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Ryan Warner
State lawmakers must cut one and a half billion dollars to balance the budget. That may come at the expense of Colorado's Medicaid program. Our metric these days genuinely is are people going to die if we vote a particular way on these things? And it's an awful place to be, but we're trying to minimize harm. Purple ish gets into the complexities and casualties. Then for Women's History Month, our colleagues at Indy 1023 share some sensational musicians who belong on your playlist, like Doll Pyle taking shots off of the highway signs.
Benta Birkland
Magic.
Ryan Warner
Oh my gosh, she sounds so cool, right? I want to be her friend.
Benta Birkland
Dreamy, ethereal and very approachable. Actually, she's a lot of fun. Did he make it?
Ryan Warner
This is Colorado Matters from CPR News and krcc. I'm Ryan Warner. The state's Medicaid program provides health coverage to low income Coloradans and to those with long term disabilities, and it may bear the brunt of the budget cutting axe that says lawmakers look to trim $1.5 billion. Time for purplish, the politics and policy podcast from CPR News and the Colorado Capital News Allian. Your hosts this time, Jesse Paul from the Colorado Sun, Seth Klamon of the Denver Post and CPR's Benta Birkland.
Jesse Paul
For the past 20 years, Nicole Villas has spent nearly all of her time taking care of her son. It is a 24, 7 job and really, there's no one to help me. Villis son Aiden has Dravet syndrome. He has seizures all the time, all day, all night. He's on oxygen. He doesn't speak well.
Benta Birkland
He functions at about a three year
Jesse Paul
old level, so he'll need care for
Benta Birkland
the rest of his life.
Jesse Paul
The family lives in rural Gilpin county, but we met Villis at the state Capitol on a rare day away from caregiving. It is me all the time, unless my husband happens to be working from home like now so that I can do something important to advocate for him. Villis has been advocating for her son a lot lately as she tries to convince lawmakers not to make cuts to Medicaid that would directly impact her family.
Seth Klamon
She's part of a group called Colorado Advocates for Adults with Intellectual and Developmental Disabilities. They're they're worried the state might reduce the compensation parents like Villis get as caregivers to their children. The money makes a big difference, even if it's not all that much.
Jesse Paul
Ours works out to about because our adults require 24, 7 care about $9 an hour, roughly
Unknown Female Host or Reporter
Villis and other members of the group have come to a meeting of the Joint Budget Committee in matching blue T shirts with the words Cut costs, not care across their backs. And they're watching anxiously as the panel weighs capping their weekly paid hours to help balance the state budget. This generated a lot of discussion, a lot of feedback from the community on March 3.
Seth Klamon
Community means parents like Kathy Fever, who also came to remind lawmakers who their cuts would hurt.
Benta Birkland
We're talking about the most needy people that bring joy to their families and bring joy to people who work with them. So I would ask that they not balance the budget on the backs of
Unknown Female Host or Reporter
the most needy people.
Jesse Paul
The six lawmakers tasked with writing Colorado's budget have an excruciating job this year. They have to find about a billion and a half dollars in savings to keep the budget in balance while knowing many of their cuts will have direct human toll.
Ryan Warner
We're doing our best to cause the
Jesse Paul
least harm, joint Budget Committee vice Chair Democratic Senator Jeff Bridges says votes like this one are a terrible part of
Ryan Warner
and our metric these days genuinely is are people going to die if we vote a particular way on these things? And it's an awful place to be, but we're trying to minimize harm.
Seth Klamon
These life or death choices, they have to be made because Medicaid is one of the largest chunks of the state's spending, if not the largest, which means members of this powerful budget drafting committee are taking a hard look at Medicaid to find ways to save money.
Benta Birkland
Are there any objections?
Unknown Female Host or Reporter
That passes on a vote of 4 to 2 with Kirkmaier and Amable objecting,
Ryan Warner
the couch cushions are being shredded looking for these coins.
Jesse Paul
There appears to be no way for lawmakers to get around balancing the budget without cuts to care. But when it comes to a program that people depend on for their health, their survival, even the smallest of savings can come with huge consequences. Lawmakers have known this was coming. They knew Colorado was facing a shortfall for the next budget cycle, but they got some very bad news recently because of worsening economic conditions because of TABOR and some unexpected increase in costs. The hole the state has to fill for the budget is about 50% bigger than they anticipated.
Seth Klamon
I was watching the JBC's faces really closely when they got this $1.5 billion budget hole news, they did not look very happy. When one Democrat found out about the situation, I actually heard him say Jesus out loud. And as we've been hearing from the committee for weeks, there are just no good options. Every cut hurts.
Benta Birkland
We are in a hell of a predicament. And I think you know that there are no good choices here.
Jesse Paul
That was GBC chair Democratic Representative Emily Sirota.
Seth Klamon
And when it comes to cuts, a lot of what they're spending their time on is Medicaid. The program to cover low income Coloradans and those with long term disabilities now makes up around a third of discretionary spending in the state, similar to what Colorado puts into K to 12 schools. And the cost of the program is ballooning. In just the past 7ish years, Medicaid spending has increased by about 86% or $2.6 billion.
Jesse Paul
So with the stage set, let's turn to some of the underlying factors to look at why Medicaid has become such a pain point for the state budget and how policymakers hope to address it. When we talk about how much Medicaid spending is increasing in the state kind of ballooning, as you described it, the first question I think I have a lot of people would have is why? Why is it going up so fast right now?
