Second Regular Session
Seventy-third General Assembly
STATE OF COLORADO
REREVISED
This Version Includes All Amendments
Adopted in the Second House
LLS NO. 22-0487.01 Jane Ritter x4342
HOUSE BILL 22-1289
House Committees Senate Committees
Public & Behavioral Health & Human Services Health & Human Services
Appropriations Appropriations
A BILL FOR AN ACT
C
ONCERNING IMPROVING ACCESS TO HEALTH BENEFITS FOR101
ECONOMICALLY INSECURE COLORADO FAMILIES BY ENHANCING102
PUBLIC HEALTH
PROGRAMS, AND, IN CONNECTION THEREWITH,103
MAKING AN APPROPRIATION .104
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov
.)
The bill makes the following changes to health insurance coverage
for low-income pregnant people and children in low-income families:
! Provides full health insurance coverage for Colorado
SENATE
3rd Reading Unamended
May 5, 2022
SENATE
Amended 2nd Reading
May 4, 2022
HOUSE
3rd Reading Unamended
April 22, 2022
HOUSE
Amended 2nd Reading
April 20, 2022
HOUSE SPONSORSHIP
Gonzales-Gutierrez and McCluskie, Amabile, Bacon, Benavidez, Bernett, Bird,
Boesenecker, Caraveo, Cutter, Duran, Esgar, Exum, Froelich, Herod, Hooton, Jodeh,
Kennedy, Kipp, Lontine, Michaelson Jenet, Mullica, Ortiz, Ricks, Roberts, Sirota, Snyder,
Titone, Valdez A., Weissman, Woodrow, Young
SENATE SPONSORSHIP
Moreno and Fields, Bridges, Buckner, Danielson, Donovan, Ginal, Gonzales, Hansen,
Hinrichsen, Jaquez Lewis, Lee, Pettersen, Priola, Rodriguez, Story, Winter, Zenzinger
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing statute.
Dashes through the words indicate deletions from existing statute. pregnant people who would be eligible for medicaid and
the children's basic health plan (CHIP) if not for their
immigration status and continues that coverage for 12
months postpartum at the CHIP federal matching rate;
! Provides comprehensive health insurance coverage to all
Colorado children who would be eligible for medicaid and
CHIP if not for their immigration status;
! Requires the state department of health care policy and
financing to create an outreach and enrollment strategy for
enrolling eligible groups into new coverage options;
! Makes comprehensive lactation supports and supplies,
including breast pumps, a covered benefit for perinatal
people on medicaid and CHIP;
! Draws down federal funds to improve perinatal and
postpartum support and requires that priorities for the funds
be determined through a stakeholder process;
! Permanently authorizes an existing survey of birthing
parents, run by the state department of public health and
environment and increases the ability of the survey to
collect and report on the experiences of birthing people of
color in Colorado;
! Creates a special enrollment period for health insurance
coverage due to pregnancy so that an eligible person can
sign up for insurance as soon as the person becomes
pregnant; and
! Improves the quality of health insurance coverage available
through the health insurance affordability enterprise.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. Legislative declaration. (1) The general assembly2
finds and declares that:3
(a) Health insurance coverage is an important social determinant4
of health because it provides both access to the health-care system and5
financial security. Access to quality prenatal care is one of the most6
important determinants of birth outcomes and a primary strategy to reduce7
infant and maternal mortality.8
(b) The stress and challenges of pregnancy and parenting with9
limited financial resources are contributing factors to a high rate of10
1289-2- depression. One in four low-income pregnant or postpartum individuals1
experience depression in a given year.2
(c) Insurance coverage improves health status and mental health,3
while decreasing infant, child, and adult mortality rates. Medicaid and the4
children's health insurance program (CHIP) are key supports for pregnant5
people and new parents, as well as their children in the critical early years6
of life.7
(d) Research shows that medicaid coverage for children and8
pregnant people is associated with improved health and well-being.9
Children born to medicaid-covered or otherwise insured parents are more10
likely to be born at a healthier birth weight and are at lower risk of infant11
mortality than babies born to people who are uninsured. Medicaid and12
other insurance coverage of pregnant people is also associated with a13
greater likelihood of children finishing high school and college and14
having higher incomes as adults.15
(e) When parents have health insurance, their children are more16
likely to be insured;17
(f) In Colorado, Hispanic and Latina individuals of reproductive18
age are three times more likely to be uninsured compared to their19
non-Hispanic peers. Research indicates that chronic stress associated with20
being a racial or ethnic minority in the United States is largely responsible21
for higher preterm birth rates and constitutes an independent risk factor22
for preterm delivery.23
(g) Approximately twenty-four percent of all pregnancy-related24
deaths occur between forty-three to three hundred sixty-five days after a25
pregnancy ends. There is growing evidence that providing insurance26
coverage for at least one year of postpartum care can reduce preventable27
1289
-3- maternal deaths, particularly among Black persons and immigrant1
populations. Expanding access to prenatal and postpartum care will2
decrease racial disparities in maternal and infant mortality.3
(h) Prenatal care is cost effective. Studies have found that4
providing prenatal care for low-income persons avoids costly infant5
complications and infant death.6
(2) The general assembly further finds that:7
(a) All Colorado children deserve access to preventive and8
life-saving health care. In Colorado, fourteen percent of uninsured9
children are ineligible for medicaid or the children's basic health plan10
because of their immigration status. Health insurance coverage is linked11
to improved access to health-care services and increased use of preventive12
services.13
(b) Without expansion of health-care coverage, immigrant parents14
with children who are ineligible for coverage are more likely to put off15
seeking critical treatment until it is an emergency. Educational success,16
physical health, emotional support, and family strength are inseparable.17
(c) The COVID-19 pandemic has disproportionately harmed18
immigrant communities across the state, exposing the dual impacts of19
racism and xenophobia on access to health care. Ineligibility for20
health-care coverage has led many immigrants to forgo COVID-19 testing21
and treatment, despite both being free.22
(d) As Colorado seeks to address these inequities to build a more23
inclusive state, it is essential to expand coverage to the communities that24
have been most impacted and vulnerable before, during, and well after the25
COVID-19 health crisis; and26
(e) Expanding health-care coverage to all children, pregnant and27
1289
-4- postpartum persons, regardless of immigration status, is fundamental to1
ensuring health equity in Colorado, allowing all parents and children to2
thrive.3
SECTION 2. In Colorado Revised Statutes, 10-16-1205, add4
(2)(d)(III) as follows:5
10-16-1205. Health insurance affordability fee - special6
assessment on hospitals - allocation of revenues. (2)7
(d) (III) N
OTWITHSTANDING SUBSECTIONS (2)(d)(I) AND (2)(d)(II) OF
8
THIS SECTION, IF THE APPROVAL OF THE DEMONSTRATION WAIVER9
RECEIVED PURSUANT TO SECTION 25.5-4-503 (2) SETS CONDITIONS ON THE10
USE OF THE MONEY RECEIVED , THE ENTERPRISE SHALL ALLOCATE THE11
MONEY RECEIVED PURSUANT TO SECTION 25.5-4-503 (2) AS SET FORTH IN12
THE APPROVAL. IF THE APPROVAL DOES NOT SET CONDITIONS ON THE USE13
OF MONEY RECEIVED, THE ENTERPRISE SHALL ALLOCATE THE MONEY IN14
THE MANNER SET FORTH IN SUBSECTIONS (2)(d)(I) AND (2)(d)(II) OF THIS15
SECTION.16
SECTION 3. In Colorado Revised Statutes, 10-16-1206, amend17
(1)(e) and (1)(f); and add (1)(g) as follows:18
10-16-1206. Health insurance affordability cash fund -19
creation. (1) There is hereby created in the state treasury the health20
insurance affordability cash fund. The fund consists of:21
(e) Money that may be allocated to the fund pursuant to section22
10-16-1308; and23
(f) All interest and income derived from the deposit and24
investment of money in the fund; AND25
(g) THE FEDERAL SHARE OF THE MEDICAL ASSISTANCE PAYMENTS26
RECEIVED PURSUANT TO SECTION 25.5-4-503 (2).27
1289
-5- SECTION 4. In Colorado Revised Statutes, 10-16-105.7, add1
(3)(a)(II)(H) as follows:2
10-16-105.7. Health benefit plan open enrollment periods -3
special enrollment periods - rules. (3) (a) (II) A triggering event occurs4
when:5
(H) B
EGINNING JANUARY 1, 2024, AN INDIVIDUAL
WHO DOES NOT6
HAVE EXISTING CREDITABLE COVERAGE RECEIVES CERTIFICATION FROM A7
HEALTH-CARE PROVIDER ACTING WITHIN THE PROVIDER 'S SCOPE OF8
PRACTICE THAT THE INDIVIDUAL IS PREGNANT . COVERAGE IS DEEMED9
EFFECTIVE AS OF THE FIRST MONTH IN WHICH THE INDIVIDUAL RECEIVES10
CERTIFICATION OF THE PREGNANCY , UNLESS THE INDIVIDUAL ELECTS TO11
HAVE COVERAGE EFFECTIVE ON THE FIRST DAY OF THE MONTH FOLLOWING12
THE DATE THAT THE INDIVIDUAL MAKES A PLAN SELECTION . ANY PERSON13
OR ENTITY ENROLLING AN INDIVIDUAL IN COVERAGE PURS UANT TO THIS14
SPECIAL ENROLLMENT PERIOD SHALL PROVIDE A NOTICE , DEVELOPED BY15
THE DEPARTMENT THROUGH A STAKEHOLDER PROCESS , TO THE16
INDIVIDUAL REGARDING THE INDIVIDUAL 'S OPTION TO BEGIN COVERAGE17
EITHER PROSPECTIVELY OR RETROACTIVELY AND THE FINANCIAL AND TAX18
IMPLICATIONS OF THOSE OPTIONS. THE NOTICE MUST BE IN, AT A MINIMUM,19
E
NGLISH AND SPANISH.20
SECTION 5.
