Colorado state lawmakers in charge of writing the state’s budget questioned Governor Jared Polis’ proposal to fund Medicaid less than its projected growth over the upcoming fiscal year.

“The Medicaid cuts here are particularly large. Given the scope of Medicaid in our budget, it’s not an unreasonable approach,” Senator Jeff Brides, a Greenwood Village Democrat, said during Polis’ presentation of his budget proposal to the Joint Budget Committee on Wednesday. “It is concerning to see, and I want to know what you’ve done to ensure that these reductions are targeted and minimize impact on accessibility in the state.”

Polis said he does not characterize his plan as cutting Medicaid, but as a reduction in how fast the program for low-income Coloradans grows. The program is projected to grow nearly 12 percent next fiscal year, which begins in July, which would require a budget increase of about $630 million. Instead, he wants the Legislature to approve a budget that would only allow Medicaid spending to grow by about $300 million.

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“This isn’t a trim,” said Senator Barbara Kirkmeyer, a Brighton Republican. “It’s a blow to families who are already fighting to get care. These numbers represent real people.”

Medicaid is responsible for more and more of the budget each year, now up to about one-third. The state’s spending power is constrained by the growth of inflation and population due to the Taxpayer’s Bill of Rights, so ballooning Medicaid costs have forced budget writers to cut other program spending.

“We want any item that grows faster than other items to be one you look at with a magnifying glass and demand better outcomes and better results,” Polis said.

Representative Kyle Brown, a Louisville Democrat, suggested that the state needs to take steps to rightsize Medicaid utilization, so clients are getting care “at the right place, at the right time and at the right level of care.” Medicaid costs are determined by utilization and provider rates, and Polis recently signed an executive order to reverse a provider rate increase to address a budget shortfall.

“What we end up doing, for the most part, is not actually attacking utilization, but attacking the rates at which we pay providers,” Brown said.

Polis and Mark Ferrandino, the director of the governor’s Office of State Planning and Budgeting, said an anticipated analysis on Colorado’s Medicaid program from a third-party firm will give insight into how the state compares nationally and what policy changes could be helpful long-term.

The Joint Budget Committee is in charge of writing the state’s annual budget, which is constitutionally required to be balanced. The governor submits an initial proposal in November and another in January. The Legislature typically debates and votes on the budget in March.

The state is also preparing to implement new Medicaid eligibility work requirements by 2027, which Ferrandino said could cost upwards of $5 million.

“That could get us a good start to get it implemented, but we are waiting on (the Centers for Medicare and Medicaid Services) to give us that guidance,” he said. “That could change significantly what the requirements would be.”