My Bottom Line

Credit where due: The Sun leans left, but this is serious reporting on a massive problem. Medicaid is eating the seed corn. Democrats will gnash their teeth, blame the feds, and curse TABOR. I will not. Thank God for TABOR. It forces a choice that politicians hate but taxpayers need: live within your means.

Colorado layered on expansions, sweetened rates, and built programs that sound compassionate but blow holes in the hull. I have written about this before. Meanwhile, high-cost drugs and long-term care are real pressures no slogan can fix. So stop attacking TABOR refunds and start pruning the add-ons and virtue signals stapled to Medicaid. Protect the truly vulnerable. Audit everything else.

Governor Gaslight’s bloaty budget is the other half of the story. If Medicaid growth outpaces the cap, you do not raise the cap. You bring Medicaid back to earth and cut the fat elsewhere. The Sun’s piece proves the math. Now the legislature needs the spine.

Here is my ask to the Capitol: quit the theatrics, do your job, and balance the books without trying to erase TABOR. Start with sunsets, performance audits, and hard guardrails on benefit creep. Colorado can be compassionate and solvent at the same time. The spreadsheet says we have to be.

Source: The Colorado Sun