House Finance [Mar 30, 2026]

. Thank you. The committee will come to order. Please call the roll.

Brooks. President. Camacho. Here. DeGrasse. Yep. Garcia. Here. Gonzalez. Hi. Hartsook. Here. Marshall. Here. Stewart. Here. Titone. Yes. Mr. Chair. Here. Running at full steam. All right. First bill up, 1327. Representative Furet, kick us off.

Thank you. Committee questions. Representative Camacho.

Representative Ferre. Thank you Mr. Chair and thank you for the question. This has been over several months of working with a myriad of people. So we worked with AG's office. We worked with HICPF DOI DOR CCLP that Law and Policy Center CFI the Fiscal Institute this is in the nonpartisan staff And we believe this is as legally sound as we can get in this topic And we understand that it is novel in some ways. And if there are concerns that are brought up through the process, we are tackling those. And these two amendments that I'm bringing forth should tackle some of the main concerns that were flagged by the AG's office. In addition, we can continue to flush through some of those concerns. I don't think anything's ever going to be foolproof in what you bring forward, but I feel confident in how we're approaching it now.

Representative Ferre. Thank you. The ERISA concern in talking with AG's office is low, and there wasn't specific recommendations around what we think should be changed. In terms of TABOR, that was the stronger concern. And so what we did here was try to bring forth an amendment that's L-002. And what I did was, since the last health committee, I had conversations with stakeholders both in the business side and just like the policy think tank side. when I met with the U.S. Chamber of Commerce and the U.S. Retail Association, they had mentioned that there were a few things that they would love to see support in terms of employee health care, and that was around wellness programs, and that was also around on-site clinics. So to strengthen the nexus argument of the enterprise, what we did was expand the scope of that enterprise to allow for direct funds to go back to those employers by way of wellness clinics and on-site clinics as well. So that is a way for us to try to strengthen the nexus and also hear what the business community is saying that they need for those employees to strengthen their healthy environment for the employees. Anything further from the committee? Representative

Rosanna Ferre. Thank you, Mr. Chair. Thank you for the question. In my data and research phase of the summer, $2,300 is half of the amount of what it costs to put someone on Medicaid. I thought that was a fair compromise to say we're not asking for all of it. We understand that there's different people that utilize Medicaid, and we certainly don't want to charge you the full amount because I thought $2,300 would be fair. In terms of hiring practices, one of the things that I found in my research was that the state of Hawaii actually has a higher or stricter requirement on healthcare employer plans than what ERISA is, and ERISA is that national standard. And there has been no change in those employers mass exiting that state. They are still operating in Hawaii, and there hasn't been a drop in that realm. The other thing that I want to note is that the size of some of these companies, of thousands of employees, they're still actively hiring. Just in Denver Metro, for example, Walmart's hiring about 350, 360 people just in that metro area. For them to cut 9,000 jobs of people that are on Medicaid seems impractical for their business operation so i don't think that's a strong argument and we've seen in another state that it hasn't dropped so that makes me comfortable in in that practice that you're concerned about

Representative Ferreira. No, that doesn't.

Thank you, Mr. Chair. Colorado spent $16 billion in Medicaid last year. My understanding is that enterprises are limited to $100 million over $5. How is this going to make a tangible impact?

Rosanna, come on. Thank you, Mr. Chair. So if you want to dive into the conversation, let's do that. So we're trading $100 million. We know we spend $16 billion. What is the tradeoff? What are we giving up? What are we creating? What precedent in Colorado? Is it a good thing to do?

Any further questions? Representative Bacon.

Representative Ferre.

Any follow-up?

Representative Ferreira.

Follow-up Representative Bacon.

Representative Ferre.

You may.

Thank you. Representative Ferret.

Rosenthal Gonzalez. Thank you, Mr. Chair. Can you tell me where these numbers that you're getting are coming from, and then why don't we just apply it to all employers? Rosenthal Ferre.

Representative Gonzalez. Thank you, Mr. Chair. And I think we saw today the top Medicaid official resign, and I think there's been some stuff on, like, fraud, waste, and abuse. So how does 1327 generate new revenue but fraud continues at current rates? What accountability mechanisms ensure that money actually reduces the deficit rather than subsidizing waste? Representative Ferre.

Anything further from the committee? Representative Stewart. Thank you, Mr. Chair. Have you done any sort of calculations around, I mean, presumably we want, especially large employers, We want employers to hopefully be actually providing health care to their employees so that they're not on Medicaid. So have you done any sort of like cost analysis on like if we're actually going to be able to change behavior with this type of legislation? Presumably we would love for there to be no money in the enterprise because everyone is insuring folks who want to be insured through employer programs But like have done any cost analysis with the fee Is the penalty actually enough to incentivize that behavior or is the penalty less than it would cost, and so therefore we really are just going to be funding the enterprise? Representative Ferre.

Back to Representative Camacho. Thank you, Mr. Chair.

Representative Foray.

Representative Garcia. Thank you, Mr. Chair. Along the line of the question from the last representative, I'm going to give an example of how a fee like this already exists, and maybe you can tell me if I'm on the right lines here. We have car registration fees that are meant to keep our roads upkept, correct? But those who are allowed to use the roads are not just those who pay the car registration fee correct So anyone that drives on Colorado roads benefits from the registration fees that Colorado registered car drivers pay correct Correct. So would that be akin to... You may dialogue. Thank you. Thank you, Mr. Chair. You may cross-examine the bills. Thank you, Mr. Chair. So wouldn't that be akin to, for example, in this case, you have the large employers that are charged a fee for the employee because they have a certain amount of employees who are on Medicaid. And so, yes, one can assume that the fee will go to supporting their employees, just like car registration fees support those who pay the registration fees. But then it also supports everyone else who happens to drive on the Medicaid road. Correct.

Representative Camacho. Thank you, Mr. Chair.

Representative Ferreira.