Unknown Female Host or Reporter
Well, there are a lot of reasons. And first it's probably important to say the cost of health care is just increasing and this is a problem for state Medicaid budgets nationwide. It's not just a Colorado problem, but also people on Medicaid are getting more care. And on top of that, the legislature has expanded what and who the program covers in recent years.
Jesse Paul
I want to dial in on one of the things you just listed. People on Medicaid seem to be needing more medical care and that's driving up costs. At a recent hearing, the nonpartisan budget staff said they didn't necessarily know why. Do either of you have an answer or have you heard from folks why they think people are needing more medical care?
Seth Klamon
There's a lot going on here. But first you have to know that Medicaid has been changing a bunch in recent years with roles expanding during COVID and then shrinking again and up again and up and down and up and down. There's a lot going on. Some of that expansion was covered by the feds though. So that's kind of irrelev into this situation. The theory about Colorado's state increased costs has to do with the people on Medicaid being older and sicker. Older and sicker means more money, more care.
Unknown Female Host or Reporter
People think there might be other reasons that Medicaid patients are needing more care right now. Maybe it was people putting off medical help during the pandemic and now they're making up for it. And maybe those delays mean the conditions they're treating are that much worse.
Jesse Paul
I also talked to a lawmaker who wondered if people on Medicaid or maybe just more aware of what programs they have access to so starting to use those programs more.
Unknown Female Host or Reporter
Yeah, and that's more clarity than we got last year when we covered this. Lawmakers then didn't seem to have a clear idea why utilization was going up even while enrollment was dropping.
Seth Klamon
Just to drill down on this point about older and sicker folks being on Medicaid, this was an interesting stat from the Sun's reporting. People who are disabled and people who are older made up 9% of the state's Medicaid enrollment in the 202324 fiscal year. But those people accounted for 50% of the program's overall spending.
Unknown Female Host or Reporter
Right. And on that note, I think it's worth noting that for many people with disabilities, Medicaid is frequently the only or the best option for care, especially if they can't work or they don't work enough hours to get health care through their employers. And private insurers often won't cover certain long term services that some with disabilities depend on, like attendant care. And it also helps older adults who maybe Medicare doesn't cover all the care
Jesse Paul
that they need to get Back to a point you mentioned, Jesse, about enrollment going up and down. It's something Republicans criticize Democrats for. I talked to Senator Barbara Kirkmeyer. She's on the Budget Committee and she said too often these Medicaid expansions sounded great at the time, but the state is now paying the price.
Benta Birkland
We need to go back and look at where did we expand, what benefits did we expand and who are we serving.
Jesse Paul
Kirkmeyer has a couple of things she singles out when she talks about this issue. She points out Colorado's health program for poor children covers families that make up to 265% of the poverty line. Lawmakers increased that from its old cutoff of 138% of poverty.
Unknown Female Host or Reporter
Well, a lot of those expansions were bipartisan, right?
Seth Klamon
Yes, definitely. The Democrats have been in charge of the Capitol since 2019. So ultimately the buck kind of stops with them sometimes. You do hear Democrats try to shift some of this blame onto Republicans, but I kind of liken that to the parents blaming the kids for their behavior. I'm not calling Republicans. Kids do not slide into my DMs, but what I am saying is that Dems own this.
Jesse Paul
Let's go over some of the main Medicaid expansions lawmakers passed in recent years essentially allow more people to be enrolled in the program.
Seth Klamon
Lawmakers have passed bills to allow people who gave birth while covered by Medicaid to remain enrolled for the following year. They passed a bill to do away with co pays for prescriptions and outpatient services. They passed a bill to expand treatment for substance use disorders and to extend state Medicaid coverage to immigrant children and pregnant women whose immigration status means they don't qualify under federal rules. And that last one, which only had the support of Democrats, has turned out to be a biggie. I could keep going, but we'd be here for a while. I think everyone gets the gist.
Jesse Paul
That last example, dealing with immigrants, definitely something that was not bipartisan at the state House. And Jesse, the numbers you've reported on that cost of that program, those are pretty eye popping.
Seth Klamon
The program's only been up and running for a little more than a year and it's seen much higher than expected enrollment and as a result, much higher than expected costs.
Unknown Female Host or Reporter
Like much higher, right? Like tens of thousands higher.
Seth Klamon
It's 600 plus percent more expensive than the state initially projected.
Unknown Female Host or Reporter
Not unsurprisingly, that's impacting the budget. State fiscal analysts project it'll cost Colorado More than $100 million, 104.5 million to be exact, in this fiscal year alone, when it is just supposed to be
Seth Klamon
around 15 million, 14.7 million to be exact.
Unknown Female Host or Reporter
Thank you.
Jesse Paul
I think one problem, though, I mean, would you both agree that when these expanded programs are getting passed, the state budget analysts, they do, I think, a good job trying to estimate how much a program is going to cost. But that's just hard to predict. And the reality can end up being very different.
Seth Klamon
You see this across the board with bills. Nonpartisan staff at the Capitol do their very best, but it is a tough job. The Medicaid coverage for immigrant children and pregnant women is a prime example of that. They really tried here. They relied on information from the Polis administration and ultimately was wrong. Things can change very quickly over a
Unknown Female Host or Reporter
matter of years and we've been talking about policy decisions that have contributed to this situation. But there's also been concerns about the state overspending and misspending Medicaid dollars. We'll get more into that later. That's prompted criticism from lawmakers and advocates and sort of complicated this, this picture as well. And I'll also say, just in case people are wondering, there is one thing that isn't contributing to Colorado's Medicaid problem, at least not this year. The Medicaid cuts passed by Republicans in Congress in HR1 this past summer.