In Colorado Revised Statutes, 10-16-1207, repeal21
(4)(c)(IV)(A); and add (4)(c.5) as follows:22
10-16-1207. Health insurance affordability board - creation -23
membership - powers and duties - subject to open meetings and24
public records laws - commissioner rules. (4) The board is authorized25
to:26
(c) Recommend, for approval and establishment by the27
1289
-6- commissioner by rule:1
(IV) The parameters for implementing the subsidies for2
state-subsidized individual health coverage plans authorized by this part3
12, including:4
(A) The coverage required under state-subsidized individual5
health coverage plans, which coverage must maximize affordability for6
qualified individuals and must include coverage for the lowest income7
group, as determined by the board, that has no premium and provides8
benefits actuarially equivalent to ninety percent of the full actuarial value9
of the benefits provided under the plan; and10
(c.5) F
URTHER RECOMMEND , FOR APPROVAL AND ESTABLISHMENT11
BY THE COMMISSIONER BY RULE , ADDITIONAL PARAMETERS FOR12
IMPLEMENTING THE SUBSIDIES FOR STATE-SUBSIDIZED INDIVIDUAL HEALTH13
COVERAGE PLANS AUTHORIZED BY THIS PART 12, INCLUDING THAT THE14
COVERAGE REQUIRED PURSUANT TO STATE -SUBSIDIZED INDIVIDUAL15
HEALTH COVERAGE PLANS MUST :16
(I) M
AXIMIZE AFFORDABILITY FOR QUALIFIED INDIVIDUALS ;17
(II) C
OVER BENEFITS EQUIVALENT TO THOSE IN A QUALIFIED18
HEALTH PLAN; AND19
(III) F
OR A PERSON WHO, AT THE TIME THE PERSON APPLIES FOR20
STATE-SUBSIDIZED COVERAGE, MEETS THE INCOME REQUIREMENTS TO21
QUALIFY FOR EMERGENCY MEDICAL ASSISTANCE PURS UANT TO SECTION22
25.5-5-103 AND WHO IS A QUALIFIED INDIVIDUAL WHO MEETS THE23
ELIGIBILITY CRITERIA ESTABLISHED IN RULE PURSUANT TO SUBSECTION24
(4)(c)(IV) OF THIS SECTION, INCLUDE COVERAGE THAT:25
(A) H
AS NO PREMIUM;26
(B) H
AS AN ACTUARIAL VALUE OF NOT LESS THAN NINETY -FOUR27
1289
-7- PERCENT; AND1
(C) T
O THE EXTENT POSSIBLE WITH AVAILABLE FUNDING ,2
INCLUDES COST SHARING THAT IS FURTHER REDUCED FROM SUBSECTION3
(4)(c.5)(III)(B)
OF THIS SECTION SUCH THAT THE PLAN HAS CONSUMER4
COST SHARING RESPONSIBILITIES FOR EMERGENCY SERVICES EQUIVALENT5
TO COST SHARING RESPONSIBILITIES FOR EMERGENCY MEDICAL6
ASSISTANCE PURSUANT TO SECTION 25.5-5-103.7
SECTION 6. In Colorado Revised Statutes, 24-75-109, add8
(1)(a.7) and (1)(a.8) as follows:9
24-75-109. Controller may allow expenditures in excess of10
appropriations - limitations - appropriations for subsequent fiscal11
year restricted - repeal. (1) For the purpose of closing the state's books,12
and subject to the provisions of this section, the controller may, on or13
after May 1 of any fiscal year and before the forty-fifth day after the close14
thereof, upon approval of the governor, allow any department, institution,15
or agency of the state, including any institution of higher education, to16
make an expenditure in excess of the amount authorized by an item of17
appropriation for such fiscal year if:18
(a.7) THE OVEREXPENDITURE IS BY THE DEPARTMENT OF HEALTH19
CARE POLICY AND FINANCING FOR THE STATE MEDICAL ASSISTANCE20
PROGRAM, ESTABLISHED PURSUANT TO SECTION 25.5-2-104; OR21
(a.8) THE OVEREXPENDITURE IS BY THE DEPARTMENT OF HEALTH22
CARE POLICY AND FINANCING FOR THE STATE CHILDREN'S BASIC HEALTH23
PLAN, ESTABLISHED PURSUANT TO SECTION 25.5-2-105; OR24
SECTION 7. In Colorado Revised Statutes, 25-1.5-101, add25
(1)(cc) as follows:26
25-1.5-101. Powers and duties of department - laboratory cash27
1289
-8- fund - report - dispensation of payments under contracts with1
grantees - definitions - repeal. (1) The department has, in addition to all2
other powers and duties imposed upon it by law, the powers and duties3
provided in this section as follows:4
(cc) T
O CARRY OUT THE HEALTH SURVEY FOR BIRTHING PARENTS5
AND REPORTING REQUIREMENTS SET FORTH IN PART 7 OF THIS ARTICLE 1.5.6
SECTION 8.
