SB 25-228
Fiscal Note
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
SB 25-228: ENTERPRISE DISABILITY BUY-IN PREMIUMS
Prime Sponsors:
Sen. Amabile; Bridges
Rep. Bird; Sirota
Published for: Senate Second Reading
Drafting number: LLS 25-0975
Fiscal Analyst:
Kristine McLaughlin, 303-866-4776
kristine.mclaughlin@coleg.gov
Version: First Revised Note
Date: April 2, 2025
Fiscal note status: This revised fiscal note reflects the introduced bill, which was recommended by the
Joint Budget Committee as part of the FY 2025-26 Long Bill supplemental and budget package.
It has been updated to make a technical clarification regarding projected fiscal impacts.
Summary Information
Overview. The bill shift premium revenue into the Healthcare Affordability and Sustainability Enterprise.
Types of impacts. The bill is projected to affect the following areas on an ongoing basis:
State Revenue
State Expenditures
TABOR Refunds
Appropriations. For FY 2024-25 and FY 2025-26, the bill requires and included several changes to
appropriations for the Department of Health Care Policy and Financing that result in no net change in
total appropriations. See State Appropriations section.
Table 1
State Fiscal Impacts
Type of Impact
1
Current Year
FY 2024-25
Budget Year
FY 2025-26
Out Year
FY 2026-27
State Revenue
2
$0 $0 $0
State Expenditures
3
$0 $1,110,126 $0
Transferred Funds $0 $0 $0
Change in TABOR Refunds -$1,110,126 -$6,660,761 -$6,660,761
Change in State FTE 0.0 FTE 0.0 FTE 0.0 FTE
1
Fund sources for these impacts are shown in the tables below.
2
The bill repeals an existing cash fund and deposits revenue into a new, TABOR-exempt cash fund,
resulting in no net change in state revenue. See Table 1A below.
3
This FY 2025-26 expenditure impact is not anticipated under the OSPB Forecast used by the Joint
Budget Committee for budget balancing purposes. Page 2
April 2, 2025 SB 25-228
Table 1A
State Revenue
Fund and TABOR Status
Current Year
FY 2024-25
Budget Year
FY 2025-26
Out Year
FY 2026-27
Medicaid Buy-in Cash Fund (nonexempt) -$1,110,126 -$6,660,761 -$6,660,761
HAS Medicaid Buy-in Cash Fund (exempt) $1,110,126 $6,660,761 $6,660,761
Net Revenue $0 $0 $0
Table 1B
State Expenditures
Fund Source
Current Year
FY 2024-25
Budget Year
FY 2025-26
Out Year
FY 2026-27
General Fund
1
$0 $1.1 million $0
Cash Funds $0 $0 $0
Federal Funds $0 $0 $0
Centrally Appropriated $0 $0 $0
Total Expenditures $0 $1.1 million $0
Total FTE 0.0 FTE 0.0 FTE 0.0 FTE
1
This expenditure is based on the March 2025 LCS Economic and Revenue Forecast. Under the
March 2025 OSPB Forecast selected by the Joint Budget Committee for balancing, the bill would not
require a $1.1 million General Fund expenditure in FY 2025-26, such that total expenditures would be
$0 in every year.
Table 1C
Change in TABOR Refunds
1
Fund Source
Current Year
FY 2024-25
Budget Year
FY 2025-26
Out Year
FY 2026-27
Property Tax Reimbursements to Local Govts -$1,110,126 $0 $0
Six-Tier Sales Tax Refunds $0 -$6,660,761 -$6,660,761
Net Change in TABOR Refunds -$1,110,126 -$6,660,761 -$6,660,761
1
Under the March 2025 OSPB Forecast selected by the Joint Budget Committee for Balancing, the bill
would reduce six-tier sales tax refunds by $1.1 million in FY 2024-25, with no change to refunds via
property tax reimbursements to local governments.
Page 3
April 2, 2025 SB 25-228
Summary of Legislation
Currently, the Department of Health Care Policy and Financing (HCPF) operates two Medicaid
buy-in programs and will receive revenue from the programs starting May 2025. The bill shifts
this revenue into the existing Colorado Healthcare Affordability and Sustainability Enterprise
(CHASE), making it exempt from TABOR.
To accomplish this, the bill creates a new cash fund under CHASE, the Healthcare Affordability
and Sustainability (HAS) Medicaid Buy-in Cash Fund (new fund) and makes the following
changes to this new fund and the existing Medicaid Buy-in Cash Fund (existing fund):
on the bill’s effective date, the bill deposits any revenue collected from the buy-in programs
or interest earned on that revenue to the new fund, rather than the existing fund;
on June 30, 2025, the bill transfers the balance of the existing cash fund into the new cash
fund; and
on July 1, 2025 the bill repeals the existing fund.
Additionally, the bill creates the Medicaid Buy-in Enterprise Support Board.
