By Matt VanAuken, DP Chief Executive Officer & Executive Director
Earlier this year, the Colorado Legislature enacted a significant new piece of legislation under Senate Bill 26-187, establishing a dedicated legislative body known as the Commission on Medicaid. This legislative milestone marks a crucial development in how the state approaches its public healthcare obligations, bringing together a bipartisan group of state lawmakers to address complex structural and financial questions regarding the state’s healthcare safety net. As this new commission begins its work, community leaders and advocacy organizations are working to ensure that the individuals and families who rely on these vital public programs understand what these deliberations mean for their daily lives and long-term care plans.
The creation of the Commission on Medicaid represents a strategic effort by state leaders to tackle some of the most pressing challenges facing public healthcare financing in Colorado. The core mission assigned to this legislative group is both straightforward and monumental: finding sustainable pathways to make Medicaid work better and last longer for the hundreds of thousands of Colorado residents who depend on it for their health and well-being. By establishing a dedicated forum outside the standard, fast-paced legislative session, state lawmakers hope to develop comprehensive, well-considered solutions to safeguard the future of public healthcare financing in the state.
What is this Commission?
The Commission on Medicaid is structured as a bipartisan working group composed of state legislators, featuring representation from both the Republican and Democratic parties. This collaborative makeup is designed to foster bipartisan dialogue and build consensus around complex policy reforms. The lawmakers serving on the commission are tasked with addressing one overarching, fundamental question: how can Colorado successfully restructure, streamline, and secure Medicaid to ensure its operational and financial viability for years to come?
To accomplish this mandate, the Commission has been granted a specific operational timeline under state law. Between the months of May and December, the group is legally required to convene for a minimum of six meetings, with a cap of no more than twelve sessions. These intensive working meetings provide lawmakers with the dedicated time and focus needed to evaluate the intricate mechanisms of the state’s Medicaid system. Once this series of interim meetings concludes, the Commission is required to compile its findings and submit a formal, comprehensive report to the full Legislature and the Governor. This report will outline specific, actionable recommendations for legislative and administrative changes aimed at improving the efficiency, coverage, and sustainability of the Medicaid program.
Why does this matter?
The implications of the Commission’s work extend across the entire spectrum of public healthcare in Colorado, but certain areas of the system are expected to draw particularly intense scrutiny. Medicaid serves as the primary funding source for a diverse array of essential medical and supportive services, making it a cornerstone of the state’s social infrastructure. Among the most critical programs funded through this mechanism are Long-Term Services and Supports, commonly referred to as LTSS. These specialized programs are designed to assist individuals with intellectual and developmental disabilities, as well as older adults, enabling them to live with dignity and independence within their own homes and local communities rather than being forced into institutional settings.
While individuals who utilize Long-Term Services and Supports represent a relatively small fraction of the total population enrolled in Colorado’s broader Medicaid program, the specialized care they require accounts for a substantial portion of the total financial expenditures within the system. Because of this high financial concentration, policy experts and healthcare advocates widely anticipate that the Commission will focus a significant portion of its discussions on operational costs, the scope of covered services, and the reimbursement rates paid to healthcare and caregiving providers.
The policy recommendations that emerge from the Commission are not merely academic exercises; they carry the potential to shape future bills and statutory changes introduced during upcoming legislative sessions. During a standard, fast-moving legislative session, lawmakers are often consumed by immediate budgetary deadlines and hundreds of competing bills, leaving very little time to dive deep into the intricate details of Medicaid funding structures, service delivery models, and administrative complexities. The creation of this interim Commission specifically bridges that gap, granting lawmakers the necessary runway between the 2026 and 2027 legislative sessions to thoroughly examine these complex systems and craft informed policy.
To better understand these discussions, it is also important to clarify a vital distinction within Colorado’s public health infrastructure. Health First Colorado, which is the state’s official Medicaid State Plan and public health insurance program, primarily covers traditional medical needs, such as routine doctor visits, hospital care, prescriptions, and acute healthcare services. Long-Term Services and Supports operate differently, providing an expanded layer of non-medical and supportive care that goes far beyond standard medical treatment. These customized supports are specifically tailored to help individuals maintain their independence, perform daily life activities, and thrive in community settings, offering a humane and often more cost-effective alternative to institutionalized care facilities.
What is DP doing?
As the Commission on Medicaid moves forward with its interim meetings and policy deliberations, organizations across the state are mobilizing to ensure that the voices of vulnerable populations are not lost in complex budgetary debates. Developmental Pathways is closely monitoring the progress and findings of the Commission at every step of the process. The organization is actively preparing to bring concrete information, real-world data, and operational insights directly to lawmakers and state officials. By doing so, DP aims to ensure that the individuals, children, and families who rely on these services remain at the center of the conversation as state leaders weigh potential structural reforms.
How can you follow along?
Transparency is a foundational component of the Commission’s mandate, and public engagement is strongly encouraged by state leadership. Every official meeting held by the Commission on Medicaid is fully open to the public, offering citizens, advocates, and providers a direct window into the policymaking process. Interested individuals have the opportunity to participate by listening to the proceedings live or by accessing comprehensive audio and video recordings of the sessions following their completion. The complete schedule of upcoming meetings, along with agendas and related documentation, has been published and is regularly updated on the official Colorado General Assembly website through the designated Commission on Medicaid committee portal.
How can you share your story?
For individuals and families who navigate the Medicaid and LTSS systems every day, this interim period represents a genuine, hands-on opportunity to make their voices heard by the state officials shaping future policy. The Commission provides distinct avenues for public participation, ensuring that the lived experiences of community members inform legislative deliberations. Following revisions made in late July 2026, the Commission incorporated specific public input surveys and testimony opportunities, allowing community members to share their personal stories, challenges, and constructive ideas directly with the lawmakers serving on the panel. For those seeking additional guidance, advocacy resources, and community networks to help navigate these developments, numerous statewide advocacy organizations offer ongoing support and informational toolkits.
We’ll keep you posted
Major legislative and systemic shifts of this magnitude can naturally raise numerous questions, concerns, and uncertainties for the families and providers who depend on stable public programs. Developmental Pathways remains steadfastly committed to watching this legislative process closely, analyzing policy proposals as they emerge, and sharing timely information with the community as it becomes available. Navigating the complex landscape of public benefits and available supports can be challenging, but families do not have to do it alone. Anyone seeking assistance with finding available resources, understanding their healthcare options, or exploring alternative support systems is encouraged to reach out through the organization’s official online contact portal or via direct email correspondence. Community members can also stay informed by subscribing to regular email newsletters and following Developmental Pathways across major social media platforms, including Facebook, Instagram, and LinkedIn, ensuring they never miss critical updates regarding the future of Medicaid in Colorado.