In Colorado Revised Statutes, add part 7 to article7
1.5 of title 25 as follows:8
PART 79
HEALTH SURVEY FOR BIRTHING PARENTS10
25-1.5-701. Health survey for birthing parents. (1) B
EGINNING11
J
ULY 1, 2022, THE DEPARTMENT SHALL BEGIN DEVELOPING A12
METHODOLOGY AND BUILDING A HEALTH SURVEY FOR BIRTHING PARENTS ,13
REFERRED TO IN THIS SECTION AS THE "SURVEY", TO GIVE PEOPLE WHO14
HAVE GIVEN BIRTH THE OPPORTUNITY TO SHARE OPINIONS AND15
EXPERIENCES DURING THE FIRST FEW YEARS OF THEIR BABIES ' LIVES. THE16
PURPOSE OF THE SURVEY IS TO INFORM COLORADO POLICIES AND17
PROGRAMS DESIGNED TO ADVANCE HEALTH EQUITY . AS PART OF THE18
SURVEY, THE DEPARTMENT SHALL:19
(a) I
NVITE A STATEWIDE COHORT OF PEOPLE WHO HAVE RECENTLY20
GIVEN BIRTH TO JOIN THE SURVEY;21
(b) A
NNUALLY AND UP UNTIL A SURVEY PARTICIPANT 'S CHILD'S22
THIRD BIRTHDAY, PROVIDE TO EACH PARTICIPANT AT LEAST TWO BRIEF23
ONLINE QUESTIONNAIRES ON A VARIETY OF HEALTH AND SOCIAL TOPICS ,24
INCLUDING:25
(I) H
OW THE PARTICIPANT FEELS PHYSICALLY AND EMOTIONALLY26
AFTER HAVING GIVEN BIRTH;27
1289
-9- (II) THE PARTICIPANT'S MENTAL HEALTH AND SUBSTANCE USE1
BEFORE, DURING, AND AFTER PREGNANCY;2
(III) T
HE PARTICIPANT'S OPINIONS ON CHILDHOOD VACCINATIONS3
AND OTHER IMPORTANT HEALTH DECISIONS ;4
(IV) T
HE PARTICIPANT'S ABILITY TO TAKE LEAVE FROM WORK ;5
(V) T
HE PARTICIPANT'S ABILITY TO FEED THE PARTICIPANT'S BABY6
IN THE PARTICIPANT'S PREFERRED WAY;7
(VI) T
HE PARTICIPANT'S EXPERIENCES WITH DOCTORS AND OTHER8
HEALTH-CARE WORKERS DURING AND AFTER PRE GNANCY , INCLUDING ANY9
EXPERIENCES OF DISCRIMINATION; AND10
(VII) T
HE PARTICIPANT'S FAMILY'S ACCESS TO HEALTH CARE AND11
HEALTH SERVICES, INCLUDING BEHAVIORAL HEALTH SERVICES AND ORAL12
HEALTH SERVICES, AND OTHER RESOURCES NECESSARY FOR THE FAMILY13
TO BE HAPPY AND HEALTHY.14
(2) T
HE SURVEY MUST BE DESIGNED TO OVERSAMPLE MEMBERS OF15
GROUPS THAT COMPRISE A SMALL PERCENTAGE OF THE POPULATION AND16
THAT DISPROPORTIONATELY EXPERIENCE HEALTH INEQUITIES , INCLUDING17
A
FRICAN AMERICANS AND NATIVE AMERICANS, SO THAT DATA ABOUT18
THE EXPERIENCES OF THESE POPULATIONS CAN BE MADE PUBLIC .19
P
ARTICIPANT DATA ABOUT RACE, ETHNICITY, SEXUAL ORIENTATION, AND20
GENDER IDENTITY MUST BE COLLECTED AND REPORTED IN A MANNER THAT21
PROTECTS PERSONALLY IDENTIFYING INFORMATION .22
SECTION 9.
In Colorado Revised Statutes, 25.5-2-103, amend23
(1)(b) as follows:24
25.5-2-103. Reproductive health-care program - report - rules25
- definitions. (1) As used in this section, unless the context otherwise26
requires:27
1289
-10- (b) "Eligible individual" means an individual with reproductive1
capacity, regardless of gender, citizenship, or immigration status, who2
would be eligible to enroll in the medical assistance program, except that3
the individual is not a citizen of the United States and is not considered4
an eligible noncitizen pursuant to 8 U.S.C. secs. 1611 and 1612 and5
section 25.5-5-101 (2)(b) AS DESCRIBED IN SECTION 25.5-4-103 (13) BUT6
IS NOT ELIGIBLE DUE SOLELY TO THE INDIVIDUAL'S IMMIGRATION STATUS,7
AND WHO IS NOT ELIGIBLE FOR, OR DECLINES TO ENROLL IN, STATE8
MEDICAL ASSISTANCE, AS DESCRIBED IN SECTION 25.5-2-104.9
SECTION 10. In Colorado Revised Statutes, add 25.5-2-104 and10
25.5-2-105 as follows:11
25.5-2-104. State-funded health and medical care.12
(1) B
EGINNING
NO LATER THAN JANUARY 1, 2025, THERE IS CREATED THE13
STATE MEDICAL ASSISTANCE PROGRAM REFERRED TO IN THIS SECTION AS14
"
STATE MEDICAL ASSISTANCE". STATE MEDICAL ASSISTANCE INCLUDES15
ALL BENEFITS AND SERVICES AT THE SAME COST TO THE BENEFICIARY AS16
ARE OFFERED PURSUANT TO THE MEDICAL ASSISTANCE PROGRAM DEFINED17
IN SECTION 25.5-4-103 (13), SUCH THAT, TO THE MAXIMUM EXTENT18
POSSIBLE, ELIGIBLE INDIVIDUALS MUST NOT BE ABLE TO TELL THAT THE19
PERSON IS ENROLLED IN A DIFFERENT PROGRAM FROM MEDICAL20
ASSISTANCE PURSUANT TO SECTION 25.5-4-103 (13).21
(2) A
CHILD WHO IS LESS THAN NINETEEN YEARS OF AGE IS22
ELIGIBLE TO RECEIVE STATE MEDICAL ASSISTANCE IF THE CHILD WOULD BE23
ELIGIBLE FOR MEDICAL ASSISTANCE AS DEFINED IN SECTION 25.5-4-10324
(13)
BUT IS NOT ELIGIBLE DUE SOLELY TO THE CHILD 'S IMMIGRATION25
STATUS.26
(3) A
CHILD WHO IS LESS THAN NINETEEN YEARS OF AGE IS27
1289
-11- PRESUMPTIVELY ELIGIBLE FOR STATE MEDICAL ASSISTANCE AND WILL1
RECEIVE SERVICES SPECIFIED BY STATE LAW ONLY IF A PARENT OR LEGAL2
GUARDIAN OF THE CHILD DECLARES ALL PERTINENT INFORMATION3
RELATING TO THE CRITERIA OF INCOME AND ASSETS OF THE CHILD 'S4
FAMILY.5
(4) S
TATE MEDICAL ASSISTANCE MUST BE FUNDED BY STATE6
FUNDS ONLY, EXCEPT TO THE EXTENT FEDERAL FUNDS ARE MADE7
AVAILABLE THROUGH EXPRESS WRITTEN AUTHORIZATION THROUGH A8
FEDERAL WAIVER, STATE PLAN AMENDMENT , OR OTHERWISE, BY THE9
CENTERS FOR MEDICARE AND MEDICAID SERVICES .10
(5) T
HE STATE DEPARTMENT SHALL SEEK ANY NECESSARY11
FEDERAL APPROVALS TO MAXIMIZE ANY AVAILABLE FEDERAL FINANCIAL12
PARTICIPATION IN IMPLEMENTING THIS SECTION .13
(6) T
O THE MAXIMUM EXTENT ALLOWABLE UNDER FEDERAL LAW ,14
THE STATE DEPARTMENT SHALL , USING APPROPRIATE FUNDING, USE THE15
SAME INFRASTRUCTURE AND PROVIDER NETWORK TO DELIVER STATE16
MEDICAL ASSISTANCE AS IT DOES TO DELIVER MEDICAL ASSISTANCE AS17
DEFINED IN SECTION 25.5-4-103 (13).18
(7) T
HIS SECTION CONSTITUTES STATE AUTHORITY WITHIN THE19
MEANING OF 8 U.S.C. SEC. 1621 (d), AS THAT LAW EXISTED ON JANUARY20
1,
2022.21
(8) (a) DURING ITS 2024 PRESENTATION TO THE JOINT BUDGET22
COMMITTEE OF THE GENERAL ASSEMBLY AND IN ITS PRESENTATION TO THE23
HEALTH AND HUMAN SERVICES COMMITTEE OF THE SENATE AND THE24
HEALTH AND INSURANCE COMMI TTEE OF THE HOUSE OF REPRESENTATIVES,25
OR ANY SUCCESSOR COMMITTEES , AT THE HEARING HELD PURSUANT TO26
SECTION 2-7-203 (2)(a) OF THE "STATE MEASUREMENT FOR27
1289
-12- ACCOUNTABLE, RESPONSIVE, AND TRANSPARENT (SMART)1
GOVERNMENT ACT", THE STATE DEPARTMENT SHALL REPORT ON ITS2
PLANS AND PROGRESS IN IMPLEMENTING STATE MEDICAL ASSISTANCE .3
(b) BEGINNING JANUARY 1, 2026, AND CONTINUING EVERY4
JANUARY THEREAFTER, THE STATE DEPARTMENT, IN ITS PRESENTATION TO5
