A state program providing health care to pregnant women and children living in the country illegally is costing far more than lawmakers expected, with expenses nearly tripling in just a year and threatening to squeeze Colorado’s budget amid a nearly $1 billion shortfall.

The program, launched in 2024, now enrolls more than 30,000 people and could require more than $112 million in general fund dollars in the next budget year — more than six times the initial estimate.

The program, initially estimated in 2022 by nonpartisan fiscal analysts to cost about $27 million in general funds in the 2025-26 budget, instead cost nearly $90 million in 2025-26 and could now cost more than $112 million in the 2026-27 budget.

The program’s cost is sharply rising at a time when state budget writers are scrambling to plug a nearly $1 billion general fund shortfall for the fiscal year 2026-27.

Known as “Cover All Coloradans,” the program resulted from legislation adopted in the 2022 session, when House Bill 22-1289 was adopted on a strict party-line vote in both the state House and Senate.

A Joint Budget Committee analysis said that, in the 2024-25 fiscal year, its first year, the program enrolled 5,283 people, mostly children, and cost $23.8 million. That included $18.5 million in general fund dollars, with the rest covered by federal funds.

But the program’s enrollment exploded in 2025-26, reaching more than 24,000. The cost also exploded, rising to $117 million, with almost $90 million in general fund dollars.

That’s more than six times the estimate contained in the 2022 bill’s fiscal analysis.

The projection for 2026-27, without any changes in eligibility, shows an estimate of more than 30,000 people enrolled — again, mostly children — with a cost of more than $151 million, of which $112 million will come from the state’s general fund.

The money simply isn’t there.

A Pew Research Center had estimated the immigrant population staying in Colorado without authorization at 170,000 in 2022. This was before a surge of immigrants arriving in metro Denver in a two-year span starting in December 2022. Later estimates put half of the roughly 42,000 immigrants — who came to Colorado after illegally crossing America’s southern border — staying in the state.

Although Denver received some state and federal funding, its taxpayers assumed the bulk of the nearly $90 million cost to house, feed and provide transportation to the immigrants.

At the state Capitol, policymakers in 2024 allocated $24 million in one-time funds from the state education fund to the Department of Education to help districts address increases in enrollment that occurred after the regular pupil count.

This year, the Joint Budget Committee staff recommended eliminating dental, long-term services, and behavioral health benefits for immigrants living in Colorado illegally, which would save about $17 million in general fund dollars.

The recommendation also came with a warning.

The expenditures are growing very quickly, the staff analysis said.

“This might be a short-term issue during the ramp-up of the program,” the analysis said, with the Department of Health Care Policy and Financing noting that Medicaid expenditures don’t typically grow this fast.

Without eliminating some of the benefits, the general fund costs could skyrocket, especially if children started using long-term services at the same rates as children on Medicaid.

Cover All Coloradans is one of the programs Republicans pointed to as emblematic of Democrats overspending over the past eight years, which resulted in a structural deficit in the state budget.

The state isn’t facing a recession and it doesn’t have a revenue problem, according to Sen. Barbara Kirkmeyer, R-Brighton, the ranking Republican on the Joint Budget Committee.

Instead, she said, the state has an overspending problem.

“From the decisions we’ve been making, we have not cut enough, and we’re still overspending,” she told Colorado Politics on Wednesday.

JBC staff informed the committee that the state overspent its budget by half a billion dollars in 2024-25 and again in 2025-26. That included largely one-time federal dollars and cash funds used to pay for ongoing programs, she said.

Kirkmeyer said most of the cuts proposed for the 2026-27 budget have come from the Medicaid program, which has been cited as a major contributor to overspending. By law, the state must cover Medicaid costs, no matter how they appear in the budget. A congressional committee is now probing reports of allegations of waste, fraud and abuse in Colorado’s Medicaid program, citing recent stories outlining over-billing in transportation spending and alleged improper payments in autism services.

The overspending has run into the hundreds of millions of dollars in the current budget year.

Cuts to Medicaid trouble her, Kirkmeyer said, adding they will jeopardize health care access for everyone.

She noted the cuts recommended for Cover All Coloradans will not make a big dent in the deficit, yet at the same time, the JBC is voting “to cut Medicaid to U.S. citizens for kids that have intellectual and developmental disabilities.”

That said, “we’re going to have to cut everywhere,” she added.

The Republican said her Democratic colleagues on the Joint Budget Committe don’t appear to be willing to cut in several areas, such as judicial, universal preschool, or the behavioral health administration. The latter two are new programs.

During the past eight years, the legislature and Polis administration have created dozens of new offices and departments, including the cabinet-level Department of Early Childhood, which in the 2025-26 budget saw an appropriation of $804 million. Of that, $310 million came from general funds.

The department manages two programs: child care assistance and universal preschool. The latter was approved by voters in 2020 and funded by taxes on cigarettes and other nicotine products.

In the 2026-27 budget, the department is recommended for a small increase, less than $100,000, although the governor asked for a hike of more than $11 million.

Universal preschool has struggled to cover the demand that exceeded estimates. The number of hours provided to certain three-year-olds with individualized educational plans and four-year-olds started at 30 hours — it’s now down to 10.

The Behavioral Health Administration, created through legislation in 2022, was allocated $308 million in the 2025-26 budget, with $149 million coming from general fund dollars. Its 2026-27 budget is recommended for a $2 million decrease in general funds. The governor’s request suggested a $4 million reduction.

Kirkmeyer predicted that once the next state revenue forecast comes out this Thursday, the Joint Budget Committee will have to go back through all the figure-setting, review most of these departments again and start looking for more cuts.