Potential Medicaid cuts could mean trouble, Colorado health care leaders, Rep. Diana DeGette say

As congressional Republicans look to slash government spending by more than $1 trillion, Colorado health care and political leaders are ringing the alarm over what that could mean for Medicaid in the state.

“These cuts would impact millions of Americans (and) thousands of people in my congressional district in order to pay for a huge tax cut for billionaires,” U.S. Rep. Diana DeGette, a Denver Democrat, said during a press conference Wednesday.

The Republican-controlled House Budget Committee has asked several committees to reduce their spending by hundreds of billions of dollars.

The request to the Energy and Commerce Committee, of which DeGette is a member, is to find $880 billion in cuts over the next decade, DeGette said. The committee oversees Medicaid, which costs about $880 billion annually and is paid for by both states and the federal government.

Despite supporting the recent tax cut proposal, top Republicans including President Donald Trump and House Speaker Mike Johnson have maintained that they don’t support cuts to Medicaid services, saying that they only want to “eliminate fraud.”

As of October, 1.1 million Coloradans were enrolled in Medicaid or the Children’s Health Insurance Program, according to KFF, formerly known as the Kaiser Family Foundation, which provides health care policy information.

While there aren’t yet specific proposals on how to cut Medicaid, Republicans have floated a few ideas, including creating a work requirement for participation in the program. But that wouldn’t save very much money since the vast majority of Medicaid enrollees are already working, attending school or serving as a caregiver for another person, DeGette said.

Another idea is to change the federal government’s reimbursement to a per-person limit, shifting costs to the states. That could be a big problem for Colorado.

State lawmakers are already facing roughly $1 billion hole in the state budget. Medicaid accounts for roughly a third of Colorado’s general-fund expenditures, with much of that money going to care for older residents or those with disabilities. The state Medicaid program overshot its budget by $120 million last year, and rising expenses are one part of the state’s budget crisis this year.

As a result, state lawmakers will be watching the federal discussions “very closely,” said Sen. Judy Amabile, a Boulder Democrat and a member of the legislature’s Joint Budget Committee. Lawmakers of both parties have expressed concern over what cuts to the program would mean for Colorado patients and for the safety-net providers who treat them.

Under the Affordable Care Act, Colorado expanded Medicaid in 2013, and the federal government now picks up 90% of the new costs.

State legislators haven’t started studying potential options for implementing cuts because it’s unclear which way the federal discussions may settle, Amabile said.

“If this was another year when we weren’t under the gun with our own budget-balancing problems, maybe (federal cuts) wouldn’t hit as hard,” she said Wednesday. But if more cuts do come down, lawmakers “are going to have to make some tough choices.”

Joining DeGette on Wednesday was Donna Lynne, the CEO of Denver Health. She expressed worry about the impact of any Medicaid cuts for the safety-net health system, which potentially could result in service cuts and layoffs.

In a statement to The Denver Post, U.S. Rep. Gabe Evans, a Fort Lupton Republican who represents north Denver suburbs, didn’t directly address possible Medicaid cuts but said he would support “commonsense spending reductions.”