THE JOINT BUDGET COMMITTEE OF THE GENERAL ASSEMBLY AND IN ITS6
PRESENTATION TO THE HEALTH AND HUMAN SERVICES COMMITTEE OF THE7
SENATE AND THE HEALTH AND INSURANCE COMMITTEE OF THE HOUSE OF8
REPRESENTATIVES, OR ANY SUCCESSOR COMMITTEES , AT THE HEARING9
HELD PURSUANT TO SECTION 2-7-203 (2)(a) OF THE "STATE10
MEASUREMENT FOR ACCOUNTABLE, RESPONSIVE, AND TRANSPARENT11
(SMART) GOVERNMENT ACT", SHALL REPORT ON THE COST SAVINGS AND12
HEALTH IMPROVEMENTS ASSOCIATED WITH STATE MEDICAL ASSISTANCE.13
25.5-2-105. State children's basic health plan. (1) B
EGINNING14 NO LATER THAN JANUARY 1, 2025, THERE IS CREATED THE STATE15
CHILDREN'S BASIC HEALTH PLAN. THE STATE CHILDREN'S BASIC HEALTH16
PLAN INCLUDES ALL BENEFITS AND SERVICES , AT THE SAME COST TO THE17
BENEFICIARY, AS ARE OFFERED PURSUANT TO THE CHILDREN 'S BASIC18
HEALTH PLAN IN SECTION 25.5-8-107, SUCH THAT, TO THE MAXIMUM19
EXTENT POSSIBLE, ELIGIBLE INDIVIDUALS MUST NOT BE ABLE TO TELL20
THAT THEY ARE ENROLLED IN A DIFFERENT PROGRAM FROM THE PLAN21
DESCRIBED IN SECTION 25.5-8-107.22
(2) A
CHILD WHO IS LESS THAN NINETEEN YEARS OF AGE IS23
ELIGIBLE TO RECEIVE THE STATE CHILDREN'S BASIC HEALTH PLAN IF THE24
CHILD WOULD BE ELIGIBLE FOR THE CHILDREN 'S BASIC HEALTH PLAN AS25
DESCRIBED IN 25.5-8-107, BUT IS NOT ELIGIBLE DUE SOLELY TO THE26
CHILD'S IMMIGRATION STATUS.27
1289
-13- (3) A CHILD WHO LESS THAN NI NETEEN YEARS OF AGE IS1
PRESUMPTIVELY ELIGIBLE FOR THE STATE CHILDREN 'S BASIC HEALTH PLAN2
AND WILL RECEIVE SERVICES SPECIFIED BY STATE LAW ONLY IF A PARENT3
OR LEGAL GUARDIAN OF THE CHILD DECLARES ALL PERTINENT4
INFORMATION RELATING TO THE CRITERIA OF INCOME AND ASSETS OF THE5
CHILD'S FAMILY.6
(4) T
HE STATE CHILDREN'S BASIC HEALTH PLAN MUST BE FUNDED7
BY STATE FUNDS ONLY, EXCEPT TO THE EXTENT FEDERAL FUNDS ARE8
MADE AVAILABLE THROUGH EXPRESS WRITTEN AUTHORIZATION THROUGH9
A FEDERAL WAIVER, STATE PLAN AMENDMENT , OR OTHERWISE, BY THE10
CENTERS FOR MEDICARE AND MEDICAID SERVICES .11
(5) T
HE STATE DEPARTMENT SHALL SEEK ANY NECESSARY12
FEDERAL APPROVALS TO MAXIMIZE ANY AVAILABLE FEDERAL FINANCIAL13
PARTICIPATION IN IMPLEMENTING THIS SECTION .14
(6) T
O THE MAXIMUM EXTENT ALLOWABLE UNDER FEDERAL LAW ,15
THE STATE DEPARTMENT SHALL , USING APPROPRIATE FUNDING, USE THE16
SAME INFRASTRUCTURE AND PROVIDER NETWORK TO DELIVER THE STATE 'S17
CHILDREN'S BASIC HEALTH PLAN AS IT DOES TO DELIVER THE CHILDREN 'S18
BASIC HEALTH PLAN DESCRIBED IN SECTION 25.5-8-107.19
(7) T
HIS SECTION CONSTITUTES STATE AUTHORITY WITHIN THE20
MEANING OF 8 U.S.C. SEC. 1621 (d), AS THAT LAW EXISTED ON JANUARY21
1,
2022.22
(8) (a) DURING ITS 2024 PRESENTATION TO THE JOINT BUDGET23
COMMITTEE OF THE GENERAL ASSEMBLY AND IN ITS PRESENTATION TO THE24
HEALTH AND HUMAN SERVICES COMMITTEE OF THE SENATE AND THE25
HEALTH AND INSURANCE COMMI TTEE OF THE HOUSE OF REPRESENTATIVES,26
OR ANY SUCCESSOR COMMITTEES, AT THE HEARING HELD PURSUANT TO27
1289
-14- SECTION 2-7-203 (2)(a) OF THE "STATE MEASUREMENT FOR1
ACCOUNTABLE, RESPONSIVE, AND TRANSPARENT (SMART)2
GOVERNMENT ACT", THE STATE DEPARTMENT SHALL REPORT ON ITS3
PLANS AND PROGRESS IN IMPLEMENTING THE STATE BASIC HEALTH PLAN.4
(b) BEGINNING JANUARY 1, 2026, AND CONTINUING EVERY5
JANUARY THEREAFTER, THE STATE DEPARTMENT, IN ITS PRESENTATION TO6
THE JOINT BUDGET COMMITTEE OF THE GENERAL ASSEMBLY AND IN ITS7
PRESENTATION TO THE HEALTH AND HUMAN SERVICES COMMITTEE OF THE8
SENATE AND THE HEALTH AND INSURANCE COMMITTEE OF THE HOUSE OF9
REPRESENTATIVES, OR ANY SUCCESSOR COMMITTEES, AT THE HEARING10
HELD PURSUANT TO SECTION 2-7-203 (2)(a) OF THE "STATE11
MEASUREMENT FOR ACCOUNTABLE, RESPONSIVE, AND TRANSPARENT12
(SMART) GOVERNMENT ACT", SHALL REPORT ON THE COST SAVINGS AND13
HEALTH IMPROVEMENTS ASSOCIATED WITH THE STATE BASIC HEALTH14
PLAN.15
SECTION 11. In Colorado Revised Statutes, 25.5-4-103, amend16
(10) as follows:17
25.5-4-103. Definitions. As used in this article 4 and articles 518
and 6 of this title 25.5, unless the context otherwise requires:19
(10) "Legal immigrant" "LAWFULLY RESIDING" means an20
individual who is not a citizen or national of the United States and who21
was lawfully admitted to the United States by the immigration and22
naturalization service, or any successor agency, as an actual or23
prospective permanent resident or whose extended physical presence in24
the United States is known to and allowed by the immigration and25
naturalization service, or any successor agency.26
SECTION 12. In Colorado Revised Statutes, 25.5-4-201, amend27
1289
-15- (1) as follows:1
25.5-4-201. Cash system of accounting - financial2
administration of medical services premiums - medical programs3
administered by department of human services - federal4
contributions - rules. (1) The state department shall utilize the cash5
system of accounting, as enunciated by the governmental accounting6
standards board, regardless of the source of revenues involved, for all7
activities of the state department relating to the financial administration8
of any nonadministrative expenditure that qualifies for federal financial9
participation under Title XIX of the federal "Social Security Act", AND10
FOR THE ADMINISTRATION OF THE STATE-FUNDED HEALTH AND MEDICAL11
CARE PROGRAM, CREATED PURSUANT TO SECTION 25.5-2-104, AND FOR12
THE STATE CHILDREN'S BASIC HEALTH PLAN, CREATED PURSUANT TO13
SECTION 25.5-2-105, except for expenditures under the program for the14
medically indigent, article 3 of this title TITLE 25.5.15
SECTION 13. In Colorado Revised Statutes, 25.5-4-301, amend16
(13) as follows:17
25.5-4-301. Recoveries - overpayments - penalties - interest -18
adjustments - liens - review or audit procedures. (13) To the extent19
allowable under federal law, the state department shall recover from a20
legal immigrant's THE sponsor OF A LAWFULLY RESIDING INDIVIDUAL all21
medical assistance paid on behalf of a THE sponsored legal immigrant22
LAWFULLY RESIDING INDIVIDUAL who is enrolled in the medical assistance23
program.24
SECTION 14. In Colorado Revised Statutes, amend 25.5-4-50325