Background
Colorado Healthcare Affordability and Sustainability Enterprise (CHASE)
Senate Bill 17-267 created CHASE under HCPF. CHASE charges hospitals a Healthcare
Affordability and Sustainability fee and provides hospitals with services that include drawing
additional federal funds that are passed on to hospitals through payments like the quality
incentive payments.
Medicaid Buy-in Programs
HCPF operates two buy-in programs that allow people with disabilities who are not otherwise
eligible for Medicaid to buy coverage. One program is for working adults with disabilities with
income up to 450 percent of the federal poverty guidelines. The other is for children with
disabilities with family income up to 300 percent of the federal poverty guidelines. Both
programs charge premiums on a sliding scale based on income.
HCPF suspended premium collection on both programs during the public health emergency and
collection will resume in May 2025.
Assumptions
The fiscal note assumes that the bill will be enacted before premium collections for the Medicaid
Buy-in programs begin again in May 2025. Page 4
April 2, 2025 SB 25-228
State Revenue
The bill shifts Medicaid buy-in premium revenue from the Medicaid Buy-in Cash Fund (existing
fund) to the HAS Medicaid Buy-in Cash Fund (new fund), as shown in Table 1B above.
State Transfers
The fiscal note assumes no funds will be transferred from the repealed fund on June 30, 2025, as
HCPF is expected to spend the existing cash fund balance (about $119,000 as of this writing)
before the end of the fiscal year. In addition, it is assumed that premium revenue, when it starts
being collected again in May 2025, will go to the new fund.
State Expenditures
The bill increases state expenditures by $1.1 million in FY 2025-26 only. These costs will be
incurred in the Department of the Treasury and paid from the General Fund. The bill also
minimally increases workload in HCPF and the Governor’s Office.
Property Tax Reimbursements to Local Governments
For FY 2025-26 only, the bill increases General Fund expenditures by $1.1 million as a result of
reduced revenue subject to TABOR in FY 2024-25. Under the March 2025 LCS Forecast, the
FY 2024-25 TABOR surplus is not expected to be large enough to fully fund reimbursements to
local governments for the constitutional homestead exemptions. The fiscal note assumes that
General Fund expenditures will be required to fully fund the reimbursements. Therefore,
reducing revenue subject to TABOR by $1.1 million in FY 2024-25 results in a corresponding
increase in General Fund expenditures for FY 2025-26 to fund property tax reimbursements.
Medicaid Buy-in Enterprise Support Board
HCPF will facilitate the Medicaid Buy-in Enterprise Support Board and reimburse members for
any actual and necessary expenses. Given the limited number of members, this impact is
expected to be minimal but will be adjusted for through the normal budget process once the
total number of in-person meetings per year is decided.
Workload will also minimally increase in the Governor’s Office to make appointments to board
and in state departments with employees appointed to the board.
Page 5
April 2, 2025 SB 25-228
TABOR Refunds
The bill is expected to decrease the amount of state revenue required to be refunded to
taxpayers by $1.1 million in the current FY 2024-25, and $6.7 million in FY 2025-26 and future
years. This estimate assumes the March 2025 LCS Forecast. A forecast of state revenue subject to
TABOR is not available beyond FY 2026-27.
The reduction occurs from bringing the Medicaid buy-in programs within the CHASE enterprise
and shifting revenue from the non-exempt Medicaid Buy-in Cash Fund into the newly created,
TABOR-exempt, Healthcare Affordability and Sustainability Medicaid Buy-in Cash Fund. The
result is a reduction in cash fund revenue subject to TABOR. Decreased cash fund revenue
subject to TABOR will increase the amount of General Fund available to spend or save elsewhere
in the budget.
Effective Date
The bill takes effect May 1, 2025.
State Appropriations
The bill requires and includes the following appropriations to the Department of Health Care
Policy and Financing, resulting in no net change in total appropriations:
for the current FY 2024-25, an increase of $1,110,126 from the newly created Healthcare
Affordability and Sustainability Medicaid Buy-in Cash Fund and a corresponding decrease in
appropriations from the Medicaid Buy-in Cash Fund; and
for FY 2025-26, an increase of $6,660,761 from the newly created Healthcare Affordability
and Sustainability Medicaid Buy-in Cash Fund and a corresponding decrease in
appropriations from the Medicaid Buy-in Cash Fund.
For FY 2025-26, under the March 2025 LCS Forecast, the bill would also require an appropriation
of $1,110,126 from the General Fund to the Department of the Treasury for property tax
reimbursements. Under the March 2025 OSPB Forecast selected by the Joint Budget Committee
for balancing, this appropriation is not required, and therefore has not been included in the bill.
State and Local Government Contacts
Health Care Policy and Financing Joint Budget Committee Staff
The revenue and expenditure impacts in this fiscal note represent changes from current law under the bill for each
fiscal year. For additional information about fiscal notes, please visit the General Assembly website.