Seth Klamon
Those cuts are actually still a ways out in the future. So the they'll be a headache for a future budget cycle and maybe a future episode of Purplish.
Jesse Paul
Yeah, book your calendars now, guys. We'll bring you back. But getting to the big picture on Colorado's state budget at the moment, even as Medicaid has all these pressures driving up costs, it's not like the legislature can just raise taxes to cover this right. We have the Taxpayers Bill of Rights, TABOR that prohibits that right.
Seth Klamon
And it's important to talk about this because as we mentioned, Medicaid is causing problems in state budgets across the country. But Colorado is unique because of TABOR. It makes budgeting really tricky. In the past seven or so years, the TABOR cap has increased by 39%. That increases the amount that government can keep and spend in its state budget. In that same time, however, the cost of providing Medicaid has increased much faster. Again, that's about 86%. So if the overall budget can't grow that fast, then money for other programs either has to get spent on Medicaid or you have to cut Medicaid.
Jesse Paul
I think that's right, Jesse. Taber does put parameters on Colorado's budget in a way that other states don't deal with, for better or worse. But one thing that's important to know, according to current revenue projections right now, let's say Colorado didn't even have Taber, the state would not be bringing in enough tax money next year to pay for Medicaid growth and everything else in the budget. And we'll get into where exactly lawmakers are looking at cuts to Medicaid next.
Ryan Warner
That's when Purplish continues. I'm Ryan Warner. You're with Colorado Matters from CPR News. It's Colorado Matters from CPR News, I'm Ryan Warner. By law, the state must balance its budget this year. That means cutting a billion and a half dollars. Medicaid will be hit. It provides health coverage to low income Coloradans and those with long term disabilities. More now from Purplish and your hosts, Jesse Paul of the Colorado Sun, Seth Klamon of the Denver Post and CPR's Benta Berkland.
Jesse Paul
Now that we know at least some of the factors driving up Medicaid costs in the state, let's dive in a little bit on how lawmakers want to try to bring these costs down. We heard Kirkmeyer complaining about how much lawmakers have expanded, who's covered under Medicaid, what programs are covered. Is the legislature significantly going to pull back on some of those expansions?
Unknown Female Host or Reporter
Yeah, I mean, already you're seeing the JBC proposing things like a cap on annual dental benefits, basically keeping some coverage in place but making it less comprehensive.
Seth Klamon
I will note that was the governor's idea first. The JBC is also starting to take the financial shears to cover all Coloradans. That's the program we just talked about that covers children and pregnant people regardless of their immigration status. So this would include those who are living in the US without authorization, as well as some green card holders and people in the US under something called temporary protected status.
Jesse Paul
So Jesse, you've reported how many more people are enrolled in that program? Way more than the state ever anticipated. So how do lawmakers reduce spending there?
Seth Klamon
Well, let's caveat this whole conversation by pointing out that the budget is still being written as we speak. So nothing is really official yet. But the JBC has voted to change coverall Coloradans going forward so that the program won't enroll kids who need serious long term care. These are the sickest of the sick children. The number of kids who are enrolled is relatively small right now, but the concern is it could reach really grow
Unknown Female Host or Reporter
when it comes to these kids too. What lawmakers are proposing isn't to kick them off of the program. The ones who are already enrolled will stay enrolled with a cap on their benefits. And this is a perfect example of why once lawmakers have created a Medicaid benefit, it's so hard to pull back. It means taking away care from families who may be depending on it to survive. It's worth noting too, defenders of this program cover all Coloradans. They'll argue that people get sick with or without insurance, with or without Medicaid. The question those folks would say is whether you want to pay for care now or emergency care when things go south.
Jesse Paul
Jesse, do you think ending this type of long term care for children would bring these programs costs down to what the state originally budgeted for it?
Seth Klamon
No, not even close. We're talking about maybe a few million dollars. But it probably isn't the end of what lawmakers will do with COVID all Coloradans in terms of cuts. The governor's office is floating ideas that would essentially slash the program in half.
Jesse Paul
I mean, the political divides around this particular issue are pretty stark. Democrats have wanted to be more supportive of immigrants, especially in the face of the Trump administration's crackdown. At the same time, you could picture campaign ads accusing Democrats of prioritizing medical coverage for undocumented immigrants and then at the same time cutting programs for citizens.
Benta Birkland
We had members who are shedding tears over cutting folks that are here illegally. And then the day after that we're cutting dollars in Medicaid that are matched by federal funds.
Jesse Paul
So that's JBC Senator Barbara Kirkmaier again, her point is that coverall Coloradans is entirely state funded. A lot of the other Medicaid cuts get a federal reimbursement. So the state also loses federal money.
Benta Birkland
That doesn't make sense to me.
Jesse Paul
Why would we cut the programs that pull down a federal reimbursement and we're
Benta Birkland
talking huge cuts in these programs. Why would we do that and at
Jesse Paul
the same time not cut the entitlement program? So given how bad the budget situation is, do you think there's a world that enough Democrats would agree with Kirkmeyer and would try to eliminate coverall Coloradans?
Seth Klamon
I don't think Democrats at the Capitol would be okay with cutting coverall Coloradans completely. Like JBC Chair Sirota, in response to Kirkmeyer's comment about pulling down federal funds, said she's less worried about that and more worried about making sure pregnant women and kids have health insurance. But with $1.5 billion to slash, there is going to be pressure to trim cover all Coloradans a lot more if they don't. If lawmakers do not do that, like we heard from Kirk Meyer, they will have to reduce other Medicaid programs for non immigrants.