as follows:26
25.5-4-503. Waiver applications - authorization. (1) The state27
1289
-16- department is authorized to apply for health insurance flexibility and1
accountability waivers that will enable the state to add more flexibility to2
Colorado's medicaid program and that will result in a cost-effective3
method of providing health-care services to Coloradans.4
(2) T
HE STATE DEPARTMENT SHALL PURSUE AND , IF APPROVED,5
IMPLEMENT A DEMONSTRATION WAIVER THAT AUTHORIZES THE STATE TO6
USE FEDERAL MEDICAL ASSISTANCE PAYMENTS AUTHORIZED PURSUANT TO7
SECTION 1903(v) OF THE FEDERAL "SOCIAL SECURITY ACT", AS AMENDED,8
IN COORDINATION WITH THE DIVISION OF INSURANCE TO ENHANCE OR9
EXPAND A STATE-SUBSIDIZED INDIVIDUAL HEALTH COVERAGE PLAN AS10
DEFINED IN SECTION 10-16-1203 (15) AND, ONLY IF NEEDED TO MAXIMIZE11
FEDERAL FINANCIAL PARTICIPATION, FOR COLORADANS RECEIVING STATE12
MEDICAL ASSISTANCE PURSUANT TO SECTION 25.5-2-104 OR 25.5-5-20113
(6). TO THE EXTENT SUCH FEDERAL FUNDS ARE USED TO ENHANCE OR14
EXPAND A STATE-SUBSIDIZED INDIVIDUAL HEALTH COVERAGE PLAN, AS15
DEFINED IN SECTION 10-16-1203 (15), THE HEALTH INSURANCE16
AFFORDABILITY ENTERPRISE CREATED PURSUANT TO SECTION 10-16-120417
MUST RECEIVE, DEPOSIT INTO THE HEALTH INSURANCE AFFORDABILITY18
CASH FUND CREATED IN SECTION 10-16-1206, AND ALLOCATE THE19
FEDERAL SHARE OF THE MEDICAL ASSISTANCE PAYMENTS PURSUANT TO20
SECTION 10-16-1205 (2), SUBJECT TO ANY CONDITIONS SET FORTH IN THE21
APPROVAL OF THE WAIVER.22
SECTION 15. In Colorado Revised Statutes, 25.5-5-101, amend23
(3) as follows:24
25.5-5-101. Mandatory provisions - eligible groups.25
(3) Notwithstanding any other provision of this article and articles 4 and26
6 of this title TITLE 25.5, as a condition of eligibility for medical27
1289
-17- assistance under this article ARTICLE 5 and articles 4 and 6 of this title1
TITLE 25.5, a legal immigrant PERSON WHO IS LAWFULLY RESIDING IN THE2
STATE shall agree to refrain from executing an affidavit of support for the3
purpose of sponsoring an alien on or after July 1, 1997, under rules4
promulgated by the immigration and naturalization service, or any5
successor agency, during the pendency of such legal immigrant's THE6
LAWFULLY RESIDING PERSON'S receipt of medical assistance. Nothing in7
this subsection (3) shall be construed to affect a legal immigrant's8
AFFECTS A LAWFULLY RESIDING PERSON'S eligibility for medical assistance9
under this article PURSUANT TO THIS ARTICLE 5 and articles 4 and 6 of this10
title TITLE 25.5 based upon such legal immigrant's THE LAWFULLY11
RESIDING PERSON'S responsibilities under an affidavit of support entered12
into before July 1, 1997.13
SECTION 16. In Colorado Revised Statutes, 25.5-5-201, amend14
(3), (4) and (4.5)(a); and add (6) as follows:15
25.5-5-201. Optional provisions - optional groups. (3) A legal16
immigrant LAWFULLY RESIDING PERSON who is receiving medicaid17
nursing facility care or home- and community-based services on July 1,18
1997, shall MUST continue to receive such services as long as he or she19
THE PERSON meets the eligibility requirements other than citizen status.20
State general funds may be used to reimburse such care in the event that21
federal financial participation is not available.22
(4) A pregnant legal immigrant shall be PERSON WHO IS LAWFULLY23
RESIDING IS eligible to receive prenatal and medical services for labor and24
delivery as long as she MEDICAL ASSISTANCE AS LONG AS THE INDIVIDUAL25
meets eligibility requirements other than
THOSE RELATED TO citizen OR26
IMMIGRATION status. State general funds may be used to reimburse such27
1289
-18- care in the event that federal financial participation is not available.1
(4.5) (a) Subject to the receipt of federal financial participation,2
to the maximum extent allowed under federal law, a person who was3
eligible for all pregnancy-related and postpartum services under the4
medical assistance program for the sixty days following the pregnancy5
remains continuously eligible for all services under the medical assistance6
program for the twelve-month postpartum period.7
(6) (a) B
EGINNING
NO LATER THAN JANUARY 1, 2025, A PREGNANT8
PERSON WHO IS NOT A CITIZEN AND WHO IS NOT ELIGIBLE FOR MEDICAL9
ASSISTANCE PURSUANT TO SUBSECTION (4) OF THIS SECTION IS ELIGIBLE TO10
RECEIVE MEDICAL ASSISTANCE PURSUANT TO THIS SUBSECTION (6)(a) IF11
THE INDIVIDUAL MEETS THE ELIGIBILITY REQUIREMENTS OTHER THAN12
THOSE RELATED TO CITIZENSHIP AND IMMIGRATION STATUS .13
(b) A
PREGNANT PERSON WHO IS ELIGIBLE FOR MEDICAL14
ASSISTANCE PURSUANT TO THIS SUBSECTION (6) REMAINS CONTINUOUSLY15
ELIGIBLE FOR ALL MEDICAL SERVICES PURSUANT TO THE MEDICAL16
ASSISTANCE PROGRAM FOR THE TWELVE -MONTH POSTPARTUM
PERIOD, SO17
LONG AS ELIGIBILITY REMAINS IN EFFECT PURSUANT TO SUBSECTION18
(4.5)(a) OF THIS SECTION.19
(c) T
HE STATE DEPARTMENT SHALL SEEK ANY NECESSARY20
FEDERAL APPROVALS TO MAXIMIZE ANY AVAILABLE FEDERAL FINANCIAL21
PARTICIPATION IN IMPLEMENTING THIS SUBSECTION (6). BENEFITS FOR22
SERVICES OBTAINED PURSUANT TO THIS SUBSECTION (6) MUST BE23
PROVIDED WITH ONLY STATE FUNDS IF FEDERAL FINANCIAL PARTICIPATION24
IS UNAVAILABLE FOR SUCH SERVICES.25 (d) (I) DURING ITS 2024 PRESENTATION TO THE JOINT BUDGET26
COMMITTEE OF THE GENERAL ASSEMBLY AND IN ITS PRESENTATION TO THE27
1289
-19- HEALTH AND HUMAN SERVICES COMMITTEE OF THE SENATE AND THE1
HEALTH AND INSURANCE COMMI TTEE OF THE HOUSE OF REPRESENTATIVES,2
OR ANY SUCCESSOR COMMITTEES, AT THE HEARING HELD PURSUANT TO3
SECTION 2-7-203 (2)(a) OF THE "STATE MEASUREMENT FOR4
ACCOUNTABLE, RESPONSIVE, AND TRANSPARENT (SMART)5
GOVERNMENT ACT", THE STATE DEPARTMENT SHALL REPORT ON ITS6
PLANS AND PROGRESS IN IMPLEMENTING THE COVERAGE EXPANSION7
CREATED PURSUANT TO THIS SUBSECTION (6).8
(II) BEGINNING JANUARY 1, 2026, AND CONTINUING EVERY9
JANUARY THEREAFTER, THE STATE DEPARTMENT, IN ITS PRESENTATION TO10
THE JOINT BUDGET COMMITTEE OF THE GENERAL ASSEMBLY AND IN ITS11
PRESENTATION TO THE HEALTH AND HUMAN SERVICES COMMITTEE OF THE12
