SB 187

NOTE: This bill has been prepared for the signatures of the appropriate legislative
officers and the Governor. To determine whether the Governor has signed the bill
or taken other action on it, please consult the legislative status sheet, the legislative
history, or the Session Laws.
     SENATE BILL 26-187
     BY SENATOR(S) Amabile and Bridges, Kirkmeyer, Ball, Bright, Catlin,
     Cutter, Exum, Frizell, Jodeh, Kipp, Marchman, Mullica, Pelton R.,
     Simpson, Snyder, Wallace, Coleman;
     also REPRESENTATIVE(S) Brown and Taggart, Sirota, Clifford, Duran,
     Gilchrist, Marshall, McCormick, Nguyen, Paschal, Rutinel, Rydin, Smith,
     Stewart K., Titone, McCluskie.
     CONCERNING THE CREATION OF A COMMISSION TO STUDY MEDICAID, AND,
          IN CONNECTION THEREWITH, MAKING AN APPROPRIATION.
     Be it enacted by the General Assembly of the State of Colorado:
            SECTION 1. Legislative declaration. (1) The general assembly
     finds and declares that:
            (a) Medicaid is a critical part of Colorado's social safety net,
     health-care system, and broader economy. It provides health-care coverage
     for more than 20% of Coloradans and represents about one-third of the state
     budget;
            (b) Because of medicaid's far-reaching impacts on the state's
     health-care system, economy, and budget, all Coloradans, whether they have
     ________
     Capital letters or bold & italic numbers indicate new material added to existing law; dashes
     through words or numbers indicate deletions from existing law and such material is not part of
     the act.
direct connection to medicaid or not, have a shared interest in ensuring the
program is stable, strong, and serving Colorado well;
       (c) Colorado's department of health care policy and financing
leadership has been criticized for their handling of medicaid public health
emergency coverage requirements, nonemergency medical transportation,
and benefits for children with autism, and state legislators have not had
timely or complete information about these issues, which has left them
limited in their ability to respond appropriately; and
       (d) In order to legislate effectively and fulfill the appropriate
oversight role of the general assembly, reliable data, timely information, and
a shared understanding of the priorities and work between the legislators
and the governor's office are needed.
        SECTION 2. In Colorado Revised Statutes, add part 26 to article
2 of title 2 as follows:
                            PART 26
                     COMMISSION ON MEDICAID
       2-2-2601. Commission on medicaid - creation - powers and
duties - report - repeal.
       (1) NOTWITHSTANDING SECTION 2-3-303.3, THERE IS CREATED IN
THE LEGISLATIVE DEPARTMENT THE COMMISSION ON MEDICAID, REFERRED
TO IN THIS SECTION AS THE "COMMISSION", FOR THE PURPOSE OF MAKING
RECOMMENDATIONS REGARDING IMPLEMENTING FEDERAL MEDICAID POLICY
CHANGES IN 2026, 2027, AND 2028 AND APPROPRIATELY SUPPORTING
COLORADANS IMPACTED BY THOSE POLICY CHANGES.
       (2) (a)    THE COMMISSION CONSISTS OF TEN LEGISLATORS AS
FOLLOWS:
       (I) THE MEMBERS OF THE JOINT BUDGET COMMITTEE ON THE
EFFECTIVE DATE OF THIS SECTION;
     (II) THE CHAIR OF THE HOUSE OF REPRESENTATIVES HEALTH AND
HUMAN SERVICES COMMITTEE ON THE EFFECTIVE DATE OF THIS SECTION;
PAGE 2-SENATE BILL 26-187
     (III) THE CHAIR OF THE SENATE HEALTH AND HUMAN SERVICES
COMMITTEE ON THE EFFECTIVE DATE OF THIS SECTION;
      (IV) A MEMBER OF THE HOUSE OF REPRESENTATIVES HEALTH AND
HUMAN SERVICES COMMITTEE, APPOINTED BY THE MINORITY LEADER OF THE
HOUSE OF REPRESENTATIVES; AND
     (V) A MEMBER OF THE SENATE HEALTH AND HUMAN SERVICES
COMMITTEE, APPOINTED BY THE MINORITY LEADER OF THE SENATE.
