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 $1 billion shortfall.

Cover All Coloradans, launched in 2024, now enrolls more than 30,000 people and could require over $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 general funds in 2025-26 and could cost more than $112 million in the 2026-27 budget.

That’s at a time when state budget writers are scrambling to cover a $1 billion general fund shortfall in the state budget for 2026-27.

The program is known as Cover All Coloradans, and a part of it resulted from legislation from the 2022 session. House Bill 22-1289 was passed on strict party-line votes in both the state House and Senate.

According to a Joint Budget Committee analysis, in the 2024-25 fiscal year, which was the program’s first year, the program enrolled 5,283 people, mostly children, and had a total cost of $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 exploded, reaching $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, with $112 million coming from the state’s general fund.

The money simply isn’t there.

The JBC 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,” and the Department of Health Care Policy and Financing said that Medicaid expenditures don’t typically grow this fast.

And 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 point to as part of the problem of Democrats’ overspending over the past eight years, which resulted in a structural deficit in the state budget.

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

“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 federal dollars and cash funds that were largely one-time and used to pay for ongoing programs, she explained.

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 the overspending problem. By law, the state must cover Medicaid costs, no matter how they appear in the budget, and overspending has run into the hundreds of millions of dollars in the current budget year.

Cuts to Medicaid trouble Kirkmeyer, who said those cuts will jeopardize health care access for everyone.

She noted the cuts recommended for Cover All Coloradans will not make a big dent in the costs, 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, but noted that her Democratic colleagues on the JBC 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 had an appropriation of $804 million. Of that, $310 million was 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 an increase 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 bipartisan legislation in 2022, had a 2025-26 budget of $308 million, 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.

She predicted that once the next state revenue forecast comes out – and that’s on Thursday – the JBC will have to go back through all the figure-setting and most of these departments again and start looking for more cuts.