SENATE AND THE HEALTH AND INSURANCE COMMITTEE OF THE HOUSE OF13
REPRESENTATIVES, OR ANY SUCCESSOR COMMITTEES, AT THE HEARING14
HELD PURSUANT TO SECTION 2-7-203 (2)(a) OF THE "STATE15
MEASUREMENT FOR ACCOUNTABLE, RESPONSIVE, AND TRANSPARENT16
(SMART) GOVERNMENT ACT", SHALL REPORT ON THE COST SAVINGS AND17
HEALTH IMPROVEMENTS ASSOCIATED WITH THE COVERAGE EXPANSION18
CREATED PURSUANT TO THIS SUBSECTION (6).19
SECTION 17. In Colorado Revised Statutes, 25.5-5-202, add20
(1)(y) as follows:21
25.5-5-202. Basic services for the categorically needy - optional22
services. (1) Subject to the provisions of subsection (2) of this section,23
the following are services for which federal financial participation is24
available and that Colorado has selected to provide as optional services25
under the medical assistance program:26
(y) F
OR ANY PERINATAL PERSON , COMPREHENSIVE LACTATION27
1289
-20- SUPPORT SERVICES, LACTATION SUPPLIES AND EQUIPMENT , AND1
MAINTENANCE OF MULTI-USER LOANED EQUIPMENT. AN INDIVIDUAL2
TRAINED IN ADVANCED LACTATION SUPPORT SHALL PROVIDE THE3
LACTATION SUPPORT SERVICES. LACTATION EQUIPMENT MUST INCLUDE A4
SINGLE-USER DOUBLE ELECTRIC BREAST PUMP , PUMP PARTS AND PUMP5
COLLECTION KIT, AND ACCESS TO A LOANED MULTI-USER HOSPITAL GRADE6
ELECTRIC BREAST PUMP ALONG WITH A COMPATIBLE INDIVIDUAL7
COLLECTION KIT. INDIVIDUALS MUST HAVE ACCESS TO SINGLE-USER8
LACTATION SUPPLIES AND EQUIPMENT PRIOR TO DELIVERY. ACCESS TO9
MULTI-USER LOANED BREAST PUMPS SHALL BE AUTHORIZED BY A10
HEALTH-CARE PROVIDER. ACCESS TO MULTI-USER LOANED BREAST PUMPS11
IS PRIORITIZED FOR INDIVIDUALS WITH PREMATURE, MEDICALLY FRAGILE,12
LOW BIRTH WEIGHT INFANTS , AND WITH LACTATION COMPLICATIONS.13
INDIVIDUALS CANNOT BE REQUIRED TO ENROLL IN SEPARATE OR14
ADDITIONAL PROGRAMS IN ORDER TO RECEIVE COVERED LACTATION15
EQUIPMENT OR LACTATION SUPPORT SERVICES .16
SECTION 18. In Colorado Revised Statutes, 25.5-5-204, amend17
(2) and (2.5) as follows:18
25.5-5-204. Presumptive eligibility - pregnant person -19
children - long-term care - state plan. (2) (a) A pregnant woman shall20
be PERSON IS presumptively eligible for the medical assistance program21
and shall receive services specified by federal law only if the woman22
PERSON declares all pertinent information relating to the criteria of23
income, assets, and status AND, ONLY IF NECESSARY TO ADMINISTER24
REIMBURSEMENT FOR SERVICES , STATUS.25
(b) A woman shall declare her immigration status unless the26
general assembly provides funding for prenatal care services for27
1289
-21- undocumented residents.1
(2.5) A child under the age of eighteen years shall be LESS THAN2
NINETEEN YEARS OF AGE IS presumptively eligible for the medical3
assistance program and shall receive services specified by federal law4
only if a parent or legal guardian of the child declares all pertinent5
information relating to the criteria of income, assets, and status AND,6
ONLY IF NECESSARY TO ADMINISTER REIMBURSEMENT FOR SERVICES ,7
STATUS of the child's family.8
SECTION 19. In Colorado Revised Statutes, add 25.5-6-115 as9
follows:10
25.5-6-115. Notification of federal immigration consequences.11
T
HE STATE DEPARTMENT SHALL CONSULT WITH STAKEHOLDERS ,12
INCLUDING PEOPLE WITH LIVED EXPERIENCE , IMMIGRANTS RIGHTS13
ADVOCATES, HEALTH-CARE ADVOCATES, AND IMMIGRATION LAWYERS, TO14
PROVIDE CLEAR AND ACCURATE INFORMATION AND REFERRALS15
REGARDING CURRENT PUBLIC CHARGE POLICIES .16
SECTION 20.
In Colorado Revised Statutes, 25.5-8-103, amend17
(4)(a)(I) and (4)(b)(I) as follows:18
25.5-8-103. Definitions. As used in this article 8, unless the19
context otherwise requires:20
(4) "Eligible person" means:21
(a) (I) A person who is less than nineteen years of age,
WHO IS A22
CITIZEN OR MEETS THE IMMIGRATION STATUS REQUIREMENTS SET FORTH23
IN SECTION 25.5-8-109 (6) OR 25.5-8-109 (7), whose family income does24
not exceed two hundred fifty percent of the federal poverty line, adjusted25
for family size,
AND WHO IS NOT ELIGIBLE FOR MEDICAL ASSISTANCE26
PURSUANT TO ARTICLES 4, 5, AND 6 OF THIS TITLE 25.5.27
1289
-22- (b) (I) A pregnant woman PERSON WHO IS A CITIZEN OR MEETS THE1
IMMIGRATION STATUS REQUIREMENTS SET FORTH IN SECTION 25.5-8-1092
(6)
OR 25.5-8-109 (7), whose family income does not exceed two hundred3
fifty percent of the federal poverty line, adjusted for family size, and who4
is not eligible for medicaid
MEDICAL ASSISTANCE PURSUANT TO ARTICLES5
4,
5, AND 6 OF THIS TITLE 25.5.6
SECTION 21.
In Colorado Revised Statutes, 25.5-8-107, repeal7
(1)(b); and add (1)(a)(V) and (1)(i) as follows:8
25.5-8-107. Duties of the department - schedule of services -9
premiums - copayments - subsidies - purchase of childhood10
immunizations. (1) In addition to any other duties pursuant to this article11
8, the department has the following duties:12
(a) (V) I
N ADDITION TO THE ITEMS SPECIFIED IN SUBSECTIONS13
(1)(a)(I), (1)(a)(II),
AND (1)(a)(III) OF THIS SECTION, AND ANY14
ADDITIONAL ITEMS APPROVED BY THE MEDICAL SERVICES BOARD , THE15
MEDICAL SERVICES BOARD SHALL INCLUDE , FOR ALL PERINATAL PEOPLE,16
COMPREHENSIVE LACTATION SUPPORT SERVICES ,
LACTATION SUPPLIES17
AND EQUIPMENT, AND MAINTENANCE OF MULTI-USER LOANED EQUIPMENT.18
AN INDIVIDUAL TRAINED IN ADVANCED LACTATION SUPPORT SHALL19
PROVIDE THE LACTATION SUPPORT SERVICES. LACTATION EQUIPMENT20
MUST INCLUDE A SINGLE-USER DOUBLE ELECTRIC BREAST PUMP , PUMP21
PARTS AND PUMP COLLECTION KIT, AND ACCESS TO A LOANED MULTI-USER22
HOSPITAL GRADE ELECTRIC BREAST PUMP ALONG WITH A COMPATIBLE23
INDIVIDUAL COLLECTION KIT. INDIVIDUALS MUST HAVE ACCESS TO24
SINGLE-USER LACTATION SUPPLIES AND EQUIPMENT PRIOR TO DELIVERY.25
ACCESS TO MULTI-USER LOANED BREAST PUMPS SHALL BE AUTHORIZED BY26
A HEALTH-CARE PROVIDER. ACCESS TO MULTI-USER LOANED BREAST27
1289
-23- PUMPS IS PRIORITIZED FOR INDIVIDUALS WITH PREMATURE, MEDICALLY1
FRAGILE, LOW BIRTH WEIGHT INFANTS , AND WITH LACTATION2
COMPLICATIONS. INDIVIDUALS CANNOT BE REQUIRED TO ENROLL IN3
SEPARATE OR ADDITIONAL PROGRAMS IN ORDER TO RECEIVE COVERED4
