Colorado Medicaid commission picks adviser, sharpens scrutiny of CES growth and funding gaps
After selecting State Health Governance as its technical adviser June 17, the Commission on Medicaid used applicant interviews to press unresolved questions about Child Extensive Services growth, state budget data and whether Colorado has missed federal Medicaid reimbursements.
Colorado’s Commission on Medicaid moved from setup to substance June 17, choosing State Health Governance as its technical adviser and using the adviser interviews to surface what many lawmakers described as the panel’s central problem: they still do not believe they have clear answers about some of the program’s fastest-growing costs.
The sharpest example was Child Extensive Services, or CES, a Medicaid home- and community-based waiver for children and teens with high support needs. During the meeting, commissioners repeatedly challenged applicants to explain how they would investigate a recent rise in the program and broader questions about whether the state has provided complete budget information.
Official budget documents confirm that CES has grown quickly, though not by a clean 100% under the most directly comparable state measures. In its FY 2025-26 cost-and-caseload adjustment request, the Department of Health Care Policy and Financing reported CES average monthly enrollment of 2,842 in FY 2023-24 and a preliminary 3,520 in FY 2024-25, with 3,941 projected for FY 2025-26. A separate Joint Budget Committee staff briefing shows CES at 3,603 enrollees on a full-program-equivalent basis by the end of FY 2024-25.
Still, the June 17 discussion showed commissioners were less focused on the exact phrasing than on what caused the increase. Sen. Barbara Kirkmeyer told applicants the commission already has the underlying numbers in budget documents and wants help figuring out "what the heck happened between 23 and 25".
HCPF’s FY 2026-27 hearing materials point to at least part of the answer. The department said it proposed ending automatic enrollment into the developmental-disabilities waiver for youth aging out of the CES and Children’s Habilitation Residential Program waivers, a practice it said had been driving future enrollment and spending. Those materials describe the change as prospective, beginning July 1, 2026, suggesting lawmakers were probing not only ordinary caseload growth but also earlier policy choices and eligibility pathways that may have expanded the program.
Commissioners also used the interviews to air broader frustration with the information they say they have received from the department. Kirkmeyer said at one point that lawmakers still do not get , framing that as one reason the adviser needs to do more than facilitate meetings.