Colorado Medicaid Spending Doubled in Last Decade

Report finds state's Medicaid program costs grew faster than enrollment or medical inflation

Published on Feb. 26, 2026

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A new analysis by the Common Sense Institute estimates Colorado's Department of Health Care Policy and Financing (HCPF) spending on Medicaid reached $16 billion in 2025 — a 101% increase from 2015 — while Medicaid enrollment has returned to nearly its 2015 level. The report cites 182 health care bills Colorado lawmakers enacted since 2019, which it says cost the state $858 million annually.

Why it matters

The rapid growth in Medicaid spending in Colorado has raised concerns about the sustainability of the program, especially given the state's Taxpayer's Bill of Rights (TABOR) law that limits revenue growth. The report argues that much of the spending growth stems from expansive policy choices rather than enrollment or medical inflation alone.

The details

The report groups recent cost drivers into broad categories, including Medicaid eligibility expansions, new or expanded services, and mental health and telehealth expansions. Thirty-six percent of the $858 million in new annual costs is covered by federal spending, according to the CSI analysis. Between 2015 and 2025, HCPF spending grew 101% — compared with 64% growth in the rest of the state budget. The authors argue this suggests HCPF is "spending more than is strictly necessary to deliver its services."

  • Between 2015 and 2025, HCPF spending grew 101%.
  • Between 2018 and 2024, Medicaid enrollment rose by 7.6%.
  • Since 2019, Colorado lawmakers have enacted 182 health care bills that cost the state $858 million annually.

The players

Common Sense Institute

A nonpartisan research organization that conducted the analysis on Colorado Medicaid spending.

Department of Health Care Policy and Financing (HCPF)

The state agency that manages Colorado's Medicaid program, which serves about 1.2 million low-income Coloradans.

Marc Williams

A spokesperson for the Department of Health Care Policy and Financing.

Greg D'Argonne

A co-author of the CSI report.

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What they’re saying

“CSI's analysis suggests that much of HCPF's last decade of spending increases could have been avoided in the absence of expansive policy and other nonessential spending.”

— Greg D'Argonne, Co-author of the CSI report (Denver Gazette)

“Knowing that TABOR is in place, more concerted efforts should have been made to keep a closer eye on spending and attempt to work within closer confines of a budget. It doesn't appear this was the case.”

— Greg D'Argonne, Co-author of the CSI report (Denver Gazette)

What’s next

The report's authors argue that the Colorado Department of Health Care Policy and Financing will need to find ways to slow spending growth without reducing Medicaid eligibility or services, in order to stay within the state's TABOR revenue limits.

The takeaway

The rapid growth in Colorado's Medicaid spending, driven by policy expansions rather than just enrollment or medical inflation, raises questions about the long-term sustainability of the program and the state's ability to manage costs within its constitutional revenue limits.