LACTATION EQUIPMENT OR LACTATION SUPPORT SERVICES .5
(b) To design and implement a system of cost sharing with6
enrollees using an annual enrollment fee that is based on a sliding fee7
scale. The sliding fee scale shall be developed based on the enrollee's8
family income; except that no enrollment fee shall be assessed against an9
enrollee whose family income is at or below one hundred fifty percent of10
the federal poverty line and no enrollment fee shall be assessed against an11
enrollee who is a pregnant woman. As permitted by federal and state law,12
enrollees in the plan may use funds from a medical savings account to pay13
the annual enrollment fee. On or before November 1 of each year, the14
department shall submit for approval to the joint budget committee its15
annual proposal for cost sharing for the plan based upon a family's16
income.17
(i) (I) T
HE DEPARTMENT SHALL DEVELOP AND IMPLEMENT AN18
OUTREACH STRATEGY FOR COLORADANS WHO BECOME ELIGIBLE FOR19
HEALTH COVERAGE PURSUANT TO SECTION 25.5-2-104, 25.5-2-105,20
25.5-5-201
(6), OR 25.5-8-109 (7). THE STATE DEPARTMENT SHALL WORK21
WITH STAKEHOLDERS TO DEVELOP AN OUTREACH STRATEGY THAT22
INCLUDES:23
(A) F
UNDING FOR COMMUNITY -BASED ORGANIZATIONS TO24
PARTNER WITH THE DEPARTMENT ON OUTREACH ;25
(B) A
METHOD FOR PROVIDING INFORMATION RELATED TO26
ELIGIBILITY AND ENROLLMENT THAT CAN BE PROVIDED TO NONPROFIT27
1289
-24- PARTNERS, SCHOOL DISTRICTS, AND CHARTER SCHOOLS FOR OUTREACH1
PURPOSES; AND2
(C) A
T A MINIMUM, PROVIDING INFORMATION RELATED TO3
ELIGIBILITY AND COVERAGE IN ENGLISH, SPANISH, AND IN EACH4
LANGUAGE SPOKEN BY AT LEAST TWO -AND-ONE-HALF PERCENT OF THE5
POPULATION OF ANY COUNTY WHO SPEAK ENGLISH LESS THAN VERY WELL,6
AS DEFINED BY THE UNITED STATES BUREAU OF THE CENSUS AMERICAN7
COMMUNITY SURVEY , AND WHO SPEAK THE MINORITY LANGUAGE AT8
HOME;9
(II)
APPROXIMATELY TWELVE AND TWENTY -FOUR MONTHS AFTER10
IMPLEMENTATION OF THE STRATEGY REQUIRED PURSUANT TO SUBSECTION11
(1)(i)(I)
OF THIS SECTION, THE DEPARTMENT SHALL CONVENE12
STAKEHOLDERS, INCLUDING DIRECTLY IMPACTED INDIVIDUALS , SERVICE13
PROVIDERS, AND ADVOCACY ORGANIZATIONS THAT ARE DIVERSE WITH14
REGARD TO RACE , ETHNICITY, IMMIGRATION STATUS , SEXUAL15
ORIENTATION, AND GENDER IDENTITY AND WHO ARE AFFECTED BY HIGHER16
RATES OF HEALTH DISPARITIES AND INEQUITIES. THE DEPARTMENT SHALL17
REPORT ON THE OUTREACH AND ENROLLMENT STRATEGY OUTCOMES ,18
INCLUDING ENROLLMENT OF ELIGIBLE PERSONS INTO THESE PROGRAMS19
COMPARED TO THOSE PERSONS WHO ARE ELIGIBLE FOR COVERAGE , BUT20
NOT ENROLLED.21
22
SECTION 22. In Colorado Revised Statutes, 25.5-8-109, amend23
(5.5)(a) and (6); and add (7) as follows:24
25.5-8-109. Eligibility - children - pregnant women - repeal.25
(5.5) (a) Subject to the receipt of federal financial participation, to the26
maximum extent allowed under federal law, a person who was eligible for27
1289
-25- the plan while pregnant and who remains eligible for all1
pregnancy-related and postpartum services under the plan for the sixty2
days following the pregnancy remains continuously eligible for all3
services under the plan for the twelve-month postpartum period.4
(6) (a) Notwithstanding any other provision of law, but subject to5
the availability of sufficient appropriations and the receipt of federal6
financial participation, the department may SHALL provide benefits under7
this article PURSUANT TO THIS ARTICLE 8 to a pregnant woman who is a8
qualified alien PERSON WHO IS LAWFULLY RESIDING , AS DEFINED IN9
SECTION 25.5-4-103 (10), and a child under LESS THAN nineteen years of10
age, who is a qualified alien WHO IS LAWFULLY RESIDING, so long as such11
woman PREGNANT PERSON or child meets eligibility criteria other than12
citizenship OTHER THAN THOSE RELATED TO CITIZENSHIP OR IMMIGRATION13
STATUS.14
(7) (a) B
EGINNING
NO LATER THAN JANUARY 1, 2025,15
NOTWITHSTANDING ANY OTHER PROVISION OF LAW , THE DEPARTMENT16
SHALL PROVIDE BENEFITS PURSUANT TO THIS ARTICLE 8 TO A PREGNANT17
PERSON WHO IS NOT A CITIZEN AND IS NOT ELIGIBLE PURSUANT TO18
SUBSECTION (6) OF THIS SECTION, SO LONG AS THE PREGNANT PERSON19
MEETS THE ELIGIBILITY CRITERIA OTHER THAN THOSE RELATED TO20
CITIZENSHIP OR IMMIGRATION STATUS . ELIGIBILITY PURSUANT TO THIS21
SECTION EXTENDS CONTINUOUSLY THROUGH THE TWELVE -MONTH22
POSTPARTUM PERIOD, SO LONG AS ELIGIBILITY REMAINS IN EFFECT23
PURSUANT TO SUBSECTION (5.5)(a) OF THIS SECTION.24
(b) T
HE DEPARTMENT SHALL SEEK ANY NECESSARY FEDERAL25
APPROVALS TO MAXIMIZE ANY AVAILABLE FEDERAL FINANCIAL26
PARTICIPATION IN IMPLEMENTING THIS SUBSECTION (7).27
1289
-26- (c) (I) DURING ITS 2024 PRESENTATION TO THE JOINT BUDGET1
COMMITTEE OF THE GENERAL ASSEMBLY AND IN ITS PRESENTATION TO THE2
HEALTH AND HUMAN SERVICES COMMITTEE OF THE SENATE AND THE3
HEALTH AND INSURANCE COMMITTEE OF THE HOUSE OF REPRESENTATIVES,4
OR ANY SUCCESSOR COMMITTEES , AT THE HEARING HELD PURSUANT TO5
SECTION 2-7-203 (2)(a) OF THE "STATE MEASUREMENT FOR6
ACCOUNTABLE, RESPONSIVE, AND TRANSPARENT (SMART)7
GOVERNMENT ACT", THE STATE DEPARTMENT SHALL REPORT ON ITS8
PLANS AND PROGRESS IN IMPLEMENTING THE COVERAGE EXPANSION9
CREATED PURSUANT TO THIS SUBSECTION (7).10
(II) BEGINNING JANUARY 1, 2026, AND CONTINUING EVERY11
JANUARY THEREAFTER, THE STATE DEPARTMENT, IN ITS PRESENTATION TO12
THE JOINT BUDGET COMMITTEE OF THE GENERAL ASSEMBLY AND IN ITS13
PRESENTATION TO THE HEALTH AND HUMAN SERVICES COMMITTEE OF THE14
SENATE AND THE HEALTH AND INSURANCE COMMITTEE OF THE HOUSE OF15
REPRESENTATIVES, OR ANY SUCCESSOR COMMITTEES, AT THE HEARING16
HELD PURSUANT TO SECTION 2-7-203 (2)(a) OF THE "STATE17
MEASUREMENT FOR ACCOUNTABLE, RESPONSIVE, AND TRANSPARENT18
(SMART) GOVERNMENT ACT", SHALL REPORT ON THE COST SAVINGS AND19
HEALTH IMPROVEMENTS ASSOCIATED WITH THE COVERAGE EXPANSION20
CREATED PURSUANT TO THIS SUBSECTION (7).21
(d) T
HIS SUBSECTION (7) CONSTITUTES STATE AUTHORITY WITHIN22
THE MEANING OF 8 U.S.C. SEC. 1621 (d), AS THAT LAW EXISTED ON23
J
ANUARY 1, 2022.24
SECTION 23.