Jesse Paul
I want to go back to where we started this episode with cuts the GBC is looking at for Medicaid caregivers and these for services for adults with intellectual and developmental disabilities. How could state support for these groups change?
Seth Klamon
I think the big one on this topic is the wait list for 24. 7 care for adults with intellectual disabilities. That's sometimes known as the IDD wait list. The JBC voted to double how long people can stay on that list from seven years up to 14 years. They're also set to prevent kids who are getting 24. 7 Medicaid care from automatically getting the same coverage as adults. Instead, they'll move on to that very long wait list.
Unknown Female Host or Reporter
And while they're on that wait list, they can get other Medicaid services, but not the specific 24. 7 care that they're waiting for. That only comes when they're off the list.
Jesse Paul
And I mean, the Budget committee had said there will be some exceptions, but you can imagine for families dealing with this and needing 24.7care, they have a lot of concerns about what this is going to mean for their day to day life. And I think the JBC members are very aware of that, that it's, it's so hard to cut services from people who truly, truly need it.
Unknown Female Host or Reporter
I will say lawmakers aren't just cutting like we talked about. TABOR means the state just can't raise taxes to fill this hole, but the legislature is trying to bring in extra money some other way. Well, at least some legislators.
Jesse Paul
Okay, we'll talk about that.
Unknown Female Host or Reporter
Yeah, there's a recently introduced bill, House Bill 1327 to be precise. Jesse, thank you. And that bill would require large employers who don't offer health insurance to their workers to pay a fee. Basically, if those workers are enrolling in Medicaid because their employers aren't offering health coverage, then backers of the bill think those employers should help pay for the program.
Seth Klamon
This would be for really large companies, right? Think Amazon or Walmart. Per the bill sponsors, under the bill, they'd have to pay the state about $2,300 per year for every uninsured, low paid worker they have.
Jesse Paul
So is the goal to get these large companies to ensure low income workers help get some of these people off of the state's Medicaid rolls or is this about bringing in some revenue for the state, you know, through these fees?
Unknown Female Host or Reporter
Yeah. So this is a policy that some other states have considered, are still considering. I spoke with one of the bill's main sponsors here in Colorado, that's Democratic Rep. Lisa Ferre of Arvada. I think the answer to your question, Benta, is it's a little bit of both.
Jesse Paul
And how many people could potentially be covered under this bill? How many low income workers?
Unknown Female Host or Reporter
So according to the fiscal analysis for the bill, there are at least 25,000 Coloradans on Medicaid who work for companies that would be covered by this legislation. And if these fees are made into law, then the program could bring the state a maximum of $100 million in TABOR exempt revenue in its first five years. Now that's not enough to fix a multi billion dollar Medicaid problem or even really make a dent into it, but it does show how lawmakers are looking for alternative options here other than cut, cut, cut. And if the bill did change employer behavior, if it did lead to more people getting insurance from their companies, then I think Foray and other people interested in this policy would consider that a win.
Jesse Paul
Yeah, and I mean maybe it's not going to solve the whole shortfall, but $100 million is still a lot of money. So what are the chances this bill could pass? You've got Democratic sponsors, a Democratic legislature.
Unknown Female Host or Reporter
It's actually in committee as we tape this. So Foray seems confident it'll at least get out of committee. The governor's office is also supporting it. It's going to get amended to address some concerns that employers could try to just get around the bill by modifying how they hire people, essentially trying to find workarounds to avoid paying the fee and avoid putting people on company health insurance policies, too. But it's got a long way to go even if it does pass committee.
Seth Klamon
Since we're talking about how the state is managing this huge growth in Medicaid, we also really have to talk about the department that administers the program. There are a lot of indications that the Colorado Department of Healthcare Policy and Financing, known to us cool kids as Hickpuff because it's so fun to say, has not been minding its books as closely as maybe it should.
Jesse Paul
Hickpuff has been in hot water lately for sure. And Seth is you broke this story that's just kind of reverberated that because of an error in the department's billing guidance, the state's Medicaid program was paying way more than it needed to for wheelchair transport providers. And it was like 600 some dollars for a ride when the state should have been paying $65.
Unknown Female Host or Reporter
Yeah. When the budget committee members found out about that, one member said he didn't know whether to laugh or cry. And there were actually two billing errors within this same program, which is a service that gives free rides to medical appointments for Medicaid members. It's complicated, but the upshot is the state was paying too much for various parts of this service, like two to ten times too much. And that was going on for several years.
Jesse Paul
Yeah, I mean, when GBC learned about some of these errors, I mean, they just seemed totally gobsmacked.
Seth Klamon
It was definitely a wtf? What the fudgesicle, to be precise, moment in the building.
Jesse Paul
And I think for families, too, a mom from Aurora, Sierra Stewart, she has a young son with disabilities, and he has two rare genetic mutations. She said this error is so infuriating, especially because of the cuts families like hers are going to have to deal with now.
Seth Klamon
The longest time the narrative has felt
Benta Birkland
like Medicaid costs were rising because families
Seth Klamon
like mine were overusing services. But when stories come out like this, billing errors and oversight failures, it's hard not to question that narrative. And I don't understand how something like that can happen for so long without being caught.
Jesse Paul
Stewart and some other people I talked to said they want the state to do more audits on Medicaid. They to look at other issues, other areas where there may be overbilling, try to find savings there instead of cutting back on services and payments families like hers rely on.
