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33: The Number Colorado's Medicaid Commission Hasn't Seen

  • Writer: Mark Fukae
    Mark Fukae
  • 1 day ago
  • 2 min read

A revenue neutrality argument - and why 731 petition signers are also the most important survey respondent pool in Colorado caregiver policy right now


By Mark Fukae - Director of Advocacy - Professionals Who Care


A bright teal digital campaign graphic for Professionals Who Care. On the right, a large yellow circular title frame displays dark green text reading: "Care Futures - 33: The Number Colorado's Medicaid Commission Hasn't Seen". In the upper left, a tilted square inset image shows a document on a desk featuring the large handwritten number "33" and the formula "$1,100,000 ÷ $33,614", with a pen resting across it. In the lower left, white text states: "You can't optimize a system you're only measuring in one direction." accompanied by large lime-green closing quotation marks. The round white "Professionals Who Care" logo is anchored in the bottom right corner.
In "Care Futures - 33: The Number Colorado's Medicaid Commission Hasn't Seen," Professionals Who Careexposes the critical flaw in the state's caregiver hour cap modeling. The Department of Health Care Policy & Financing (HCPF) projected $1.1 million in savings by capping family caregiver hours. However, their models only measure expenditure in one direction.

On July 1, 2026, Colorado's Home and Community-Based Services program capped the hours a family member can be paid to provide Medicaid-funded care. The projected savings: $1.1 million annually.


Here is the equation that did not appear in five hours of Commission testimony on July 28:


$1,100,000 ÷ $33,614 = 33


Thirty-three caregiving arrangement failures statewide - out of 910,000 Colorado caregivers — erase the entire projected savings. Not thirty-three thousand. Thirty-three. The moment those arrangements fail and care recipients move into skilled nursing facilities at $93,000 per year, the fiscal math runs in the opposite direction.


This is not a critique of the modelers. The data instrument to measure arrangement fragility doesn't exist. No Colorado survey captures household-level risk of arrangement failure. No actuarial model weights the probability that a given hour reduction triggers a downstream institutional placement.


The Caring Costs Survey - developed through CASI in collaboration with Professionals Who Care - is designed to close that gap. Build begins this weekend. Pilot launches September 11. The Commission's final report is due December 11. The data can be in hand before the October 7 Commission meeting - the last session before the report is written.


For CASI Founder Mark Fukae, the 731 people who signed the Colorado CARE Act petition are not just advocacy supporters. They're pre-qualified respondents - people who already know what caregiver employment discrimination costs, who already identified this fight as worth their name. At a typical 8–15% response rate, that's 58–109 people from that list alone who could be part of the evidence base that reaches the Commission before December 11.


The data this survey generates is designed to inform not just Colorado - but to serve as a model for how states across the U.S. measure the true cost of caregiver policy decisions.


Read and Listen to the full Care Futures piece on The Revenue Neutral Caregiver on Substack. Sign and promote the petition at chng.it/zHbMzKnBwJ. The survey opens September 11.


Professionals Who Care is a national nonprofit supporting working caregivers through advocacy, community, and policy.

 
 
 

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