     (b) THE COMMISSION SHALL SELECT A CHAIR AND VICE-CHAIR FROM
AMONG ITS MEMBERS.
      (c) (I)   IF A VACANCY ON THE COMMISSION OCCURS, THE
APPROPRIATE APPOINTING AUTHORITY SHALL APPOINT A QUALIFIED
REPLACEMENT MEMBER OF THE GENERAL ASSEMBLY TO FILL THE VACANT
POSITION NO LATER THAN TEN BUSINESS DAYS AFTER THE DATE THE
VACANCY IS DEEMED TO EXIST.
      (II) FOR THE PURPOSES OF FILLING A VACANCY OF A COMMISSION
MEMBER DESCRIBED IN SUBSECTION (2)(a)(I) OF THIS SECTION, THE
QUALIFIED REPLACEMENT NEED NOT BE A MEMBER OF THE JOINT BUDGET
COMMITTEE AND THE APPROPRIATE APPOINTING AUTHORITY IS:
      (A) THE SPEAKER OF THE HOUSE OF REPRESENTATIVES, IF THE
DEPARTING MEMBER WAS A MEMBER OF THE MAJORITY PARTY OF THE HOUSE
OF REPRESENTATIVES;
     (B) THE PRESIDENT OF THE SENATE, IF THE DEPARTING MEMBER WAS
A MEMBER OF THE MAJORITY PARTY OF THE SENATE;
      (C) THE MINORITY LEADER OF THE HOUSE OF REPRESENTATIVES, IF
THE DEPARTING MEMBER WAS A MEMBER OF THE MINORITY PARTY OF THE
HOUSE OF REPRESENTATIVES; AND
     (D) THE MINORITY LEADER OF THE SENATE, IF THE DEPARTING
MEMBER WAS A MEMBER OF THE MINORITY PARTY OF THE SENATE.
     (III) FOR THE PURPOSES OF FILLING A VACANCY OF A COMMISSION
MEMBER DESCRIBED IN SUBSECTION (2)(a)(II) OF THIS SECTION, THE
PAGE 3-SENATE BILL 26-187
QUALIFIED REPLACEMENT NEED NOT BE THE CHAIR OF THE HOUSE OF
REPRESENTATIVES HEALTH AND HUMAN SERVICES COMMITTEE, BUT MUST BE
A MEMBER OF THE COMMITTEE, AND THE APPROPRIATE APPOINTING
AUTHORITY IS THE SPEAKER OF THE HOUSE OF REPRESENTATIVES.
     (IV) FOR THE PURPOSES OF FILLING A VACANCY OF A COMMISSION
MEMBER DESCRIBED IN SUBSECTION (2)(a)(III) OF THIS SECTION, THE
QUALIFIED REPLACEMENT NEED NOT BE THE CHAIR OF THE SENATE HEALTH
AND HUMAN SERVICES COMMITTEE, BUT MUST BE A MEMBER OF THE
COMMITTEE, AND THE APPROPRIATE APPOINTING AUTHORITY IS THE
PRESIDENT OF THE SENATE.
     (3) NOTWITHSTANDING SECTION 2-2-307 (3)(e), MEMBERS OF THE
COMMISSION ARE ENTITLED TO PER DIEM AND TRAVEL EXPENSES FOR THEIR
ATTENDANCE AT COMMISSION MEETINGS DURING THE 2026 INTERIM.
      (4) (a) AS SOON AS FEASIBLE AFTER THE EFFECTIVE DATE OF THIS
SUBSECTION (4), THE DIRECTOR OF RESEARCH FOR THE LEGISLATIVE COUNCIL
SHALL ISSUE A REQUEST FOR PROPOSALS FOR A TECHNICAL ADVISOR. THE
TECHNICAL ADVISOR MUST HAVE EXPERIENCE IN HEALTH-CARE POLICY,
HAVE AN UNDERSTANDING OF HOW COLORADO'S DEPARTMENT OF HEALTH
CARE POLICY AND FINANCING WORKS, HAVE NO CONFLICTS OF INTEREST,
HAVE EXPERIENCE FACILITATING MEETINGS AND PROVIDING TECHNICAL
SUPPORT TO WORKING GROUPS, AND HAVE THE ABILITY TO WRITE A REPORT.