Unknown Female Host or Reporter
And on top of this issue with the Medicaid transportation program, a federal watchdog has said that Colorado Medicaid overpaid nearly $78 million for autism services in 2022 and 2023. And the watchdog recommended the state repay the federal government roughly $43 million for the error.
Jesse Paul
Hickpluff has acknowledged this audit and a spokesperson told news outlets they're taking it seriously. And the governor's office told CPR News that if any irregular billing is found, it will be investigated and prosecuted to the fullest extent of the law. They want to request future audits and ensure full transparency.
Seth Klamon
The bottom line is that families and lawmakers are getting increasingly frustrated with hicpuff and how the agency operates.
Ryan Warner
Right.
Unknown Female Host or Reporter
And I don't think there's a lot of trust or confidence in hicpuff. And it's not just the overpayments. There's also been some measure of fraud. And in that transportation program I mentioned at least $25 million in total funds. So state and federal was lost to fraudulent drivers because the program was so lucrative and didn't have the level of oversight that it needed. And it took Hiccpuff more than two years to provide any sort of estimate on the cost from that fraud.
Jesse Paul
Ultimately, the billion dollar question, or the billion and a half dollar question here, how successful could any of these actions be, from program cuts to trying to kind of root out waste and overspending? Is that going to be close to closing Colorado's budget shortfall just on dealing with Medicaid alone?
Seth Klamon
On the back of the napkin calculation, we're really just talking about a drop in the bucket here.
Unknown Female Host or Reporter
Yeah, I mean, fixing the Medicaid billing errors will save tens of millions of dollars. And Frey's bill, if it passes, will add maybe 20 million more a year in at most in TABOR exempt revenue. That's all helpful. And at this moment you'd rather fix errors and come up with every dollar you can. But those things are going to solve the bigger hole here. It's just too large. And that's without factoring in the cuts that are coming from the federal government.
Jesse Paul
Since this episode has been so light and fluffy so far, let's just Try to bring it down to earth a bit to wrap it up.
Seth Klamon
I think we meta can do that.
Unknown Female Host or Reporter
That's so bad, it's horrifying.
Jesse Paul
We need to get a few jokes in here, right? Because I mean this, this is a downer episode. A lot's going on with the struggles lawmakers are dealing with with Medicaid this year. And that's almost the tip of the iceberg because budget analysts at the Capitol are warning lawmakers that the state is likely to face another billion dollar budget shortfall next year. So in a way, this is kind of the beginning of the story.
Seth Klamon
That reality is part of why some more left leaning groups are saying that this might finally be the year that voters are willing to give the state more money. There's a pair of ballot measures out there to increase the amount of money the state has to spend by making changes to tabor.
Jesse Paul
One proposal is moving through the legislature. It would refer a ballot question to voters to increase school funding by 2% a year for the next decade. And it would do that by letting the state keep more tax revenues and reduce taper refunds. This is money that would otherwise go back to taxpayers. And then the other proposal is a progressive income tax. This isn't happening at the Capitol. It's outside of the Capitol. Advocates are gathering signatures to try to put it on the ballot. So right now Colorado has a flat tax rate. But this change would decrease the tax rate for households earning a house half a million dollars or less. And then it would increase the tax rate for high income earners and for companies.
Seth Klamon
Just a fine print, little asterisk to put there. A lot of the money that that second ballot measure would raise would actually come from increasing income taxes on businesses. But even if either of both of those measures pass, and that's an awfully big if, that money might not even be enough to cover the increasing cost of Medicaid in Colorado, but it would certainly reduce the amount of cuts that that would have to happen in future years.
Jesse Paul
You hinted this, Jesse. We have no idea if voters would pass either of these initiatives. Historically, voters have been supportive of TABOR and rejected efforts to increase taxes, even for education. I talked to Michael Fields and he heads the conservative group Advance Colorado. He thinks lawmakers should just figure out how the state should live within its means.
Seth Klamon
If you want to spend again, 40% or 50% of your budget on Medicaid, that's your choice. I can disagree and say I think there should be more public safety or whatever, but that's the job of legislators. To hear from people to make those decisions. What I don't believe in is raising taxes even more and chasing more revenue out of the state.
Jesse Paul
The progressive tax in particular. Fields thinks if that passes, it'll eventually hurt state finances. He notes that wealthy people, businesses, do bring in a lot of revenue. And Field says if they're taxed too much, they'll leave for states like Florida or Texas. Then Colorado could be stuck with a bigger budget and once again, not enough money to pay for it.
Unknown Female Host or Reporter
I think the counter to that from Democrats and progressive groups would be that the state can't adequately fund core services that its residents expect it to, like Medicaid and schools.
Benta Birkland
And.
Unknown Female Host or Reporter
And that costs, particularly for health care, as we've talked about at length here, are going up faster than the state can handle. Right.
Seth Klamon
Aside from raising taxes, the reality is that the TABOR cap increases by overall inflation, not medical inflation. And if you've been to the doctor recently, you know that the cost of health care is not increasing in the same way that the cost of food or other consumer goods are going up. Your medication costs a lot more than your milk.
Jesse Paul
So progressives and some Democrats are going to put a lot into these ballot measures. What are other ideas out there for Democrats if these ballot measures don't pass?
Seth Klamon
Well, the legislature is just going to have to keep cutting. This isn't a one year problem. We've heard that time and again. The governor does have some long term ideas, though. He's suggesting letting Medicaid grow only as fast as the TABOR cap. But as I said, that's more complicated than it sounds. Regular inflation and medical inflation are not the same thing. And ultimately the governor is leaving office. So in just a few short months, this is going to be someone else's problem.