Anything further from the committee? Oh, thank goodness. You sure? Positive. Okay, we're going to go on to the witness testimony phase. We have basically two panels that we're calling up. We're going to start with opponents. If we can get Parker White, Katie Wolf Megan Dollar and then Shannon Huska from HickPuff should be online for questions only. Mr. White, if you'd kick us off. Thank you, Mr. Chair. Good afternoon. My name is Parker White. I am here representing the Colorado Competitive Council and the Denver Metro Chamber of Commerce. Both organizations are here today in opposition of House Bill 26-13-27. First, once again, as I said last week, I'd like to thank Representative Furet for sincere outreach throughout this process. Our primary concern with the bill is that its definitions are simply too broad and too unclear. As written the bill does not adequately protect employers from decisions that are ultimately made by employees themselves For example if an employee opts to choose out of an employer health care coverage even when that coverage is offered the employer could still be exposed to consequences under this framework The bill also lacks definitions around who is covered and what compliance actually looks like. It does not clearly define what types of employees are included, the extent to which employers would be responsible for contractors, how coverage standards would be applied across different employment structures, are what constitutes adequate coverage in a manner that is effectively applicable at the state level. Stepping back, it's important to recognize that employers and employees are already major contributors to Colorado's health care system. The majority of Coloradans receive coverage through employer-sponsored health plans, and businesses help fund those programs like health insurance affordability enterprise while also paying taxes that support Medicaid, asking employers to take on additional burdens with undefined responsibilities and lacking clear standards adds to growing concerns about Colorado's economic competitiveness. Lastly, there are multiple philosophical concerns with the legislation that have become a trend this session specifically. The first is that this excludes the state government in order to avoid a fiscal note. The question we ask there is to the business community, if this is too expensive for the state, why would it be any more affordable for companies that are under similar economic conditions? Second, the bill is almost certainly preempted by ERISA and even more so runs afoul of TABOR. This bill, along with multiple others in consideration by the legislature, is likely preempted in multiple manners. In a year when we are discussing budgetary concerns and deploying the limited resources we have in a manner that can help the most Coloradans, why are we discussing legislation that will result in massive amounts of taxpayer dollars being spent on litigation that will ultimately find that this law is unconstitutional either at the state or federal level? We remain committed to working as thoughtful partners to develop solutions that expand health care access in the state while providing the clarity and fairness that employers need to operate with confidence. We feel that this bill does not meet those objectives. Thank you. Thank you. Please hold for questions with Ms. Wolfe. Thank you, Mr. Chair and members of the committee. My name is Katie Wolfe, and I'm here on behalf of the Colorado Retail Council in opposition to House Bill 1327. The Colorado Retail Council represents retailers across the state, including grocery stores, pharmacies, convenience stores, online retailers, and nationally and locally owned businesses that serve millions of Colorado consumers every day. Medicaid costs are rising and the state faces a real funding gap. But House Bill 1327 doesn't solve that problem. It shifts the cost of a public policy choice onto a handful of private employers while exempting everyone else. Publications across the state have also been consistently covering the program's mismanagement. This bill doesn't ask large employers to contribute to Medicaid. It's a penalty tax that asks them to subsidize the cost of coverage. They have no role in designing. The exemptions make the inequity impossible to defend. A corporate retailer pays the fee. A franchise operator running 20 locations across the Denver metro, same workforce, same wage structure, potentially more Medicaid-enrolled workers pays nothing. At least one Colorado-founded company is on the target list. The corporate franchisee down the street is not. We are not drawing lines based on behavior but ability to pay. We're drawing lines on corporate structure and politics, and we're putting yet another burden on business. The revenue that this bill claims to raise is roughly $33 to $106 million per year, according to the latest fiscal note. Colorado's Medicaid shortfall is measured in billions. This is not a solution. It's a Band-Aid and doesn't fix the systematic problems. The bill is not a real solution to the very real problems the state's budget and Colorado working families are facing. The compliance mechanism is offering single-employee coverage, but Medicaid eligibility is determined by household income and household size, not by whether a coverage offer exists. Children remain on Medicaid even when a worker enrolls in single coverage. This bill generates revenue. It does not generate coverage transitions. One other consideration is that employers cannot and should not ask workers whether they are on Medicaid. Medicaid forms include only an optional employment question that isn't necessarily updated when workers change jobs. You're proposing to levy legal financial penalties on companies based on data they cannot see, cannot verify, and cannot contest until after the bill arrives. that raises process concerns and creates administrative burdens without clear accountability washington state introduced this bill and dropped it oregon had a very similar bill that they turned into a study and it effectively died on the calendar maryland had a similar version that was overturned by the courts no state has enacted this policy at this scale and that's not lack of ambition it's because every state that has looked at this closely has found the same problems we're raising today the retail council is not here to simply say no we appreciate the sponsors reached out to us and tried to work with us throughout many months, but under the confines of the structure, we can't say yes. Give us a real seat at the table, and we'll work on real solutions to help address the problem. But this bill is unverifiable, unequally applied, and we urge a no vote. Thank you. Ms. Dollar. Thank you, Mr. Chair and members of the committee. My name is Megan Dollar. I'm the Senior Vice President of Government Affairs for the Colorado Chamber of Commerce, and we are respectfully here in opposition to House Bill 1327. We believe the bill would impose significant new costs and administrative burdens on Colorado employers at a time when businesses are already facing economic uncertainty. Estimates suggest this proposal could cost an employer anywhere between $15 million and $100 million annually. These costs will not exist in a vacuum. They will be passed on through higher prices for consumers, reduced hiring and investment, and in some cases, business closures or decisions to leave the state. Colorado is already an outlier in many respects when it comes to the cost of doing business. Adding this fee risks further eroding our competitiveness. We are already seeing data that's showing that businesses are reconsidering their presence here in Colorado, and we're concerned that a policy like this will only accelerate that trend. Beyond cost, the bill presents serious legal and practical challenges, And the bill appears to require employers to track or report information related to their Medicaid status, information, most importantly, that employers typically do not have access to and in many cases cannot legally obtain due to privacy protections. We all agree that Colorado must address the sustainability of its Medicaid program and broader budget challenges. However, shifting the costs onto employers through a legally uncertain and administratively complex mechanism is not the right solution. We respectfully urge a no vote on this bill. Thank you. Thank you. Our witness online is for questions only. So, committee, any questions for this panel? Representative Amel Bacon.

