Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
Room 029 State Capitol, Denver, CO 80203-1784
Phone: (303) 866-3521 • Fax: (303) 866-3855
lcs.ga@state.co.us • leg.colorado.gov/lcs
Fiscal Note
Memorandum
April 18, 2022
TO: House Appropriations Committee
FROM: Erin Reynolds, Principal Fiscal Analyst
Erin.Reynolds@state.co.us | 303-866-4146
SUBJECT: Fiscal Assessment of Proposed Amendment L.005 to House Bill 22-1289
This memorandum is an assessment of the fiscal impact of the attached proposed Amendment L.005
to House Bill 22-1289. This fiscal assessment is for the impact of the bill with inclusion of this
amendment only. Any other added amendment could influence the fiscal impact.
Summary of Proposed Amendment s
Amendment L.005 delays the implementation of services — including Medicaid and CHP+ lookalike
coverage for pregnant women and children regardless of immigration status — to no later than
January 1, 2025. The bill’s provisions regarding breast pump and lactation consulting coverage for all
Medicaid and CHP+ members take effect upon signature of Governor.
The amendment also allows HCPF to have over-expenditure authority for the lookalike programs
parallel to the authority the department has for Medicaid and CHP+ programs. HCPF is required to
use a cash system of accounting for the program. Finally, the amendment modifies SMART Act
reporting requirements to require program implementation reporting through 2025, then program
cost savings and health improvement reporting beginning 2026 and each year thereafter.
Fiscal Impact of Amendment
The primary fiscal impact of Amendment L.005 is the pushing out of the implementation date for
lookalike benefit programs to no later than January 1, 2025. This shifts most implementation costs to
FY 2023-24.
Bill’s Revised Fiscal Impact with Amendment
Table 1 on the following page shows the impact of the HB 22-1289 with Amendment L.005. In
addition, Table 2 provides a detailed expenditure breakdown by agency and Table 3 outlines service
costs. Costs are unchanged for the CDPHE. Costs in the memorandum have also been updated to
include new information on Health Services Initiative funding, the impact for which is assumed to
begin in FY 2023-24, and require a 35 percent General Fund match. 2
State appropriation. As amended, the bill requires $730,571 General Fund and $885,482 federal funds
to HCPF and 5.1 FTE. The bill also requires an appropriation of $423,626 General Fund to the CDPHE
and 2.5 FTE.
Table 1
State Fiscal Impacts Under HB 22-1289_L.005
Budget Year
FY 2022-23
Out Year
FY 2023-24
Out Year
FY 2024-25
Out Year
FY 2025-26
Revenue
- - - -
Expenditures General Fund $1,154,197 $4,988,292 $3,813,368 $9,974,467
Federal Funds $885,482 $6,852,170 $7,210,928 $16,736,557
Centrally Appropriated $133,468 $230,169 $252,364 $245,799
Total Expenditures $2,173,147 $12,070,631 $11,276,660 $26,956,823
Total FTE 7.6 FTE 12.8 FTE 13.2 FTE 13.7 FTE
Transfers - -
Other Budget General Fund Reserve $173,130 $748,244 $572,005 $1,496,170
Table 2
Expenditures Under HB 22-1289_L.005
Cost Components FY 2022-23 FY 2023-24 FY 2024-25 FY 2025-26
Department of Health Care Policy and Financing
Personal Services $440,320 $919,207 $1,021,428 $992,914
Operating Expenses $7,155 $14,175 $15,525 $14,850
Capital Outlay Costs $43,400 $24,800 $6,200 -
Service Costs
(see Table 3) $375,178 $568,660 $17,300,270 $34,916,034
Service Savings (see Table 3) - ($5,046,187) ($20,435,685) ($20,700,316)
MMIS Programming - $3,114,696 $2,612,463 -
CBMS Programming - $122,463 $573,909 -
Actuarial Contractor - $250,000 - -
Outreach Costs $750,000 $750,000 $750,000 $750,000
County Support - $125,000 $221,227 $189,022
Health Services Initiatives - $10,398,715 $8,349,675 $9,928,371
Centrally Appropriated Costs $90,608 $183,684 $205,879 $199,314
FTE – Personal Services 5.1 FTE 10.1 FTE 11.4 FTE 11.0 FTE
HCPF Subtotal $1,706,660 $11,425,213 $10,620,892 $26,290,189
General Fund $730,571 $4,389,358 $3,204,086 $9,354,318
Federal Funds $885,482 $6,852,170 $7,210,928 $16,736,557
Centrally Appropriated $90,608 $183,684 $205,879 $199,314
3
Table 2
Expenditures Under HB 22-1289_L.005 (Cont.)
Cost Components FY 2022-23 FY 2023-24 FY 2024-25 FY 2025-26
Department of Public Health and Environment
Personal Services $198,560 $216,611 $216,611 $216,611
Operating Expenses $3,645 $3,645 $3,645 $3,645
Capital Outlay Costs $18,600 - - -
Survey Materials and Postage $34,403 $36,124 $37,930 $39,826
Software and Licenses $6,207 $6,232 $6,259 $6,287
Participant Incentives $162,211 $170,322 $178,838 $187,780
Centrally Appropriated Costs $42,860 $46,485 $46,485 $46,485
FTE – Personal Services 2.5 FTE 2.7 FTE 2.7 FTE 2.7 FTE
CDPHE Subtotal $466,486 $479,419 $489,768 $500,634
Department of Human Services
Computer Programming - $166,000 $166,000 $166,000
DHS Subtotal - $166,000 $166,000 $166,000
Total $2,173,147 $12,070,631 $11,276,660 $26,956,823
Total FTE 7.6 FTE 12.8 FTE 13.2 FTE 13.7 FTE
Table 3
Estimated Service Costs and Savings Under HB 22-1289_L.005
Service Costs FY 2022-23 FY 2023-24 FY 2024-25 FY 2025-26
Non-Citizen Pregnant Adult Medicaid - - $9,413,010 $19,514,304
Non-Citizen Pregnant Adult CHP+ - - $804,313 $1,635,438
Non-Citizen Postpartum Adult Medicaid - - $3,909,198 $7,919,640
Non-Citizen Postpartum Adult CHP+ - - $249,940 $506,095
Non-Citizen Children State-only Medicaid - - $976,234 $2,020,865
Non-Citizen Children State-only CHP+ - - $1,126,430 $2,339,998
Breast Pumps Medicaid $322,138 $495,256 $620,108 $745,421
Breast Pumps CHP+ $53,040 $73,404 $82,435 $92,771
Lactation Support Services Medicaid - - $104,685 $125,840
Lactation Support Services CHP+ - - $13,916 $15,661
Total Service Costs $375,178 $568,660 $17,300,270 $34,916,034
General Fund $179,633 $273,319 $7,530,545 $15,185,862
Federal Funds $195,545 $295,340 $9,769,725 $19,730,172
Service Savings
EMS Savings from Non-Pregnant Adults - ($5,046,187) ($20,435,685) ($20,700,316)
Total Service Savings - ($5,046,187) ($20,435,685) ($20,700,316)
General Fund - ($2,523,094) ($10,217,843) ($10,350,158)
Federal Funds - ($2,523,094) ($10,217,842) ($10,350,158)