In Colorado Revised Statutes, add 25.5-8-109.325
as follows:26
25.5-8-109.3. Health services initiatives. (1) T
O THE EXTENT27
1289
-27- FEDERAL FINANCIAL PARTICIPATION IS AVAILABLE , THE DEPARTMENT1
SHALL DESIGN AND IMPLEMENT HEALTH SERVICE INITIATIVES PURSUANT2
TO SECTION 2105(a)(1)(D)(ii) OF THE FEDERAL "SOCIAL SECURITY ACT",3
AS AMENDED, TO PROVIDE FUNDING FOR CONTINUOUS ENROLLMENT FOR4
THE TWELVE-MONTH POSTPARTUM PERIOD FOR A PERSON WHO IS5
ENROLLED IN HEALTH-CARE COVERAGE PURSUANT TO SECTION 25.5-5-2016
(6)
OR 25.5-8-109 (7).7
(2) T
O THE EXTENT ADDITIONAL FEDERAL FINANCIAL8
PARTICIPATION IS AVAILABLE, THE DEPARTMENT SHALL ESTABLISH A9
STAKEHOLDER PROCESS IN COLLABORATION WITH DEPARTMENT STAFF TO10
DETERMINE ADDITIONAL PRIORITIES AND BUDGET ALLOCATIONS THAT11
DRAW DOWN AT LEAST FIFTY PERCENT OF THE REMAINING HEALTH12
SERVICES INITIATIVE FUNDS TO EXPAND ACCESS TO PERINATAL AND13
POSTPARTUM SUPPORTS .
THE DEPARTMENT SHALL REPORT ON THE14
ESTABLISHED PRIORITIES AND BUDGET ALLOCATIONS AND THE WAYS IN15
WHICH THEY ARE INCLUSIVE OF STAKEHOLDER INPUT DURING THE16
DEPARTMENT'S 2024 PRESENTATION TO THE JOINT BUDGET COMMITTEE OF17
THE GENERAL ASSEMBLY AND IN THE DEPARTMENT'S PRESENTATION TO18
THE HEALTH AND HUMAN SERVICES COMMITTEE OF THE SENATE AND THE19
HEALTH AND INSURANCE COMMI TTEE OF THE HOUSE OF REPRESENTATIVES,20
OR ANY SUCCESSOR COMMITTEES, AT THE HEARING HELD PURSUANT TO21
SECTION 2-7-203 (2)(a) OF THE "STATE MEASUREMENT FOR22
ACCOUNTABLE, RESPONSIVE, AND TRANSPARENT (SMART)23
GOVERNMENT ACT". IN CONDUCTING THE STAKEHOLDER PROCESS , THE24
DEPARTMENT SHALL:25
(a) E
NGAGE DIRECTLY WITH IMPACTED INDIVIDUALS , SERVICE26
PROVIDERS, ADVOCACY ORGANIZATIONS , AND INDIVIDUALS WORKING IN27
1289
-28- OR REPRESENTING COMMUNITIES WHO ARE DIVERSE WITH REGARD TO1
RACE, ETHNICITY, IMMIGRATION STATUS , AGE, ABILITY, SEXUAL2
ORIENTATION, GENDER IDENTITY, OR GEOGRAPHIC REGION OF THE STATE3
AND WHO ARE AFFECTED BY HIGHER RATES OF HEALTH DISPARITIES AND4
INEQUITIES;5
(b) P
UBLICIZE, CONDUCT, AND REPORT OUTCOMES OF6
STAKEHOLDER MEETINGS IN, AT A MINIMUM, ENGLISH AND SPANISH;7
(c) I
NCLUDE OPPORTUNITIES FOR PARTICIPATION IN THE8
STAKEHOLDER PROCESS OUTSIDE OF REGULAR WORK HOURS ;9
(d) CONDUCT A MINIMUM OF FIVE STAKEHOLDER MEETINGS AND10
CONDUCT ADDITIONAL MEETINGS FOCUSED ON HEARING INPUT FROM11
INDIVIDUAL CONSTITUENCIES LISTED IN SUBSECTION (2)(a) OF THIS12
SECTION.13
(e) TAKE INTO CONSIDERATION RESEARCH AND INFORMATION14
FROM REPORTS ISSUED BY THE MATERNAL MORTALITY REVIEW15
COMMITTEE, AS REQUIRED BY SECTION 25-52-104 (6);16
(f) TAKE INTO CONSIDERATION DATA FROM THE HEALTH SURVEY17
FOR BIRTHING PARENTS TO INFORM STAKEHOLDER DECISION -MAKING; AND18
(g) CONSIDER INITIATIVES TO REDUCE DIAPER NEED , EXPAND19
ACCESS TO GROUP-BASED PRENATAL AND PEDIATRIC CARE MODELS , AND20
EXPAND HOME VISITATION PROGRAMS , INCLUDING VOLUNTARY NEWBORN21
NURSE VISITATION PROGRAMS THAT ARE UNIVERSALLY OFFERED TO ALL22
FAMILIES IN A GIVEN COMMUNITY AND PROVIDE AT LEAST ONE NURSE VISIT23
WITHIN THE FIRST THREE MONTHS OF LIFE.24
(3) (a) T
HE DEPARTMENT SHALL SEEK ANY NECESSARY FEDERAL25
APPROVALS TO OBTAIN FEDERAL FINANCIAL PARTICIPATION IN26
IMPLEMENTING SUBSECTION (1) OF THIS SECTION.27
1289
-29- (b) TO THE EXTENT ALLOWABLE , THE DEPARTMENT SHALL1
MAXIMIZE FEDERAL FINANCIAL PARTICIPATION IN IMPLEMENTING THIS2
SECTION.3
SECTION 24. Appropriation. (1) For the 2022-23 state fiscal4
year, $730,573 is appropriated to the department of health care policy and5
financing. This appropriation is from the general fund. To implement this6
act, the department may use this appropriation as follows:7
(a) $258,733 for use by the executive director's office for personal8
services, which amount is based on an assumption that the office will9
require an additional 5.1 FTE;10
(b) $29,707 for use by the executive director's office for operating11
expenses;12
(c) $262,500 for general professional services and special13
projects;14
(d) $161,069 for medical and long-term care services for15
Medicaid eligible individuals, which amount is subject to the "(M)"16
notation as defined in the annual general appropriation act for the same17
fiscal year; and18
(e) $18,564 for children's basic health plan medical and dental19
costs.20
(2) For the 2022-23 state fiscal year, the general assembly21
anticipates that the department of health care policy and financing will22
receive $885,480 in federal funds. The appropriation in subsection (1) of23
this section is based on the assumption that the office will receive this24
amount of federal funds to be used as follows:25
(a) $181,587 for use by the executive director's office for personal26
services, which amount is subject to the "(I)" notation as defined in the27
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(b) $20,848 for use by the executive director's office for operating2
expenses, which amount is subject to the "(I)" notation as defined in the3
annual general appropriation act for the same fiscal year;4
(c) $487,500 for general professional services and special5
projects, which amount is subject to the "(I)" notation as defined in the6
annual general appropriation act for the same fiscal year;7
(d) $161,069 for medical and long-term care services for8
Medicaid eligible individuals; and9
(e) $34,476 for children's basic health plan medical and dental10
costs.11
(3) For the 2022-23 state fiscal year, $423,626 is appropriated to12
the department of public health and environment for use by the center for13
health and environmental information. This appropriation is from the14
general fund and is based on an assumption that the center will require an15
additional 2.5 FTE. To implement this act, the center may use this16
appropriation for health statistics and vital records for health surveys.17
SECTION 25. Appropriation - adjustments to 2022 long bill.18
(1) To implement this act, appropriations made in the annual general19
appropriation act for the 2022-23 state fiscal year to the department of20
health care policy and financing are adjusted as follows:21
(a) The cash funds appropriation from the children's basic health22
plan trust created in section 25.5-8-105 (1), C.R.S., for children's basic23
health plan medical and dental costs is decreased by $340,727, which is24
subject to the "(H)" notation as defined in the annual general25
appropriation act for the same fiscal year; and26
(b) The cash funds appropriation from the healthcare affordability27
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C.R.S., for children's basic health plan medical and dental costs is2
decreased by $564,678, which is subject to the "(H)" notation as defined3
in the annual general appropriation act for the same fiscal year.4
(2) For the 2022-23 state fiscal year, $144,229 is appropriated to5
the department of health care policy and financing. This appropriation is6
from the general fund. To implement this act, the department may use this7
appropriation for children's basic health plan medical and dental costs.8
(3) For the 2022-23 state fiscal year, the general assembly9
anticipates that the department of health care policy and financing will10
receive $761,176 in federal funds for children's basic health plan medical11
and dental costs to implement this act. The appropriations in subsections12
(1) and (2) of this section are based on the assumption that the department13
will receive this amount of federal funds.14
SECTION 26. Safety clause. The general assembly hereby finds,15
determines, and declares that this act is necessary for the immediate16
preservation of the public peace, health, or safety.17
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