Thank you, Mr. Chair. Representative Bacon, the primary concern that we've gotten on that front, and I'm sure Megan and Katie can speak to the part-time piece, is actually the 1099 function. That's one of the bigger concerns that we're getting. At least from the C3 membership we have a greater presence of companies that have that 1099 concern The companies that we do have that are concerned about the part workers Katie can certainly speak too much better But the 1099 flexibility on whether an individual contractor, especially in the case of certain TNCs, manufacturing, some of the defense companies, as you kind of move through and you look at companies and industries that are high on contractors, and as they come in, whether that employer would have to cover healthcare costs for contractors. In a lot of ways, contractors are cheaper and intended to operate that way because of the different benefits there, and that allows contractors to pick up more contracts. And so it's a negotiated thing between the contractor and the employer. and as part of that deal back and forth is that they are not an employee of that company. They are a contractor to that company. And so that is, I think, the greater concern that we're seeing from our membership is setting the precedent that we are going to be treating contractors the exact same way that we are treating full-time employees, and we're getting at the difference between those two. Anyone else want to add in on that? Ms. Dollar. Thank you for the question, Representative Bacon. And I think we have not specifically polled our members to see what those dynamics look like. I'm happy to kind of get more information. Our opposition is stemming from direct feedback that we have from businesses that believe they will be impacted by this bill. Ms. Will. Thank you, Mr. Chair, and thank you, AML Bacon. I think that with the members that we talked to, it was about a third of their workforce, typically, I would say on average. and that changes varying with seasonal workers included or not included. However, when we did look across the country, it seemed like that was pretty much in line with where everyone else was when it comes to part-time work, regardless of the size of the company. Percentage-wise, it looks similar. Representative M.L. Bacon.

Mr. Chair Representative Bacon I guess working backwards this isn't necessarily representative of a shift in trends this is more there are certain business models that operate heavier with contractors in order to have flexibility with certain workers in their own work schedule, right? And that's part of, at least from our view, a win-win for both the worker and the employer. If you as a worker can set your own terms without having to be a full-time employee on how you work, when you work, sometimes that makes sense for that employee to be a contractor, and that's why they may opt into that piece. And then if an employee or a worker decides they want to be an employee and have the certain benefits there, they can pursue working for an employer where they have that coverage. And so then working back, now I'm going to get into a legal analysis that we have and is broken into some bullets here. And the amendment that came through so the amendment removed one of the direct inclusion of contractors from the definition of worker However it still explicitly requires employers to report 10 to 9 employees and subcontractors meaning they remain a part of that regulatory structure And so I guess that's if that answers your question.

Ms. Wolfe. Thank you, Mr. Chair, and thank you, AML Bacon. And so I think, I mean, it's an interesting question and one that we asked our members also when we first started discussing, you know, what this bill would look like. And, you know, what we found is that in the post-COVID era that employers would much prefer to have full-time employees. The training costs are lower. The scheduling is easier. There is more autonomy there. And they have a lot of folks coming in and requesting to work Tuesday from noon to 6 and Sunday from, you know, 3 to 9. and that's it for availability and so it's trying to balance both perspectives needing the workforce to be able to run and operate the stores and finding the folks willing to do that. Thank you Representative Gonzalez. Thank you Mr. Chair. Thank you for your guys' testimony. So maybe I might have missed this but I know this bill is aimed to address large employers businesses in the state of Colorado How will this specifically impact the mid and small businesses in the state mr white i i so as this is written i think in getting to actually both of these points here it's from a from a philosophical standpoint this is starting to get at what is the difference in terms of benefits packages that are able to be offered to full-time employees versus part-time employees versus contractors. And then when you look at that as an employer, to what extent are you responsible for what is essentially a worker choice? There are different classifications of different types of work because different people need work or conduct work in different ways as their life permits. If you opt to be a contractor and to pursue your working life as a contractor, there is a flexibility that comes with that, But there's also a piece from a company's perspective where they are taking on a contractor at a different cost basis. For part-time employees like Katie just mentioned, if an employee opts to be part-time or take on multiple part-time jobs, whether that's due to flexibility, whether that's due to their own choices for a multitude of reasons, as opposed to a full-time job, from an employer perspective, So it makes it very, very difficult to manage if you're having to manage full-time benefits with part-time employees as opposed to Katie's point where we got the same thing. Most of our large employers, at least all of the ones that I've heard from on this, they do not have a shortage or a dearth of full-time roles. What they do have is a lot of employees that choose to take part-time roles. and then how do the businesses navigate a decision that is functionally made on the workers' behalf, if that makes sense. Representative Garcia, we're over on time, but I want to make sure that this panel gets its ability. Thank you. I just wanted to address, Ms. Wolf, you referenced in your testimony that it's impossible for employers to be asking their employees if they're on Medicaid. Could you tell me where in the bill it would require an employer to do so? Ms. Will? Thank you, Mr. Chair, and thank you, Representative Garcia. There is nowhere in the bill that it says that, and I think my point was that there is no way for these companies to know, you know, how many folks are saying they're responsible for paying for. So they're going to receive a large bill. They're going to have to pay that, and everyone deserves the opportunity to contest or to look at the details of the bill that they're being told that they should pay, and so that is one of the problems that I was trying to identify with that statement. All right. So, committee, he didn't appear on the list for some reason, but Trey Rogers is also here to testify in opposition, and I would like to give him an opportunity to do so. And then we're going to extend the question period if anyone has any questions for him. The other witnesses are Hickpuff for another four minutes. Mr. Rogers, so nice to see you, Counselor. Hit the button in front of you, make sure it's green. Let us have it.

Okay. Any questions? In light of that testimony, Representative Camacho, then AML Bacon.

Mr. Rogers. Thank you, Mr. Chair. Thank you for the question, Representative. So that's not something we've had to deal with yet under the statute, the voter-approved statute. But I believe the way it would work is that that $100 million limit is for the full five years. So if I read the fiscal note right, this bill would hit the $100 million figure sometime in the second year. And I think at that point, once it hits $100 million, there would be no further collection of the fee. And I don't think that's just for the five-year period. I think that's ever. I think at that point, voter approval is required. So I think what you're going to get out of this is $100 million over about a year and a half or two years and then nothing more ever.

