Advocacy helps limit Medicaid cuts and shape key health care legislation
Colorado's 2026 legislative session was defined by one issue: a state budget shortfall approaching $1.5 billion.
As lawmakers searched for savings, Medicaid became a primary target. Early discussions included Medicaid provider rate reductions of up to 4 percent, along with additional cost-cutting measures that would have significantly impacted providers and the patients they serve.
Throughout the session, the Home Care and Hospice Association of Colorado (HHAC) worked closely with legislators, state agencies and stakeholders to ensure policymakers understood the real-world impact of these proposals on providers, caregivers and the Coloradans who depend on care at home.
While difficult decisions were ultimately made, HHAC's advocacy helped prevent even deeper cuts and ensured providers had a seat at the table as policymakers weighed options.
HHAC fights to reduce the impact of Medicaid cuts
The final state budget included a 2% across-the-board Medicaid provider rate reduction. While any cut is concerning, it represents a significant improvement from earlier proposals that contemplated reductions as high as 4%.
HHAC worked extensively with lawmakers and the Department of Health Care Policy and Financing (HCPF) to highlight how additional cuts would threaten access to care, particularly at a time when providers are already struggling with workforce shortages, rising labor costs and increasing regulatory requirements.
The budget debate also included a series of long-term support services (LTSS) sustainability measures designed to slow Medicaid spending growth. HHAC actively engaged with policymakers throughout these discussions, advocating for flexibility and protecting access to services whenever possible.
Keeping providers at the table on major Medicaid changes
Several Medicaid cost-containment measures approved this year will affect providers and consumers over the coming months and years.
These include:
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New service limits, or "soft caps," for certain home- and community-based services.
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A phased implementation of caregiver-hour limits, eventually capping most caregivers at 56 hours per week.
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Changes to developmental disability waiver enrollment and transitions.
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Additional efforts by the state to control Medicaid spending growth.
HHAC worked to ensure policymakers understood the potential impact of these changes and will continue advocating for practical implementation that protects access to care.
Reshaping reporting requirements
HHAC also worked to refine House Bill 26-1235, which initially would have required home- and community-based services providers to submit annual medical loss ratio reports and would have directed the state to publicly post provider-specific information online.
HHAC raised concerns that the proposal would create unnecessary administrative work, fail to account for differences among provider business models and potentially create future pressure for arbitrary reimbursement policies.
As a result of advocacy by HHAC and through discussions with stakeholders, the bill was amended. The final legislation replaces the ongoing reporting requirement with a one-time state data collection and legislative report.
Supporting patient access to care
HHAC supported House Bill 26-1262, which helps preserve access to compounded medications and medical products that are often important in hospice and long-term care settings.
The association also monitored more than 50 bills affecting health care providers, workforce issues, Medicaid policy and regulatory requirements to ensure members' perspectives were represented throughout the legislative process.
What we're watching next
Although the legislative session has ended, the work continues.
Medicaid Commission
State lawmakers have created a new commission focused on Medicaid spending, utilization and administration. With Medicaid costs continuing to outpace state revenue growth, HHAC expects home care, home health and hospice services to remain a significant topic of discussion.
HHAC will actively participate in these conversations and continue educating policymakers about the value of home-based care and the importance of maintaining adequate reimbursement rates.
Additional budget pressures
State budget experts expect Colorado's fiscal challenges to continue. Many lawmakers have acknowledged that this year's budget relied on one-time solutions, raising concerns that additional cuts could be considered during the next budget cycle.
HHAC will continue advocating for policies that protect access to care and recognize the critical role providers play in helping Coloradans remain safely at home.
HHAC will continue working with state agencies to seek practical solutions and ensure members' concerns are heard.
Get involved
The challenges facing home care, home health and hospice providers are growing more complex each year. Effective advocacy includes providers willing to share their experiences and explain how policy decisions affect patients, caregivers and local communities.
HHAC members interested in becoming more involved are encouraged to join the HHAC Legislative Ambassador Program. The program provides opportunities to engage directly with lawmakers, respond to emerging policy issues and help shape the future of care in Colorado.
Together, we can ensure policymakers understand the essential role home-based care plays in Colorado's health care system. |
