Colorado’s Medicaid caseload nearly doubled in the past two years after the state expanded coverage, surprising state budget officials and putting more pressure on state coffers.

And in 2017, the federal government will start decreasing the percentage of the expanded population it funds, raising concerns about a budget crunch caused by hospital provider fee income clashing with Taxpayer Bill of Rights limits.

Linda Gorman, who studies health care issues for the Independence Institute, said the Medicaid expansion has been a disaster for the budget and patients.

“It’s a really clunky program and turned into this behemoth,” she said.

But John Bartholomew, chief financial officer of the Colorado Department of Health Care Policy and Financing, said the state would have likely seen a flood of new people qualifying for Medicaid even without the state’s decision to expand.

“We’ve seen numerous other states that didn’t expand affected because of this (Affordable Care Act) mandate,” he said.

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