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ColoradoHB26-12352026 Regular SessionHouseWALLET

Updates to Medicaid

Sponsored By: Lindsey Daugherty (Democratic), Lisa Feret (Democratic)

Signed by Governor

Civil LawHealth Care & Health Insurance

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Bill Overview

Analyzed Economic Effects

5 provisions identified: 2 benefits, 1 costs, 2 mixed.

Medicaid access and limits for noncitizens

Colorado Medicaid includes qualified noncitizens who entered before August 22, 1996. Those entering on or after that date generally face a five-year waiting period. During that period, Colorado may cover pregnant people and children under 19 who meet Medicaid rules other than citizenship. This coverage requires federal funding, or specifically approved state money when federal funding is unavailable. Optional coverage groups include qualified noncitizens barred from disability-based Supplemental Security Income by the 1996 federal law. They also include other qualified noncitizens who entered or were present before August 22, 1996. These optional groups can receive required and optional Medicaid services when federal funding is available. The law removes prior waiting-period and sponsor-income and asset rules for these optional groups. The scheduled start is August 12, 2026, assuming final adjournment on May 13, 2026. A referendum petition filed within 90 days after final adjournment delays challenged provisions until voters approve them in November 2026. Approved provisions then start when the governor officially declares the vote.

More Medicaid treatment providers in jails

Beginning August 12, 2026, Colorado Medicaid must pay more kinds of providers for medication-assisted treatment in jails. Payment is no longer limited to opioid treatment programs. Providers must be licensed and authorized to prescribe, dispense, compound, or administer the treatment. State oversight must ensure providers have emergency plans for harmful outcomes. The start date is subject to the law's referendum rules.

New coverage rules for Medicaid members

Beginning August 12, 2026, Colorado's Medical Services Board must adopt federal Medicaid community engagement rules by January 1, 2027. The rules must keep paperwork burdens as low as possible for people getting or keeping coverage. The law does not spell out required activities or individual eligibility outcomes. The board's authority to make these rules ends if the federal requirements are repealed. The start date is subject to the law's referendum rules.

Advance notice for Medicaid therapy cuts

Beginning August 12, 2026, Colorado must give affected providers at least six months' notice before new outpatient therapy payment reductions. This applies to reductions for multiple procedures, not every therapy payment cut. The state must also hold at least one stakeholder meeting, including discussion of the measures it plans to use. Colorado may propose leaving rates out of its Medicaid rate schedule when other state or federal rules require regular review or adjustment. Neither change itself sets payment amounts or changes what Medicaid members pay. The start date is subject to the law's referendum rules.

Home care agencies must report costs

Beginning August 12, 2026, home- and community-based care agencies face new cost reporting rules. Agencies serving more than 30 members and covered by state minimum-wage requirements must submit data by September 30, 2027. Colorado may also collect data from agencies serving 30 or fewer members. Reports cover Medicaid payments and service volume by service code, separated between employees and independent contractors. They also cover wages, leave, benefits, payroll taxes, hiring and retention supports, supervision, training, operating costs, and wage-compliance statements. The law defines a measure comparing direct-care pay, training, and supports with administrative and general costs. Colorado must report the collected information to legislative health committees and the Joint Budget Committee by December 31, 2027. The data is for legislative information only and is not available through Colorado Open Records Act requests. The start date is subject to the law's referendum rules.

Sponsors & Cosponsors

Sponsors

  • Lindsey Daugherty

    Democratic • Senate

  • Lisa Feret

    Democratic • House

Cosponsors

  • Chad Clifford

    Democratic • House

  • Elizabeth Velasco

    Democratic • House

  • Jamie Jackson

    Democratic • House

  • Kenny Nguyen

    Democratic • House

  • Michael Carter

    Democratic • House

  • Tammy Story

    Democratic • House

  • Cathy Kipp

    Democratic • Senate

  • James Coleman

    Democratic • Senate

  • Marc Snyder

    Democratic • Senate

  • Tony Exum

    Democratic • Senate

Roll Call Votes

All Roll Calls

Yes: 96 • No: 32

Senate vote • 5/4/2026

Third reading: Bill

Yes: 31 • No: 4

Senate vote • 4/29/2026

Refer House Bill 26-1235 to the Committee of the Whole and with a recommendation that it be placed on the consent calendar.

Yes: 7 • No: 0

House vote • 4/16/2026

Third reading: Bill

Yes: 44 • No: 18

House vote • 3/11/2026

Adopt amendment L.004 (Attachment L).

Yes: 7 • No: 5

House vote • 3/11/2026

Refer House Bill 26-1235, as amended, to the Committee of the Whole.

Yes: 7 • No: 5

Actions Timeline

  1. Governor Signed

    6/3/2026House

  2. Signed by the Speaker of the House

    6/2/2026House

  3. Signed by the President of the Senate

    6/2/2026Senate

  4. Sent to the Governor

    6/2/2026House

  5. Senate Third Reading Passed - No Amendments

    5/4/2026Senate

  6. Senate Second Reading Passed - No Amendments

    5/1/2026Senate

  7. Senate Committee on Health & Human Services Refer Unamended - Consent Calendar to Senate Committee of the Whole

    4/29/2026Senate

  8. Introduced In Senate - Assigned to Health & Human Services

    4/21/2026Senate

  9. House Third Reading Passed - No Amendments

    4/16/2026House

  10. House Third Reading Laid Over Daily - No Amendments

    4/14/2026House

  11. House Second Reading Special Order - Passed with Amendments - Committee, Floor

    4/13/2026House

  12. House Second Reading Laid Over Daily - No Amendments

    3/16/2026House

  13. House Committee on Health & Human Services Refer Amended to House Committee of the Whole

    3/11/2026House

  14. Introduced In House - Assigned to Health & Human Services

    2/18/2026House

Bill Text

  • Engrossed

    PDF

  • Final Act

    PDF

  • House Health & Human Services Preamend

    PDF

  • Introduced

    PDF

  • Reengrossed

    PDF

  • Rerevised

    PDF

  • Revised

    PDF

  • Signed Act

    PDF

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