Jesse Paul
So it sounds like depending upon what cuts lawmakers make this year, we could be having a very similar conversation next year.
Seth Klamon
Precisely.
Unknown Female Host or Reporter
It's almost guaranteed.
Seth Klamon
So same time, same place in 2027.
Jesse Paul
No, please, Seth, we need you. But I would have to say getting through this budget, fair to say there's still a lot of pain ahead. The full legislature ultimately has to vote on this proposal. And JBC vice chair Jeff Bridges, he's already warning his colleagues if they don't like what this budget committee has come up with, this committee that spent months and months all day hearings hearing about the budget, lawmakers better be ready to take the heat themselves.
Ryan Warner
And if you're not willing to stand up there and take those consequences and say this is what I would cut instead, then you have no right to criticize the people that are in this room, standing up and making those hard decisions and saying that to the people of Colorado because of what it is
Seth Klamon
that our rationing limit in the Constitution makes us do.
Ryan Warner
Purplish is the Politics and Policy podcast from CPR News and the Colorado Capitol News alliance. You heard CPR's Ben to Birkeland, the Denver Post, Seth Klamon and Jesse Paul from the Colorado Sun. And I'm Ryan Warner. You're with Colorado Matters from CPR News and krcc. You're back with Colorado Matters from CPR News and krcc. I'm Ryan Warner. Twas a busy news weekend. No Kings protests, the first home game for Denver's new women's soccer team. And in Pueblo, Democrats assembled ahead of the primary. The top line from Pueblo. All of the incumbents have made the ballot. The but some of them face challenges from within. Among them, John Hickenlooper squares off against Julie Gonzalez for U.S. senate on Saturday. She echoed the Assembly's focus on resisting President Trump.
Seth Klamon
The world is on fire, and every
Benta Birkland
day we wake up dreading whatever fresh
Jesse Paul
hell this fascist administration has wrought upon us. But folks like us, we don't have the luxury of opting out.
Seth Klamon
We still have bills to pay.
Benta Birkland
We have loved ones to care for
Jesse Paul
and work to do.
Ryan Warner
State Senator Jesse Danielson and Jefferson County Clerk Amanda Gonzalez made the primary ballot for secretary of state. Here's Gonzalez.
Benta Birkland
We are living in a country led by people who want us to believe that cruelty is what makes us strong, that violence is normal and that corruption has no consequences. They are wrong. They want us afraid, they want us divided and they want us exhausted. But here's what they don't understand. Democracy is how we protect what we love.
Ryan Warner
In the 1st Congressional District, Denver's Diana DeGette will likely face two challengers. Mehlat Quiroz, who describes herself as a democratic socialist, received 67% support to get 33, just enough to qualify. CU Regent Wanda James may also qualify via petition. State election officials have until mid April to validate signatures. Meanwhile, Attorney General Phil Weiser made the Democratic primary ballot.
Jesse Paul
When you're up against a lawless bully,
Seth Klamon
do you accommodate or appease?
Unknown Female Host or Reporter
Or do you fight for what you believe in?
Ryan Warner
Well, Colorado, that's why I've sued this
Unknown Female Host or Reporter
lawless, bullying administration 63 times and counting.
Ryan Warner
Weiser will face Senator Michael Bennett, who petitioned on the primary race for attorney general. On the Democrats side will likely include four candidates via state Assembly Secretary of State Janet Griswold workers rights attorney David Seligman as well. Here's Seligman. I will take on the Goliaths, the big tech, the private equity, the monopolistic
Seth Klamon
bros. Because I know that if we use the law boldly and courageously, we can take down these Goliaths.
Ryan Warner
And I want to be the David
Seth Klamon
on your shoulder when we do.
Ryan Warner
AG hopeful's Michael Dougherty, who's Boulder's DA and former federal prosecutor Hedledoshi, may still qualify by petition. 1400 Colorado Democrats took part in the state assembly in Pueblo Saturday. You can keep tabs on the primary ballot as it shapes up@cpr.org the Republicans hold their state assembly Saturday, April 11th, also in Pueblo. The primary is June 30th. You're with Colorado Matters from CPR News. You're with Colorado matters from CPR News. I'm Ryan Warner. It's Women's History Month, and for all of March, our colleagues at Indy 1023 have celebrated Colorado musicians, women who push the envelope, make great art. Ahead of tonight's Local 303 meetup, this is your chance to engage with artists face to face. Indy's local music director, Alicia Sweeney's back.
Seth Klamon
Hi.
Ryan Warner
And Happy Women's History Month.
Benta Birkland
Lish, right back at you, Ryan.
Ryan Warner
Can I call you Lish?
Benta Birkland
Yes. Ry.
Ryan Warner
Why don't we start with Isadora Eden. This is a former solo artist who has, I guess, rebranded.
Benta Birkland
Yeah. You know, she's been playing with her band for a really long time and she finally put a name to that band instead of just playing under her name. So she's been on my radar for a handful of and rebranded as Doll Pile.
Ryan Warner
Doll Pile. Oh, my God. That's so visual. I'm just picturing a pile of dolls.
Benta Birkland
Right. Like a whole bunch of vintage dolls all stacked up.
Seth Klamon
Yeah.
Ryan Warner
It's giving me Courtney Love Doll Parts vibes, but okay, 100%.
Benta Birkland
And they do give a little bit of that 90s alternative vibe a la Courtney Love Doll Parts and the band whole. So this new record of doll piles is called Someone else's Heaven and I of Isidore's favorite song from it. Nothing here ever looks quite the way it should. Taking shots off of the highway signs which could to drive us home.