THE COMMISSION SHALL SELECT A TECHNICAL ADVISOR AND ENTER INTO A
CONTRACT WITH THE TECHNICAL ADVISOR TO ASSIST IN WRITING THE
RECOMMENDATIONS OF THE COMMISSION AND PROVIDING ASSISTANCE TO
THE COMMISSION.
      (b) THE LEGISLATIVE COUNCIL STAFF SHALL ASSIST THE COMMISSION
IN CARRYING OUT ITS DUTIES REQUIRED IN THIS SECTION.
      (5) (a) THE COMMISSION SHALL INVITE REPRESENTATIVES FROM THE
DEPARTMENT OF HEALTH CARE POLICY AND FINANCING, THE BEHAVIORAL
HEALTH ADMINISTRATION, THE COLORADO DEPARTMENT OF HUMAN
SERVICES, THE GOVERNOR'S OFFICE, AND OTHER STATE AGENCIES, AS
DETERMINED BY THE COMMISSION, TO PRESENT TO OR COLLABORATE WITH
THE COMMISSION.
      (b) THE COMMISSION MAY INVITE COMMUNITY-BASED MEDICAID
PAGE 4-SENATE BILL 26-187
STAKEHOLDERS, INCLUDING MANAGED CARE ENTITIES, OR NATIONALLY
RECOGNIZED MEDICAID EXPERTS TO PRESENT TO THE COMMISSION AND
PROVIDE FEEDBACK ON COMMISSION RECOMMENDATIONS.
      (c) THE COMMISSION MAY REQUEST DATA FROM THE DEPARTMENT
OF HEALTH CARE POLICY AND FINANCING OR OTHER STATE AGENCIES. THE
DEPARTMENT OF HEALTH CARE POLICY AND FINANCING OR OTHER STATE
AGENCIES SHALL, WITHIN EXISTING RESOURCES, PROVIDE THE COMMISSION
WITH THE DATA REQUESTED.
      (6)  THE COMMISSION SHALL MEET BEGINNING AS SOON AS
PRACTICABLE AFTER MAY 13, 2026. THE COMMISSION CHAIR, IN
CONSULTATION WITH THE TECHNICAL ADVISOR, SHALL DETERMINE THE
COMMISSION'S MEETING FREQUENCY AND DURATION, BUT THE COMMISSION
SHALL MEET AT LEAST SIX TIMES AND NO MORE THAN TWELVE TIMES BEFORE
DECEMBER 11, 2026.
      (7) (a) THE PURPOSE OF THE COMMISSION IS TO IDENTIFY, CONSIDER,
AND EVALUATE LEGISLATIVE AND EXECUTIVE BRANCH ACTION OPTIONS TO
IMPLEMENT A SUSTAINABLE MEDICAID PROGRAM. THE COMMISSION SHALL
IDENTIFY, CONSIDER, AND EVALUATE RECOMMENDATIONS FOR POLICY
CHANGE.
      (b) THE COMMISSION SHALL UTILIZE EXISTING COLORADO AND
NATIONAL STUDIES, REPORTS, ANALYSES, AND AUDITS TO:
     (I) ESTABLISH A SHARED UNDERSTANDING OF THE FEDERAL POLICY
CHANGES COMING THROUGH THE IMPLEMENTATION OF H.R. 1, 119TH
CONGRESS (2025-2026), PUB. L. 119-21, AND RELATED FEDERAL POLICIES;
IDENTIFY ADDITIONAL WORKLOAD FOR THE DEPARTMENT OF HEALTH CARE
POLICY AND FINANCING ASSOCIATED WITH FEDERAL CHANGES; AND IDENTIFY
PREPARATIONS TO SUPPORT COLORADANS IMPACTED BY REQUIRED CHANGES
COMING IN 2026, 2027, AND 2028;
     (II) EXPLORE HOW COLORADO'S ADMINISTRATIVE STRUCTURES OF
HEALTH CARE HAVE CHANGED OVER THE PAST TEN YEARS, ESTABLISH A
SHARED UNDERSTANDING OF HOW THESE ADMINISTRATIVE STRUCTURES ARE
WORKING TOGETHER TODAY, AND IDENTIFY POINTS OF FRICTION AND
OPPORTUNITIES FOR EFFICIENCIES;
PAGE 5-SENATE BILL 26-187
      (III) ANALYZE MEDICAID ELIGIBILITY AND ENROLLMENT, BENEFITS,
ADMINISTRATION OF BENEFITS AND DELIVERY SYSTEMS, PROVIDER
CONTRACTING, PAYMENT RATES AND METHODOLOGY, CHALLENGES
REGARDING MEDICAID ADMINISTRATION STATEWIDE, AND PROGRAM
QUALITY FOR EFFICACY AND VALUE; AND
      (IV)    EXPLORE MEDICAID FINANCING AND EVALUATE HOW
COLORADO CAN OPTIMIZE FEDERAL FUNDING TO SUPPORT HEALTH-CARE
DELIVERY.