Mr. Rogers. Thank you for the question, Representative. Yes, I believe the board here could adjust that fee. Sure.

Mr. Rogers. I'm sorry, Representative, but outside of my area, I mean, I think it probably incentivizes employers to work for certain employers. I think that's the primary reason.

Mr. Rogers. Thank you for the question, Representative. Well, I'm certainly not making a judgment. I'm just making a legal observation. And the legal observation is that under the Tabor case law in Colorado, there is typically a fee paid for a benefit that the fee payor receives. And that has to typically be fairly direct. So Representative Garcia, in your example, we pay car registration fees. Those are used to fix bridges. That's the payor getting the benefit. Here, the payor doesn't get the benefit. Here the payer pays and the employees or some employees, some beneficiary of Medicaid in the state gets the benefit. Actually, I would postulate that it is the state. It is the budget. It's the General Assembly that gets the benefit because this bill is going to defray what the state has to pay for Medicaid. It's not helping the employer at all.

we have to take a step back. I have to take a step back to answer that question. What Tabor says is that an enterprise is a government-owned business. So when the courts have looked at this question, they have asked, for instance, well, is there a private analog to this? Right. So someone buys a fishing license, they get to fish. Someone pays a car registration fee, they get a, they get a safer bridge. Right. So I'm not suggesting that it is of no benefit to an employer that their employees will be healthy, but, but there are other things that would benefit an employer. Let's say that the employer paid a fee to get cleaner air in Colorado. Well, of course that's a benefit, but that's not the kind of, uh, there's no private business analog to that. There's no business that says, you pay me a fee, I'll make the air cleaner. There's no business that says, you pay me and I'll try to make sure that your employees and all the other folks on Medicaid in the state of Colorado are a little bit healthier. There's no nexus because there's no private business corollary to this as there is for our other enterprises.

under taper mr rogers thank you for the question representative and just to be clear we're a little bit in uncharted territory to my knowledge there has been no litigation under the voter approved measure that limited enterprises to 100 million over five years so i'm i'm giving you an opinion the best guess here about how the courts would handle it um yes the bill sets the fee amount but As I read the bill, it would be possible for the board, the enterprise board, to adjust that fee either up or down. So I suppose after forming, I mean, I don't know how long it would take for that to happen, but it does appear to me under the bill that, yes, the board could reduce that fee. As I read the statute that limits enterprises to $100 million in their first five years, the question is one of whether voter approval was required. So once that enterprise gets to $100 million, if it doesn't have voter approval, it's just no longer able to collect fees. It's no longer able to function. That's certainly the way I read it. But let's say I'm wrong about that, and let's say that the enterprise gets to come back, I don't know, for another $100 million in the second five years. Well, at that point, you have to question whether it's in fact an enterprise. I mean, we're just in very strange territory here where we have a voter-approved limitation on what an enterprise can bring in, where the enterprise is, I think, pretty clearly going to exceed that limit within a couple of years. And then you have to ask, it didn't get voter approval. The point of the law is it's not an enterprise at that point.

I am Mark Longshore. I'm a registered nurse and the executive director of the Colorado Nurses Association. CNA asks for your yes vote to maintain access to health care services by providing funds to maintain current or preferably increased health care provider reimbursement rates, including those for advanced practice nurses. But our support goes beyond that. Part of CNA's mission is to improve health for all. I've heard more than once that Colorado's budget is in a death spiral, and that spiral is wreaking havoc on health care in our state. Since 1950s, the U.S. system of health care has been predominantly employer-based. Get a job, get health insurance. A reasonable plan as long as the employer actually pulls up their end of the bargain. But we are in a place where we had to pass a law to say an employer must provide health insurance if the employee works more than 30 hours a week. As my family member experienced, that's not a problem for the employer. They just hire twice as many people at 15 hours a week, so they won't qualify for health insurance. The state can pick up the extra insurance expense. And a little off topic, but they pay them a non-livable wage, so they can't support their family, in this case, leaving the state to cover SNAP benefits. Large corporations continue to send their profits to stockholders and C-suite employees' large salaries and lower-taxed stock options, while cutting the wages and health insurance coverage for their lowest-paid employees. Then they rely on taxpayers to make up that difference. Simply put, they broke the deal made in the 1950s, forcing the state to pay providers less and reduce coverage for enrollees. For the sustainability of the medical assistance program, for the sustainability of the health care workforce to care for the people of Colorado, remind the corporations they have a responsibility to support health care in Colorado. As I heard recently, this bill doesn't give a single payer, but until we get a more equitable system, we need employers to contribute. employers to contribute. CNA asks for your yes vote on House Bill 26-1327. Thank you.

Thank you, Mr. Chair and members of the committee. I appreciate the opportunity to testify today. My name is Adela Flores Brennan. I'm the Medicaid Director at the Department of Healthcare Policy and financing. I'm here on support or on behalf of the department in support of House Bill 1327. Colorado's Medicaid program covers more than one in four Coloradans. A significant share of those enrollees are working adults, people who are employed full-time or part-time by large employers who do not offer affordable health coverage. Research from the Kaiser Family Foundation consistently shows that low-wage workers at large employers are among the most likely to rely on public coverage, not because they are outside of the workforce, but because their employment does not come with health benefits. Full-time minimum wage workers in Colorado fall well below the 138% federal poverty level threshold for Medicaid eligibility. These are people who are working, not just earning enough to afford private coverage. The bill recognizes that reality and creates a mechanism for large employees to share in the cost of the coverage their workers depend on. It is worth being precise about who this bill reaches. The fee applies only to employers with 500 or more supported Medicaid workers. This is not a small business bill. Employers who offer Affordable Care Act compliant coverage to their workers are explicitly excluded. The fee targets employers who benefit from Medicaid precisely because they do not offer that coverage. And the supported worker calculation is based solely on ACA expansion adults. That's a definition in Medicaid. Those are working age, low income Coloradans enrolled through the income based expansion pathway in Medicaid. Medicaid enrollees who qualify on the basis of disability are entirely excluded from that calculation. This is not a novel approach. Several states have explored employer contribution models as a tool for Medicaid sustainability, and the policy rationale is sound. When large employers benefit from a publicly subsidized healthy workforce, a cost-sharing structure is a reasonable and fair response to that dynamic. The enterprise model mirrors the hospital provider fee structure Colorado has successfully operated, so this is a proven mechanism, not an experiment. At a time when Colorado faces significant Medicaid budget pressures, this bill creates a durable program-funded revenue stream that does not rely on the general fund. HICPUF has worked closely with the bill's sponsors and the governor's office throughout the bill's development, including on amendments. Those amendments ensure the enterprise is structured appropriately within HICPUF, and the department has the data infrastructure needed to accurately identify large employers and calculate the supported workers. We I'm happy to take questions. We also have a SME available for questions.