Ryan Warner
Didn't wanna drive alone.
Benta Birkland
Did he make it?
Ryan Warner
Oh, my gosh. She sounds so cool, right? I wanna be her friend.
Benta Birkland
Dreamy, ethereal and very approachable. Actually, she's a lot of fun.
Ryan Warner
Oh, yeah. I'm glad to hear that, actually. Because you're not sure listening to that.
Benta Birkland
Yeah. Sometimes when you do hear an artist song, and it's very serious or it takes you places emotionally. Once you get to know them, just outside of stepping away from the stage, you know, they are many things. And what's cool about Isadore Eden is when they went on their last tour this past fall for the new record, they released a tour documentary that you can watch on YouTube.
Ryan Warner
Oh, that's interesting. All the backstage realities. Doll pile. Okay, an up and coming R and B artist is next. This is Lokana, who grew up in Littleton.
Benta Birkland
Yes. And she has been so fun to watch over the last handful of years. She's really coming up in the R and B and pop scene locally, and she recently won at the Denver Spotlight Awards singer of the year.
Unknown Female Host or Reporter
Whoa.
Benta Birkland
And she just really continues to impress me. In fact, when she put out her new album last month called Masterpiece, she surprised herself by selling out her album release show. And I want to play you a little bit of this pop R and B singer Lokana. This is the song I made it Got a lot of people who depend
Jesse Paul
on me is great. Not a lot of people really know all my mistakes. Not the perfect person But I always find a way to make it up to heaven before I even reach the
Benta Birkland
gate hey I'll be patient every day hey Find the way hey no more breaking Think I made it man I made it man I made it man I made it Lots of changing Done. We're playing Life's amazing I've been waiting no more chasing Think I'm.
Ryan Warner
You know what's fascinating, Alicia, is that I would hear her acapella. Like, that voice is so stunning. But then, as if that wasn't enough. That music is so lush.
Benta Birkland
Yeah. And. And just so catchy. I teased her when I met her recently because, you know, I've known of her and we've been friends online, and I've played her music for years. I finally met her, and I teased her that she writes these bops that literally have stayed with me for years. And this new record, that song right there, I made it. I'm gonna be bringing that into springtime and into summer. I just love her vibe. And can I tell you something cool about Lorcana?
Ryan Warner
Something more, even more cool? Sure.
Benta Birkland
Okay. She's big in Japan. Oh.
Ryan Warner
How did she. What, did she land in a whiskey commercial or something?
Benta Birkland
I mean, it's the dream, right? So Lokana, when she was in high school, so she's in her early 20s now, and I've been playing her on the radio since 2020. Well, when she was in high school in Littleton, her song Ride or Die was big in Japan. It even charted and made it onto a top 10 pop chart.
Ryan Warner
When she was in high school in Littleton.
Benta Birkland
Yeah, Imagine like, you know, just telling your classmates like, oh yeah, what'd you do last night? Oh, well, I got notified by the Japanese pop charts that I'm in the top 10.
Ryan Warner
Oh, that's amazing. All right. Lokana is someone to keep our eye on. Now, another recent debut, French Cuffs. This is a female fronted rock band from Denver.
Benta Birkland
Yeah, not only something you can wear and look dapper, but French Cuffs, a female fronted rock band here in Denver. I got a soft spot for bands that channel that 90s alternative rock sound like we heard earlier. And this band really hits the spot for me. Front woman Ashley Niven is a powerhouse singer, great on record, but also recommend checking the whole band out live. And they have their debut album and a release show coming up in May. And I want to share a bit of their song. Give up.
Ryan Warner
Give up from French Cuffs.
Benta Birkland
It's not the tides it's not the moon it's not a simple as fading
Jesse Paul
into you NCO It's a slow demise
Benta Birkland
and we're rip and wise not ready for the afterlife but not done Getting high didn't leave it in 2009. Giving up at the same time.
Ryan Warner
It makes me want to break the law.
Benta Birkland
Right.
Ryan Warner
Like I would say, I would tell the judge, but you don't understand, your honor. The music made me do it.
Benta Birkland
The music made me do it. I was listening to Ashley Niven of French Cups, which this might not surprise you. A couple years back she was a part of a tribute to show for Alanis Morissette and did some Alanis covers, which you can hear that in her voice, right, that she'd be a perfect person to sing her songs.
Ryan Warner
Okay. French Cuffs giving us some very, very rockin vibes. Lot of fresh artists this month, including a young singer songwriter who's hitting her stride on the Denver scene. What should we know, Alicia, about Cameron cade, both with Cs Cameron Cade.
Benta Birkland
Cameron Cade, a cool name, cool girl. She's originally from Virgin but has been based in Colorado here in Denver for a handful of years. And what I love about observing her over the last couple of years and what made me want to bring her into the local 303 is that she's really pairing up with a lot of cool artists and producers in our city. And she put out a really impressive debut record in late 2025 and she said she Recorded so many songs in the process of working on that new album. Album and a lot of collabs that she has another new EP coming out this year. Being a good girl or so it seems I'm learning to go quietly because what you did is actually totally fine I could could say it all But
Jesse Paul
I don't want to be that person
Benta Birkland
I could watch you fall Just to convince you that I'm hurting But I bite the bullet Turn around and pick up all my patience I've forgotten who I am Trying to meet your expectations
Ryan Warner
I've forgotten who I am Trying to meet your expectations oh, right.
Benta Birkland
Like innocent pop, but fierce as well.