       (c) THE COMMISSION SHALL:
       (I) SOLICIT AND CONSIDER INPUT FROM MEDICAID MEMBERS,
DISABILITY MEMBERS, DISABILITY ADVOCATES, HEALTH-CARE PROVIDERS,
AND COMMUNITY-BASED ORGANIZATIONS, INCLUDING THROUGH PUBLIC
MEETINGS OR WRITTEN COMMENT; AND
       (II)EVALUATE THE IMPACT OF THE COMMISSION'S PROPOSED
RECOMMENDATIONS ON MEMBER ACCESS TO CARE, QUALITY OF CARE, AND
HEALTH EQUITY, INCLUDING IMPACTS ON INDIVIDUALS WITH DISABILITIES,
INDIVIDUALS IN RURAL AREAS, AND OTHER VULNERABLE POPULATIONS.
       (8) (a) NO LATER THAN DECEMBER 11, 2026, THE COMMISSION
SHALL SUBMIT A REPORT TO THE GENERAL ASSEMBLY AND THE GOVERNOR
DOCUMENTING THE PROCESS OF THE COMMISSION AND ANY
RECOMMENDATIONS FOR BOTH SHORT-TERM AND LONG-TERM LEGISLATIVE
CHANGES, EXECUTIVE ACTION, AND OTHER POLICY CHANGES.
       (b)THE FINAL REPORT MUST INCLUDE A DESCRIPTION OF
STAKEHOLDERS THAT PROVIDED INPUT TO THE COMMISSION.
       (9) THIS SECTION IS REPEALED, EFFECTIVE JUNE 30, 2027.
       SECTION 3. Appropriation. (1) For the 2026-27 state fiscal year,
$500,000 is appropriated to the legislative department. This appropriation
is from the general fund. To implement this act, the department may use this
appropriation as follows:
       (a) $28,314 for use by the general assembly; and
       (b) $471,686 for use by the legislative council, which amount is
PAGE 6-SENATE BILL 26-187
based on an assumption that the legislative council will require an
additional 0.5 FTE.
       (2) The legislative department may spend money appropriated for
the 2026-27 state fiscal year to implement this act through December 31,
2026. On January 1, 2027, the unexpended and unencumbered money
appropriated to the legislative department to implement this act reverts to
the general fund.
       SECTION 4. Effective date. This act takes effect upon passage;
except that section 2-2-2601 (3), Colorado Revised Statutes, as enacted in
section 2 of this act, takes effect only if House Bill 26-1331 becomes law,
in which case section 2-2-2601 (3) takes effect on the effective date of this
act or House Bill 26-1331, whichever is later.
      SECTION 5. Safety clause. The general assembly finds,
determines, and declares that this act is necessary for the immediate
PAGE 7-SENATE BILL 26-187
preservation of the public peace, health, or safety or for appropriations for
the support and maintenance of the departments of the state and state
institutions.
____________________________  ____________________________
James Rashad Coleman, Sr.  Julie McCluskie
PRESIDENT OF  SPEAKER OF THE HOUSE
THE SENATE  OF REPRESENTATIVES
____________________________  ____________________________
Esther van Mourik  Vanessa Reilly
SECRETARY OF  CHIEF CLERK OF THE HOUSE
THE SENATE  OF REPRESENTATIVES
       APPROVED________________________________________
                          (Date and Time)
                   _________________________________________
                  Jared S. Polis
                  GOVERNOR OF THE STATE OF COLORADO
PAGE 8-SENATE BILL 26-187