Hi, all members of the committee. My name is Michael Ruddock. I'm here with the Adams County Health Department. We do support this bill. Access to health care is a key indicator of good public health. It's one of our three community health priorities in Adams County mandated by our residents. And it's a mandatory public health core service as directed by the Colorado General Assembly. We're really concerned about a couple different factors that will have impacts on our health enrollment in the county. increasing premiums through the marketplace, state budget cuts impacting various healthcare programs, and of course, HR1's projected impacts, especially on the expansion population. This bill has the potential to stem or slow some of those systemic factors that could lead to rises in uninsurance for our residents. We're particularly excited about the prospect of employers extending coverage to employees. We see this as a very useful intervention as we see expansion population Medicaid enrollees churning off the rolls following those new requirements from HR1. That would be a really important stopgap to keep folks insured and limit financial liability for hospitals, for community providers. They're going to see uncompensated care rise as the uninsured rate climbs. It would also allow us to prioritize our limited Medicaid dollars for Coloradans with the highest acuity needs which is really important On the other side of the coin the fee could help maintain a sustainable network of Medicaid providers at a time when there's, as we all know, a pretty significant cut in the state budget for across-the-board provider rates. It seems to us that reimbursing providers fairly for maintaining a healthy workforce is a fair and important trade-off where both sides really win. There really is a cost on the entire system when we support privately employed residents with public health care. There's a cost to our county caseworkers who need to verify applications, which then create backlogs and slower response times. There's a cost to my health enrollment team at the health department who are underwater trying to help people navigate what public option best meets their needs, even when they're gainfully employed. There's a cost to community providers and health systems that receive lower reimbursement or no reimbursement at all, even though their patient is employed. We realize this is a really hard and imperfect option, but given the gravity of the situation, we're inclined to support solutions like this one that meet the very stark need of the moment that we're in. Really grateful to Rep. Foray for her willingness to think big and work really diligently to address needs and concerns of a ton of different stakeholders. With that, we would ask for your yes vote and hear for any questions that the committee

unmute yourself. You know the drill. Floor's yours for three. Yes. Good afternoon, Mr. Chair and members of the committee. My name is George Marlin. I am a Clear Creek County Commissioner speaking on behalf of counties and commissioners acting together, as well as my constituents. who cannot afford the healthcare system we have today, let alone the one we will have when the impacts of HR1, Medicaid changes, Obamacare divestment, and reduced reimbursement rates are fully realized. CCAT, made up of urban and rural counties that collectively govern more than half of the state's population, supports this bill. It is a crucial step in rebuilding our healthcare system after these attacks from the Trump administration and Congress increased Medicaid expenses and severe budget constraints. CCAT has a long history of engagement in healthcare policy, including the 2019 reinsurance program and the public option. This is because counties sit at the center of the complex impacts of a failing medical system. As employers who do pay health insurance, our budgets are strained under cost growth that far exceeds growth caps. As case managers for people who seek Medicaid, often while employed, we see the impact when doctors begin to refuse new Medicaid patients. We are preparing furiously, in collaboration with the state, for a new red tape reality in which a mistake on someone's paperwork can render them ineligible. Counties also manage public health departments and emergency medical services, where we do our best to serve people who cannot afford any other option than seeking a public health nurse or emergency health care. Some of our members have even stood up hospitals in rural areas where only county support can guarantee any medical access at all. Counties have a constant feed of information from so many aspects of our healthcare systems. All of them are currently flashing red. As policymakers, commissioners understand this moment. We understand the difficulty of the decisions this body faces. We know that the Medicaid reimbursement rate, already too low, is one of the things that will take a hit. And we know what that means for our healthcare system. In the short term, the most vulnerable will suffer. Over even the medium term everyone will unless this body acts That includes businesses who may no longer be able to rely on Medicaid to keep their employees healthy enough to come to work The nexus between a viable health care system and a viable labor force is undeniable. CCAT supports this bill as a solution that can give our health care system a chance on a timeline that can make a difference in the lives of our constituents and our employees and in our economy. I want to thank the bill's sponsor and everyone on this committee for taking this policy seriously. We implore you to allow the work to continue. Please vote yes, and I welcome any questions.

The floor is yours for three minutes. Thank you, Mr. Chairman. My name is Christina Manthe. I am a volunteer lobbyist with the League of Women Voters of Colorado. On behalf of the League, I am here to support House Bill 26-13-27. The League of Women Voters, as a nonpartisan organization, has encouraged informed and active participation in government and influences public policy through education and advocacy, and they have done so for 106 years. The League believes that a basic level of quality health care at an affordable cost should be available to all U.S. citizens. The League supports social and economic incentives that encourage the development of cost-effective ways of delivering and paying for health care. In this country, we have chosen over time to have our employers provide health care. This system allows employers to establish criteria for benefit eligibility. Large employers manipulate their employee hours so that employees are ineligible for benefits, particularly health insurance. Employees ineligible for their employer's health care insurance are forced into public assistance for health care and become a societal burden. Under the present law, there is no consequence to employers for these actions. The harm to the public health care system is significant because of the volume of employees involved. House Bill 261327 attempts to address the burden placed on society. Large employers will be required to make payments to an enterprise fund to affect the state's burden of providing health care for employees who work at least 20 hours a week. Employers, the benefit to them is that they will be allowed to continue doing business as usual. The League supports House Bill 26-13-27 for its innovative way to encourage the provision of health care to workers. The League urges you to vote yes on House Bill 26-13-27.