Ryan Warner
Yes, exactly.
Benta Birkland
And like a little wink and a nudge in her voice.
Ryan Warner
It's interesting to hear something that's both so light and so heavy at the same time. Well done, Cameron Cade.
Jesse Paul
Yeah.
Benta Birkland
That song was called Kicked out of the Band.
Ryan Warner
Okay, we're going to wrap things up with Baby, Baby Forever. That's all one word, lowercase four. Baby Baby Forever. You say she's as visually engaging on stage as she is musically.
Seth Klamon
Yeah.
Benta Birkland
So Baby, Baby Forever. I'm a person that likes synth pops, so she draws me in that way. But then when you see her on stage, you can appreciate her artistry. She's got this style that stands out with these bright outfits. Her presence is otherworldly and really playful. So when you see her perform, her shows are really fun and sometimes interactive. And she's going to be performing at our local 303 meetup tonight at the Skylark.
Ryan Warner
Sounds immersive to me, Alicia.
Seth Klamon
Yeah.
Benta Birkland
No tickets sold. That's okay. My friends are coming. Smoke to increase my nerves. Just go outside and feel something. You've gotten smiler since I saw you last. Read me a poem when I saw him last. Cars they Pass on by.
Unknown Female Host or Reporter
Lord.
Ryan Warner
Emphasis on the synth in synth pop.
Benta Birkland
Right.
Ryan Warner
Spacey.
Benta Birkland
Very spacey, very otherworldly. That's Baby Baby Forever.
Ryan Warner
I'm excited for her to interact with folks.
Benta Birkland
It'll be going down tonight at Skylark Lounge for our Local 303 meetup.
Ryan Warner
Alicia, thank you so much. What fabulous women we got to meet.
Benta Birkland
Thank you.
Ryan Warner
Alicia Sweeney is local music director for Indy 1023. Learn more about the artists selected for Women's history month@indy1023.org and connect. Congratulations to the Local 303 named Best Local Music Networking Event by Westward. That is Colorado Matters for now, with thanks to my bandmates, Sandy Botoulga, Tyler
Unknown Female Host or Reporter
Bender, Carl Bielek, Anthony Cotton, Pete Kramer,
Seth Klamon
Andrea Dukakis Zan Huckpechone.
Unknown Female Host or Reporter
Matt Herz.
Seth Klamon
Tom Hess.
Unknown Female Host or Reporter
Michael. Michael Hughes.
Jesse Paul
Pedro Lumbragno.
Ryan Warner
Shane Rumsey.
Benta Birkland
Haley Sanchez.
Jesse Paul
Chandra. Thomas Whitfield.
Ryan Warner
And I'm Ryan Warner. Thanks for spending time with us at CPR News and krcc.
Episode Overview
This episode of Colorado Matters dives into two main themes:
Hosted by Ryan Warner and Chandra Thomas Whitfield, with deep reporting from the Purplish politics team (Jesse Paul of The Colorado Sun, Seth Klamon of The Denver Post, and CPR’s Benta Birkeland), the episode balances hard policy reality with vibrant local culture.
Colorado lawmakers must find $1.5 billion in savings to balance the budget, with Medicaid likely suffering major cuts.
Medicaid, covering low-income adults, people with disabilities, and long-term needs, now comprises about a third of Colorado's discretionary spending, rivaling K-12 education.
Nicole Villis cares for her son with Dravet syndrome (severe epilepsy), highlighting dependence on Medicaid payments to parents as caregivers.
Parents and advocates, wearing “Cut costs, not care” shirts, plead with legislators.
Ballooning Costs: Medicaid spending up 86% (or $2.6B) in 7 years.
Drivers of Increased Medicaid Spending:
Potential Cuts:
Political tension: Some programs (e.g., Cover All Coloradans) are entirely state-funded, so cutting them doesn’t lose federal matching dollars, unlike most Medicaid cuts, leading to difficult partisan debates.
State agency HCPF (“Hickpuff”) has allowed major billing errors and some fraud — e.g., overpaying six hundred dollars for a wheelchair van ride that should cost $65.
$78 million in overpayments for autism services; calls for more audits and scrutiny rather than service cuts.
Even big reforms or fixes to oversights only scratch the surface; the structural deficit remains.
Potential Ballot Measures:
Future Outlook:
Final Reflection:
Indy 1023’s Alicia Sweeney highlights five women or women-led acts whose music embodies Colorado’s current creative scene.
Doll Pile (formerly Isadora Eden)
90s alternative vibes, dreamy, and emotionally evocative.
“Dreamy, ethereal and very approachable. Actually, she's a lot of fun.” — Benta Birkeland (00:48/38:57)
Song Highlight: “Nothing here ever looks quite the way it should. Taking shots off of the highway signs…” (38:34)
Lokana — R&B/pop, Littleton-born, big in Japan as a high schooler.
French Cuffs — Female-fronted alt-rock, led by powerhouse singer Ashley Niven.
Cameron Cade — Young singer-songwriter, “light and heavy at the same time.”
Baby, Baby Forever — Synth pop with a spacey, immersive live presence.
This episode offers an in-depth, humanized look at Colorado’s forced reckoning with budget realities—especially the squeeze on Medicaid—amid rising costs, inflexible revenue limits, and tough political choices. While lawmakers and advocates wrestle with high-stakes decisions and the fallout from administrative errors, new revenue options and ballot proposals emerge.
On a lighter note, the second half lifts the mood: a celebration of inspirational women artists shaping the local music scene, showing Colorado’s enduring creative resilience even in challenging times.