Colorado’s Free Health Care For Illegal Immigrants, ‘Pregnant Persons’ Projected To Cost 7x More Than Expected

A Colorado health care program designed to expand coverage to certain noncitizens is under scrutiny after costs far exceeded initial projections, adding pressure to the state’s budget during a period of fiscal strain.

The initiative, known as “Cover All Coloradans,” was created by state lawmakers in 2022 and launched in 2025 to provide taxpayer-funded health coverage for children and pregnant women who do not qualify for Medicaid due to immigration status. Early estimates projected the program would cost about $14.7 million annually and serve roughly 3,700 people.

However, actual enrollment and expenses have significantly surpassed those expectations. According to reporting from The Colorado Sun, about 28,000 people enrolled in the program in its first year, pushing costs to approximately $104.5 million — more than seven times the original estimate.

The surge in enrollment comes amid broader demographic changes in the state. Data from Pew Research Center indicates that Colorado’s illegal population increased from around 160,000 in 2021 to more than 200,000 by 2025, contributing to higher-than-expected demand for services.

The rising costs are creating challenges for state lawmakers as they work to close a projected $1.5 billion budget gap. Under Colorado’s balanced budget requirement, legislators must identify spending cuts or adjustments to offset the shortfall. The Colorado Joint Budget Committee has already approved a 2% reduction in Medicaid provider reimbursements, which is expected to save about $95 million.

So far, lawmakers have not approved immediate reductions to the Cover All Coloradans program. Instead, the committee voted to impose a cap on enrollment if spending exceeds $96 million in the next fiscal year, signaling an effort to control future costs without eliminating the program.

State leaders have acknowledged that the program’s impact has been larger than anticipated. Julie McCluskie, who sponsored the original legislation, said the state relied on available forecasts at the time the program was created but has since encountered “unanticipated impacts.”

The issue also intersects with electoral politics. Former state lawmaker Shannon Bird and current state representative Manny Rutinel — both of whom supported the program — are now running in the Democratic primary for Colorado’s 8th Congressional District, a competitive seat currently held by Republican Gabe Evans.

The program’s cost overruns come as Colorado continues to navigate broader debates over immigration policy, public spending, and health care access. With budget pressures mounting and enrollment still high, lawmakers are likely to face ongoing decisions about how to balance fiscal constraints with coverage goals in the years ahead.

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