Thank you, Mr. Chair. I have three questions for Ms. Adela Flores-Brennan. So for the first one, of the $13.3 billion in total Medicaid spending, what percentage has been identified as improper payments, fraud, or waste in the last three fiscal years? Who's that for? Ms. Adela Flores-Brennan from Colorado Medicaid. Ms. Flores-Brennan, did you hear the question?

Maybe you can follow up afterwards.

Mr. Chair, members of the committee, thank you for that question. That's another one I would need to follow up with. I will just note that a lot of that total that you're citing is federal funding, So our $16 billion total fund budget represents about $5 billion in general fund.

And then lastly, maybe I think this pertains to the state. So before the state asks employers to subsidize Medicaid, what reforms has KickPuff implemented to ensure that the employer dollars won't go towards the $303 million in inflated transport costs of the $77.8 million in ABA improper payments?

Thank you.

This floor is Brennan. Thank you, Mr. Chair, members of the committee. So I don't think it's an either or accountability is absolutely something that we must continue to provide to our taxpayers and to our legislature and legislators. tours. The reason we can report on the amount of fraud in the news is because we have identified it and we are going after it. And we are taking measures to recoup those payments from providers to the extent possible. We've referred providers to the attorneys general, to the U.S. attorneys, to our own fraud unit. So we are absolutely taking the accountability very seriously and going after providers. And again, like I said, we are putting a lot of analytics in place to

Any further questions from the committee? All right, seeing none, thank you all for your time this afternoon. Final call for witnesses on House Bill 1327. Seeing none, the witness testimony phase is closed. Amendments, bill sponsor.

I appreciate that, but you don't. Oh. Madam Vice Chair. I'm sorry, I'm used to health.

There been a motion by Madam Vice Chair a second by Representative Garcia Tell us about L002 Thank you Mr Chair Sorry I usually only in health so I apologize for that motion

Any questions committee on L002? Representative Brooks.

Representative Frey.

Representative Brooks, any follow-up? Any other questions or comments on L002? Any objection to L002? Seeing none, L002 has passed. Representative Frey, any other amendments?

There's been a motion by the vice chair, second by Representative Gonzalez. Representative Frey, tell us about L003.

Any comments on L-003? Any objection to L-003? Seeing none, L-003 is passed. Any other members? Bill sponsor? No. Committee, any further amendments? Seeing none, the amendment phase is closed. Wrap up, bill sponsor.

the committee. Representative Garcia.

Amel Bacon. Thank you, Rep. Ray. I do want to say of what I look forward to that I think this bill is actually helpful for us. Quite honestly, I do think we need to talk about all things with costs for health care. from everything from the opportunity costs to the actual costs. And I am struck by this notion that having a workforce that does or does not have access to health care is not of concern to anybody, let alone businesses. I will say that while I do appreciate that this is not judiciary and I'm treating it like that, and on behalf of the lawyers in the room, I will also recognize that we have three branches of government. One of them is the judicial branch. to help us sift through what we determine here to be our purpose, which is we do everything that we can to find the boundaries, but our purpose is to legislate, given the interest of our communities. So in regards to the nexus, I would just ask, you know, not even a view, but everyone in the room, if we're going to make arguments in regards to what impact is, I too would also like to see data. We are asked to provide that all the time. And so I'm going to ask that everyone else stand up to that. I would like to know what is happening with business in regards to our workforce, because there is no report that I've heard of late talking about people do not want to go to work or work full time. And so I'd like to understand what's happening amongst businesses if people are being brought on as contractors where there is very clear law to separate a contractor from an employee, not only from benefits that are offered, but also in regards to management structure. So to hear people say they want to negotiate their hours, that's great. What does that also mean about how they're managed? Because that is functionally the difference between contractors and employees. And so if we are walking into the space that we heard from our witnesses, I would like to actually see what we're talking about. And I do think we should be concerned of who's moving us to contractor versus employee, especially of what we know to be true about costs, that the state, and to be clear, the General Assembly does not benefit. It is not our money, as we hear all the time. So if the state is paying for it, that means everybody in here, right, tax dollars, are paying for the health care of other people who might want it and aren't offered the opportunities to go work and get it. And I have not heard why it is that we have to be paying the difference on behalf of all of my neighbors And so all of this has been about a balance Colorado has done a good job but we are not the highest state when it comes to tax rates And yet we have things that we have to pay for like everybody else does that is not keeping up with inflation. And so I just want to remind of who the we are. And so if we're going to talk about this, then everyone needs to pay their fair share. And that is what I believe with this. and I look forward to some of these questions being answered with other attorneys. Thank you.

Thank you, Mr. Chair, and thank you, Representative Ray, for bringing this. And I'm sorry you have to. And I think when you go to the root cause of why you have to, it's because of Tabor. We have a system that's antiquated, that isn't serving any of us very well, and instead we have to be creative in ways that may not be the most efficient. I have significant concerns about the logistical implementation of this bill. I have significant concerns about the legal parts of this bill. But as you mentioned earlier, it is required that we have this conversation because our system dictates it. I encourage you to continue to work on this bill because I do see some problems. And if this bill gets out of committee, I would like to have this conversation more. So thank you for bringing it. I appreciate it. Please, please keep working on it.

Thank you, Mr. Chair. So we're here in the Finance Committee, so I've held myself to not what's in the best health of the state, but what is the financing implications. And there's just no way around my ability to try and say that this is an enterprise, because it's not. It's not the original intent of an enterprise. When Tabor was first put in effect, there were three enterprises in the state. There were things like the lottery and CCI, the correctional institute's prison where people would pay money and get a service. Over the next 25 years, we established 13 more enterprises. And there were things like the fair, the state fair. Get that off our books so the revenue doesn't count against labor. People pay the sponsorship fees. People pay for tickets. It runs itself as a business. Same thing with our parking garage right here. Rather than having to spend all the money and have the revenue count against our Tabor cap, it was made in an enterprise, got its own bonding, and the parking fees pay for it. The higher ed system, the tuition, all of those were fee for services. Since 2020, in just the last five years, we've created ten more, and they have just gotten far away from the original intent. Many of the lawyers will know when you look at Supreme Court cases, they'll often say, this law was implemented by the first Congress. Meaning that those were the people who probably knew best what the Constitution meant because they wrote the darn thing. Well, I think the people that understood what Tabor meant the best were probably the ones that were keeping to its original intent. Throughout this entire thing, I've heard the sponsor and all the witnesses constantly trip up and say, this is all money for the general fee, for our general problems. H.R. 1 is causing us problems. This is going to go to all the providers. It's a general tax. We're trying to raise revenue. And if I was an attorney, I would probably be using transcripts from this hearing when they wind up going to suit of everything people kept saying. Because it was clear it's not a fee for service. It's to support the general Medicaid because we're upset at a very few businesses. And it's clear that's what we're looking at too, which also brings up concerns. this is not a true bill of attainer but if look at what the historical reasons are for that, it sure is close. We carved out every other non-profit, anything we could, to get down to just a few employers. One in particular because people kept using their name. We're trying to punish this one employer. I kept hearing that. And I don't like that employer either. But the Constitution is set up to protect individuals and protect minority groups. So this whole system here that you're setting up is very disturbing to me just from a policy perspective. And I get it. We always will side with the people against big businesses, people over profit. Well, I'll side on the rule of law versus the rule of the mob, even if it's the legislature. Thanks.

Thank you, Mr. Chair. I'm always amused by how it's Tabor's fault. It's Tabor's fault. it's for the children those are uh those are kind of the uh the tabor protects us from the voracious appetites of the general assembly which we can see would just grow unchecked um you know when we're dealing with a republic that protects us from the mob the democracy feeds us to it the you know we have this we we have this legislation of of legalized plunder where it's we just say well we're bigger than everybody else so we can start taking from this group and then giving it to another group and we're not looking at the structural issues that are causing the rise in health care costs. And while I'm tempted to vote yes, because I would really be interested to see how that lawsuit turns out that might trigger the entire collapse of the enterprise system of Colorado because the trans taxes that it's created are just beyond comprehension, just taxes that identify as fees, don't make them anything other than taxes. And what I'd say from this, looking at this, the unintended consequences are the only likely outcomes of this. I think what we would have is we would have a lot of minimum wage go to zero because you would have a lot of people that would be, I think they would be looked at as a liability. And when we start looking at these, adding all this stuff, we take it and we basically move the ladder of success the bottom rungs of the ladder of success. We move them up, or basically we just remove the bottom ones where they can get on it. And we have to, as we socialize medical, it's ironic when we're looking at this because as we socialize medical, it becomes more expensive and more dysfunctional. And the healthcare started as a bypass, is my understanding. the healthcare started as a bypass to bypass the wage caps. And that began the foobarring of the healthcare market. And now we're just entrenched in this. Instead of rolling it back and where you see the free market allowed to actually breathe, you start to get better outcomes and you start to get lower costs. And that's not an option. Instead, we blame Tabor and say, if we could only tax our way out of this problem, we would have a solution. So again, I am very tempted to vote yes, because I'd love to see how that lawsuit goes, if we could get rid of the abuse of the enterprise system that is beginning to grow like mushrooms as well. But I'll have to be a no for today. Oh yeah, yeah, yeah, I'm pretty sure. Yeah, okay. Anything further? No, that's all I got. Okay, a proper motion,

Yes.

No.

Yes.

Yes.

No.

Thank you, Mr. Chair. Thank you, members of House Finance Committee. Me and my amazing co-prime from Glenwood Springs are proud to present to you today House Bill 1230. This bill is very simple. It just extends the Conservation Easement Tax Credit sunset by five years from 2031 to 2036. Since 2000, the Conservation Easement Tax Credit has been an important tool to incentivize landowners to put their lands in conservation easements, which benefit their families, our wildlife habits, habitats, and the climate and promotes resiliency. For both of us, this tax credit is an incredibly important tool and asset to both of our communities. I've seen firsthand how farmers in my community deciding to protect their land in perpetuity has not only allowed them to stay on their land, but also benefits the whole community. For example, I have a sixth generation of the Lucero family ranch that we visited as a Latino Caucus this year that operates a ranch outside of Antenito, Colorado. Being able to place their land in a conservation easement and receive an incentive has allowed the family to continue to operate their agricultural land in difficult economic times while also benefiting the larger community by supporting wildlife habitat, open space, and protecting senior water rights In addition to that for this specific case this family the entire family works the ranch And they all work two jobs two three jobs just to be able to fund the ranch and being able to keep it alive to making sure that they don't want to sell. They don't want to sell their water, but they still want to continue this way of life that has been in their family before Colorado was Colorado. And so this gives them another option. Given the high demand for the credit, we anticipate all conservation easement tax credits through the current sunset period of 2031 will be reserved by the end of the spring, which will leave several projects that have already started the complex conservation easement process without a credit to access it at the end of it. The straightforward bill allows the tax credit projects in the pipeline to access critical funding while also giving the larger conservation community time to determine the best path forward with the credit given the high demand that we've seen over the lifetime of this program.

Thank you so much, Mr. Chair. committee members as representative martinez shared this tax credit is a huge asset to both all rural communities and the state of colorado i've visited uh some of the conserved properties in my district that range from farmers trying to keep their land in agricultural production to non-profits this conservationism and tax credit has been our single most powerful tool in protecting rural land, as well as community spaces such as public parks, outdoor education campuses, trails, and community farms in our communities. This credit also very much pays for itself. Through a study completed in the fall of 2023, CSU's Department of Agriculture completed a report that found for every $1 Colorado invests in conservation, the public receives between $31 and $49 in economic return. The total cumulative impact of conservationism tax credits to Colorado taxpayers is estimated to be about $20,000 per acre conserved. However, this credit and private land conservation is on the cusp of being halted due to the high demand outpacing our current sunset period. Conveying a conservationism is a multi-year process. There are currently several landowners across the state working with accredited land trusts and open space agencies to pursue a conservation easement who will complete the project after 2026 when all tax credits are accounted for, making them ineligible for state benefits. This uncertainty is likely to effectively stall or raise questions for private land conservation projects already underway. And we understand the difficult budget situation our state faces, which is why we are asking for a simple extension. And we ask for your support on House Bill 1230.

Thank you, Mr. Chair. We will also be bringing an amendment that we have out. This is a one. What this amendment does is it clarifies that landowners who donated a conservation easement prior to Colorado's House Bill 26-1230 taking effect will not be eligible to receive any credits from that extension. The amendment also makes clear that projects already eligible under the existing timeline are not affected by said extension This amendment was at the request of DOR as a clarifying amendment from their perspective Thank you Committee any questions for the bill sponsors Representative Hartzell

I've looked at this from multiple, whether you're looking at conservation, agriculture, grazing, I mean, you name it, it's been great. Can you tell me, with your amendment, as far as trying to look at here in the fiscal note, I'm looking, I know we're pushing it out, but is there any impact on the fiscal note that the amendment is going to do in the implementation? Or, because it's just talking about until after the bill is signed, is there anything that we're going to hit it?

Thank you, Mr. Chair. Thank you, Representative Hartzell, for the question. And this does not impact the fiscal note at all. So as this remains, and just again, like we had covered in our opening statements, that the amount of credits are already likely going to be taken up. So that's why this won't really affect it. It's just a clarifying point on essentially when the cutoff is.

Thank you. And thank you, Mr. Chair. So then the we're pushing everything out. We've already on the implementation. So we're not going to see an additional impacts. I know they can't forecast for TABOR, but still it looks like from a ROI perspective, we're going to be doing well. Is that anticipated or did you get any feedback on any of that, that that will stay steady state?

Thank you, Mr. Chair. Thank you, Representative Hartzell, for the question. To our understanding, I mean that this should stabilize what we already had thought. And again, this is what the extension was for in the first place, is just because of those that have applied already or are in the process already of doing this, that this is just kind of matching the demand.

I have two real quick. So it's my understanding these conservation credits have been transferable and syndicable, and that will continue. They can sell them to people

Thank you, Mr. Chair. Thank you for the question, Representative Marshall. We are not affecting at all how the Conservation Easement Program is being conducted at this point. Again, this is just a simple extension of what is currently on the books, what has been working for the state, and then again with the amendment just as a kind of a clarifying point at that point. So.

And then the second question on if it's so oversubscribed, is it just a first in first out determination? Or does the department have any ability to choose what is more valuable easements for the state to protect versus just whatever dirt someone puts in front of them?

Thank you, Mr. Chair. Thank you, Representative Marshall, for that. the departments here, I'm sure they'll be happy to answer what their evaluation process currently is for conservation easements.

Thank you for the opportunity to testify today. My name is Laura Cusick. I am the executive director of the Rio Grande Headwaters Land Trust. We are based in Del Norte, Colorado, and we serve the entire San Luis Valley, so based in southern Colorado. I'm here representing the organization, of course, as well as the community that we serve in support of this bill to extend the tax credits. our land trust has been around since 1999 so we've been doing this for a little while we are locally based grounded in our community and we're really small we're only three staff full-time one part-time employee and that includes me we currently steward 64 conservation easements across more than 37,000 acres and 95 of those easements at least 95 are on working family farms the community we serve as I'm sure you're all aware is not a wealthy one so it's a rural agricultural based economy and the conservation easement tax credit is usually used to pay off debt or as was introduced by the sponsors to keep land within the family to be able to pass on to the next generation and to keep working lands working we work with landowners across the valley small family farms that might not be able to stay in business without the conservation easement tax credit. And I'm sure you all know that farming and ranching is hard work and is becoming more and more expensive. So this tax credit really benefits the community that we serve. Conservation easement incentives also allow us obviously to protect open space, conserve wetlands for wildlife habitat, and protect both water quality and quantity in addition to the working lands that I mentioned. There's definitely a positive impact, of course, on the economy of the San Luis Valley. The Lucero family that Representative Martinez mentioned is one of our easements, and they employ a lot of people in their area. I would say across the valley, probably 80% of employment is coming from agriculture. So it helps the economy, helps these people stay in production. And I would just wrap up to say that the conservation easement tax credit is not just about continuing conservation. It's really about supporting humans, supporting working farms and families across the state of Colorado. So that's really why I'm here is to support that and to support the land trust community and the work that we do.

Afternoon. Thank you very much for having me here today. I'm Nick Concilia. I've had a chance to speak to at least one of you, Representative Brooks. I'm here to talk about a very unique project that's being enabled by the conservation tax credits, which is the development of 40 homes for individuals with intellectual and developmental disabilities. So myself and 15 other families are hoping to access the conservation easement to develop or not develop 10 of 15 acres in Wheat Ridge It is the largest contiguous undeveloped piece of land that still remains in Wheat Ridge today We are going to develop seven of the acres into 40 homes for a neuro-inclusive development and hope to have a minimum of 20 of those reserved as forever homes for our kiddos with IDD. The remaining 10 acres is on what's sort of a gentleman's working farm today that borders on a little bit of a creek that comes off of Clear Creek, the Galena Gulch, and we intend to maintain that as a working urban farm for the benefit of both our kiddos as well as the community as a whole and invite them in to participate in the activities there. Both to give the community access to that kind of outdoor space but as well as to provide integration with our kids who are often misunderstood and sometimes feared. Buying 17 acres in Wheat Ridge is not inexpensive, and accessing the conservation easement and monetizing those tax credits is a material aspect of the capital stack that enables us to do this development. It'll be a one-of-a-kind development in Colorado, one-of-a-kind in the United States. we are developing it further to restrict the sort of profit modem motive of the project and so the homeowners that buy into this development will be in a structure where their shares or their ownership will be reselled to the partnership at a fixed rate of inflation And so once we develop this and deliver it at cost, it will not become some kind of luxury item in the future. And so I think that it is an excellent example of how we're maximizing a great program for a really unique use to provide forever homes for my son and his peers who don't have access to this otherwise.

Good afternoon, Mr. Chairman and members of the committee. I am Eric Glenn, the CEO of the Colorado Cattlemen's Agricultural Land Trust. CCLT has worked with over 500 farm and ranch families across the state to conserve more than 840,000 acres of productive agricultural land made possible by this tax credit. For context, that's larger than the state of Rhode Island. We currently have more than 25 active projects in queue, with additional landowners reaching out weekly.